On the other hand, c-myc and Rb did not appear much affected during the chronic cystitis phase. The expression of p53 protein was higher in SBT than in NSBT, higher in NSBT than in SC/NSC, and higher in SC/NSC

than in CTL. It was highly expressed in high grade SCC in both SBT and NSBT. Therefore, p53 could be exploited as a useful indicator for high grade SCC bladder cancer in general and in SBT in particular. These results are in agreement with other reports which showed that 72% [22] and 73% [23] of the SBT cases Bcl-2 inhibitor expressed immunoreactive p53. In addition, the current study showed that the higher the p53, the higher the grade of tumor. This is in agreement with other reports showing that p53 was detected in 75% of high grade bladder tumor and 25% of low grade tumors [24] and p53 expression is higher in the poorly differentiated SBT tumors [25]. The current study did not show any association of p53 with disease staging MLN0128 and presentation. This indicates that p53 is not a reliable prognostic factor for both SBT and NSBT. This finding was supported by a

study [26] which stated that no evidence has proved the reliability of p53 as prognostic factor in bladder cancer. However, another report stated that p53 is an independent prognostic factor in SCC and TCC bladder cancer [27]. Regarding p16, there was no difference in the expression of p16 between SBT and NSBT but it was remarkably lower in both SBT and NSBT than in SC, NSC, and CTL groups. However, it was stated that p16 genes were altered and deleted in schistosomal bladder cancer [12, 28]. Unlike p53, p16 appeared as a reliable marker for assessing the grade and invasiveness of NSBT rather than SBT. In addition, p16 appeared to serve as a good prognostic factor in both SBT and NSBT. This study revealed clearly the association of p16 with disease staging and Farnesyltransferase presentation which was strongly supported by another report

[29]. This study also showed that p16 is inversely correlated with p53 indicating that the more mutated p53, the more overexpression of dysfunctional p53, the less p16 proteins will be transcribed. Rb expression was severely diminished in NSBT and SBT when compared to SC/NSC and CTL groups and was significantly lower in NSBT than in SBT. In addition, Rb was associated with SCC SBT, invasive NSBT, and late and recurrent SBT and NSBT. Therefore, Rb protein can be used as an efficient prognostic and discriminatory factor for both SBT and NSBT. This might give a clue that schistosomiasis has no particular relationship with Rb gene in bladder cancer. There is a report [30] revealed that infrequent loss of Rb expression was found in invasive lesions associated with schistosomiasis.