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Papers by Dr.Noha Elkady

Research paper thumbnail of Evaluation of the diagnostic utility of NCOA3, Maspin and VHL protein expression in pancreatic ductal adenocarcinoma: An immunohistochemical study

Annals of diagnostic pathology, Jun 1, 2024

Research paper thumbnail of Reappraisal of psoriasis pathogenesis: the role of <scp>TEAD4</scp> expression in keratinocytes

International Journal of Dermatology, Apr 18, 2024

Research paper thumbnail of The Role of P4HB and SOX4 in Prostatic Carcinoma and Their Clinical Significance

Iranian journal of pathology, Feb 15, 2024

Research paper thumbnail of The Role of Galectin3, Tubulinβ, and Maspin in Promoting Tumor Budding in Colorectal Carcinoma and Their Clinical Implication

Research paper thumbnail of Evaluation of ARK5 and SIRT3 expression in renal cell carcinoma and their clinical significance

Diagnostic Pathology, Nov 22, 2023

Background Globally Renal Cell Carcinoma (RCC) represents 3% of malignant tumours in adults and 1... more Background Globally Renal Cell Carcinoma (RCC) represents 3% of malignant tumours in adults and 1.78% in Egypt. AMPK-related protein kinase 5 (ARK5) is mainly associated with a hypoxic microenvironment which is a feature of the major RCC subtypes. Additionally, it displays decreased mitochondrial respiration. SIRT3 is a mitochondrial deacetylase that modifies multiple mitochondrial proteins. Material and methods Fifty eight cases of RCC, and 30 non-neoplastic cases (of End-Stage Kidney Disease (ESKD) were subjected to immunohistochemistry by ARK5 and SIRT3. The results of IHC were correlated together and correlated with the available clinicopathologic and survival data. Results Although no significant difference was detected between RCC and ESKD groups regarding ARK5 expression, there was a significant association with RCC regarding H-score and nucleocytoplasmic expression (both P = 0.001). Also, SIRT3 was highly expressed in RCC in comparison to the ESKD group (H-score: P = 0.001). There were significant associations between nucleocytoplasmic ARK5 expression and higher tumour grade, low apoptotic and high mitotic indices, tumour extent, advanced tumour stage, and impaired response of tumours to chemotherapeutic drugs (P = 0.039, P = 0.001, P = 0.027, P = 0.011, P = 0.009, and P = 0.014 respectively). Moreover, the H score of ARK5 expression showed significant associations with tumour grade, apoptotic and mitotic indices, tumour extension, tumour stage, and response to therapy (P = 0.01, 0.035, 0.001, 0.004. 0.003 and 0.013). Regarding SIRT3 expression, it showed significant associations with apoptotic and mitotic indices, tumour extent, tumour stage and response to therapy (P = 0.022, 0.02, 0.042, 0.039 and 0.027). Interestingly, there was a highly significant correlation between the expression of ARK5 and SIRT3 (P = 0.009). Univariate survival analysis revealed a significant association between short survival duration and both nucleocytoplasmic expression of ARK5 and positive SIRT3 expression (P = 0.014 and 0.035). Conclusion ARK5 and SIRT3 are overexpressed in RCC and associated with parameters of poor prognosis as well as short survival. Both seem to influence response to therapy in RCC. So, they could be new targets for therapy that may improve tumour response and patients' survival. There is a postulated relationship that needs more extensive investigation.

Research paper thumbnail of Comparison between endobronchial forceps-biopsy and cryo-biopsy by flexible bronchoscopy

Egyptian Journal of Chest Diseases and Tuberculosis, 2016

Background: Invasive procedures such as bronchoscopic biopsy, bronchial washing, and bronchial br... more Background: Invasive procedures such as bronchoscopic biopsy, bronchial washing, and bronchial brushing are widely used in the diagnosis of lung cancers. The mean diagnostic rate with bronchoscopic forceps biopsy is 74% in central tumors; the new biopsy technique of cryobiopsy appears to provide better diagnostic samples. Aim of the work: To compare the efficacy and diagnostic yield of endobronchial cryobiopsy with forceps biopsy in the diagnosis of lung cancer. Methods: Twenty-five patients who underwent bronchoscopy were included in this study. Three forceps biopsies and one cryobiopsy with ERBE cryo probe were obtained from each subject. Biopsies interpretations were done by one expert pathologist. Results: Hemorrhage was the only complication in both procedures, there was no significant difference between these two procedures in the incidence of hemorrhage (P > 0.05). There is significant difference as regarding crushing and loss of architecture under microscopy (P < 0.001), forceps biopsies shows crushing and loss of architecture more than cryo. Mean diameters of samples taken with forceps biopsy and cryoprobe biopsy were 0.5 and 1.4 cm, respectively (P < 0.001), 20 patients (80%) were diagnosed with forceps biopsies, and 25 patients (100%) were diagnosed with cryoprobe biopsies. Conclusions: We concluded that cryoprobe biopsies were more successful than forceps biopsies in the diagnosis of lung cancer. Nevertheless, further investigations are warranted to determine an efficacy of cryoprobe biopsy procedures and a rationale to use as a part of routine flexible bronchoscopy.

Research paper thumbnail of The diagnostic role of vimentin in differentiation between muscularis propria and muscularis mucosa in urinary bladder carcinoma

Menoufia Medical Journal, 2017

Objective The aim of this study was to evaluate the diagnostic value of vimentin expression for d... more Objective The aim of this study was to evaluate the diagnostic value of vimentin expression for differentiation between muscularis mucosa (MM) and muscularis propria (MP) in urinary bladder carcinoma cases. Background The single most important prognostic factor in urothelial carcinoma is the pathological stage, which includes the anatomic depth of invasion on which major therapeutic decisions are made. Correct assessment of invasion necessitates discrimination between MM and MP. Vimentin is the most widely distributed intermediate filament and is expressed in virtually all mesenchymal tissues. Materials and methods This study was carried out on 70 urinary bladder specimens, including 59 cases of primary urinary bladder carcinoma and 11 cystitis specimens. The specimens were submitted to vimentin immunostaining under the streptavidin–biotin amplified system. Results MM was identified histologically in 40 cases, whereas MP was morphologically designated in all cases (70 cases). Vimentin was negative in MP and showed positive expression in 32/40 (80%) cases of MM with a statistically significant difference (P = 0.000), 80% of sensitivity, and 100% of specificity. Conclusion Negative vimentin expression in MP could be a useful tool for identification of MP with 80% of sensitivity and 100% of specificity in urinary bladder carcinoma cases.

Research paper thumbnail of Effect of atorvastatin and erythropoietin on renal fibrosis induced by partial unilateral ureteral obstruction in rats

Menoufia Medical Journal, 2014

Objective This work aims at investigating the effects of atorvastatin and erythropoietin (EPO) on... more Objective This work aims at investigating the effects of atorvastatin and erythropoietin (EPO) on tubulointerstitial fibrosis induced by partial unilateral ureteral obstruction (PUUO) in rats. Background Renal fibrosis is the final manifestation of chronic kidney disease. It is one of the biggest problems in nephrology, indicating that patients inevitably reach end-stage renal disease. Atorvastatin has anti-inflammatory, antiproliferative, and immunomodulatory potential. EPO has been demonstrated to play an important cytoprotective role. Methods Fifty adult albino rats were divided into five equal groups: group 1 received saline intraperitoneally and methylcellulose orally for 14 days and served as the negative control; group 2 (sham-operated group) rats underwent the same surgical procedures as group 3 without ureteral obstruction; group 3 rats underwent PUUO without any medication; group 4 rats underwent PUUO and received atorvastatin at a dose of 50 mg/kg orally; group 5 rats underwent PUUO and received EPO at a dose of 3.000 IU/kg daily intraperitoneally. After 14 days, systolic blood pressure was measured. Blood and urine samples were also collected for measurement of serum transforming growth factor-β1, tumor necrosis factor-, urea and creatinine, and urinary protein and albumin levels. Renal tissue samples were collected for determination of malondialdehyde and -smooth muscle actin levels, as well as for histopathological and immuonohistochemical examination. Results Our results showed that systolic blood pressure; serum levels of transforming growth factor-β1, tumor necrosis factor-α, and malondialdehyde; and biochemical parameters were significantly elevated. Histopathological examination of kidney tissue revealed marked degenerative changes and increased expression of α-smooth muscle actin in group 3 compared with groups 1 and 2. In contrast, biochemical, histological, and immuonohistochemical features in groups 4 and 5 showed significant improvement compared with group 3. Conclusion It is concluded that both atorvastatin and EPO have renoprotective effects against renal fibrosis, shown by improvement in kidney functions and using fibrosis markers.

Research paper thumbnail of Diagnostic Value of Smoothelin and Vimentin in Differentiating Muscularis Propria from Muscularis Mucosa of Bladder Carcinoma

International Journal of Biological Markers, Jul 1, 2017

The carcinoma may be limited to the epithelium (noninvasive papillary carcinoma [pTa] or carcinom... more The carcinoma may be limited to the epithelium (noninvasive papillary carcinoma [pTa] or carcinoma in situ [pTis]), extend into the subepithelial connective tissue or lamina propria (pT1), have invaded the detrusor muscle or muscularis propria (pT2), or extend into the perivesical soft tissues (pT3) (4). Although this might appear relatively straightforward, there are several well-known pitfalls in the pathological staging of bladder carcinoma (3, 5) which one should be aware of to avoid both understaging and overstaging of bladder carcinoma. Overstaging caused by misdiagnosis of muscularis mucosa as muscularis propria will lead to radical surgical management (cystectomy) for a tumor that would otherwise be treated conservatively (intravesical bacille Calmette-Guérin [BCG] therapy). Understaging will lead to improper treatment, with an increased mortality rate (5, 6). Differentiation between invasion of muscularis mucosa (MM) and of muscularis propria (MP) can be made based on histological form, histological relations or antigenic properties. MM is usually dispersed, has an interrupted layer and is usually associated with vascular plexus (7), whereas MP forms regular bundles (8); however, hyperplastic MM could

Research paper thumbnail of Can β-catenin, Tenascin and Fascin be potential biomarkers for personalized therapy in Gastric carcinoma?

Journal of Immunoassay and Immunochemistry

Research paper thumbnail of Comparison between endobronchial forceps-biopsy and cryo-biopsy by flexible bronchoscopy

Egyptian Journal of Chest Diseases and Tuberculosis, 2016

Background: Invasive procedures such as bronchoscopic biopsy, bronchial washing, and bronchial br... more Background: Invasive procedures such as bronchoscopic biopsy, bronchial washing, and bronchial brushing are widely used in the diagnosis of lung cancers. The mean diagnostic rate with bronchoscopic forceps biopsy is 74% in central tumors; the new biopsy technique of cryobiopsy appears to provide better diagnostic samples. Aim of the work: To compare the efficacy and diagnostic yield of endobronchial cryobiopsy with forceps biopsy in the diagnosis of lung cancer. Methods: Twenty-five patients who underwent bronchoscopy were included in this study. Three forceps biopsies and one cryobiopsy with ERBE cryo probe were obtained from each subject. Biopsies interpretations were done by one expert pathologist. Results: Hemorrhage was the only complication in both procedures, there was no significant difference between these two procedures in the incidence of hemorrhage (P > 0.05). There is significant difference as regarding crushing and loss of architecture under microscopy (P < 0.001), forceps biopsies shows crushing and loss of architecture more than cryo. Mean diameters of samples taken with forceps biopsy and cryoprobe biopsy were 0.5 and 1.4 cm, respectively (P < 0.001), 20 patients (80%) were diagnosed with forceps biopsies, and 25 patients (100%) were diagnosed with cryoprobe biopsies. Conclusions: We concluded that cryoprobe biopsies were more successful than forceps biopsies in the diagnosis of lung cancer. Nevertheless, further investigations are warranted to determine an efficacy of cryoprobe biopsy procedures and a rationale to use as a part of routine flexible bronchoscopy.

Research paper thumbnail of Androgen receptor expression in estrogen receptor-negative breast cancer

Menoufia Medical Journal, 2018

Objective The aim of this study was to estimate the expression of androgen receptors (ARs) in pat... more Objective The aim of this study was to estimate the expression of androgen receptors (ARs) in patients with estrogen receptor (ER)-negative breast cancer. Background Growth of breast cancer is hormone dependent. Estrogen and progesterone play a fundamental role in the pathogenesis and treatment of patients with ER-positive breast cancer and those with progesterone receptor-positive breast cancer. Patients who lack the expression of these receptors receive no benefit from hormonal treatment and are considered to have a poor prognosis. AR is a member of nuclear steroid receptors with ambiguous role in patients with breast cancer. There is growing evidence about its prognostic and predictive value in patients with breast cancer. Patient and methods This study included 56 patients who presented to Department of Clinical Oncology, Menoufia University, between January 2012 and December 2014. We included patients with pathologically proven invasive breast cancer and negatively expressing E...

Research paper thumbnail of Predictive Factors of Positive Circumferential and Longitudinal Margins in Early T3 Colorectal Cancer Resection

International Journal of Surgical Oncology, 2020

Background. Malignant involvement of circumferential resection margin (CRM) and longitudinal rese... more Background. Malignant involvement of circumferential resection margin (CRM) and longitudinal resection margin (LRM) after surgical resection of colorectal cancer (CRC) are associated with higher rates of recurrence and development of distant metastasis. This can influence the overall patient’s prognosis. The aim of the current study was to identify pathological factors as predictors for the involvement of resection margins in early T3 CRC.Patients and Methods.Fifty patients radiologically diagnosed to have cT3a/b (CRC) were included in the study. After resection, the pathological examination was performed to identify patients with positive CRM and/or LRM. Relations between the different pathological parameters and the CMR and LRM involvements were assessed.Results. Positive CRM was present in 17 cases (34%), while positive LRM was found in 6 cases (12%). The involvement of both margins was significantly associated with rectal tumors and tumors with infiltrative gross appearance, gra...

Research paper thumbnail of Evaluation of the role of HIF-1α and GLUT-1 in the pathogenesis of ovarian surface epithelial tumors and their prognostic impact

Egyptian Journal of Pathology, 2018

Objective The study aims to evaluate the role of HIF-1&agr; and GLUT-1 expressions in the pat... more Objective The study aims to evaluate the role of HIF-1&agr; and GLUT-1 expressions in the pathogenesis of ovarian surface epithelial tumors and their prognostic impact. Background Ovarian carcinoma is the most lethal gynecological malignancy. Although many surgical techniques and chemotherapies have been developed, the prognosis remains poor, with a 5-year survival rate of 45%. Patients and methods This retrospective study included 89 surface epithelial ovarian tumors from Egyptian patients, including 16 cases of benign tumors (cystadenoma), 19 cases of borderline tumors, and 54 cases of malignant tumors. The malignant group was divided into types I and II for comparison. Immunohistochemical staining for HIF-1&agr; and GLUT-1 was performed and their expression was correlated with the clinicopathological features of prognostic importance. Results HIF-1&agr; was significantly expressed in borderline and malignant groups as compared with benign groups (P<0.001). The H-score of GLUT-1 immunostaining showed a gradual increase from benign to borderline to malignant groups (P=0.000). A significant association was found between GLUT-1 expression and tumor bilaterality (P=0.004), solid or mixed cut section (P=0.03), presence of vascular invasion (P=0.05), presence of gross and microscopic omental nodules (P=0.003 and 0.001), T3 stage (P=0.01), and FIGO stage III (P=0.01) which indicate poor prognosis. Conclusion HIF-1&agr; and GLUT-1 may play a significant role in the carcinogenesis and progression of ovarian carcinomas.

Research paper thumbnail of Expression of HER2-neu, SKP2, and hypoxia-inducible factor-1 and their role in predicting the response of muscle-invasive urothelial carcinoma to bladder preservation chemotherapy

Egyptian Journal of Pathology, 2018

Background Cystectomy is the primary treatment of muscle-invasive urothelial carcinoma, but it is... more Background Cystectomy is the primary treatment of muscle-invasive urothelial carcinoma, but it is associated with many complications and affects patients' quality of life. Chemotherapy is an alternative modality, but it may not give the expected response. This arouses the need for markers that help to predict the response to chemotherapy. Human epidermal growth factor receptor 2 (HER2-neu), S-phase kinase associated protein 2 (SKP2), and hypoxia-inducible factor-1 (HIF-1) regulate cell cycle progression, tumor adaptation to hypoxic environment, and response to chemotherapy. Aim This study aimed at evaluation of HER2-neu, SKP2, and HIF-1 expressions in muscle-invasive urothelial carcinoma and investigated the association between their expressions and tumor response to chemotherapy. Materials and methods A total of 100 specimens from patients with nonmetastatic muscle-invasive urothelial carcinoma were collected at the pathology Department, and the selected patients received the treatment and follow-up at Clinical Oncology and Urology departments, Menoufia University. HER2-neu, SKP2, and HIF-1 expressions were evaluated using immunohistochemical techniques. The patients received chemotherapy followed by cystoscopic examination. Bladder biopsy was examined to determine tumor response. Results A significant association was found between partial tumor response to chemotherapy and HER2-neu, SKP2, and HIF-1 positive expression (P=0.004, 0.029, and 0.004). SKP2 expression was significantly associated with low apoptotic count and high mitotic one (P=0.008 and 0.01), whereas HIF-1 expression was significantly associated with necrosis (P=0.008). A statistically significant association was found between SKP2 and HR2-neu expression (P=0.018) and between SKP2 and HIF-1 expression as well (P=0.013). Conclusion This study showed that evaluation of HER2-neu, SKP2, and HIF-1 expression can predict poor response to chemotherapy in muscle-invasive urothelial carcinoma and help in selecting patients who will benefit from chemotherapy. In addition, target therapy against these markers can be effective in treatment.

Research paper thumbnail of The diagnostic role of vimentin in differentiation between muscularis propria and muscularis mucosa in urinary bladder carcinoma

Menoufia Medical Journal, 2017

Objective The aim of this study was to evaluate the diagnostic value of vimentin expression for d... more Objective The aim of this study was to evaluate the diagnostic value of vimentin expression for differentiation between muscularis mucosa (MM) and muscularis propria (MP) in urinary bladder carcinoma cases. Background The single most important prognostic factor in urothelial carcinoma is the pathological stage, which includes the anatomic depth of invasion on which major therapeutic decisions are made. Correct assessment of invasion necessitates discrimination between MM and MP. Vimentin is the most widely distributed intermediate filament and is expressed in virtually all mesenchymal tissues. Materials and methods This study was carried out on 70 urinary bladder specimens, including 59 cases of primary urinary bladder carcinoma and 11 cystitis specimens. The specimens were submitted to vimentin immunostaining under the streptavidin–biotin amplified system. Results MM was identified histologically in 40 cases, whereas MP was morphologically designated in all cases (70 cases). Vimentin was negative in MP and showed positive expression in 32/40 (80%) cases of MM with a statistically significant difference (P = 0.000), 80% of sensitivity, and 100% of specificity. Conclusion Negative vimentin expression in MP could be a useful tool for identification of MP with 80% of sensitivity and 100% of specificity in urinary bladder carcinoma cases.

Research paper thumbnail of Evaluation of topoisomerase II, ki-67, and P53 expression in non-muscle-invasive urothelial carcinoma and their clinical significance

Indian Journal of Pathology and Microbiology, 2018

Background: Transurethral resection of tumor is the main treatment of non-muscle-invasive urothel... more Background: Transurethral resection of tumor is the main treatment of non-muscle-invasive urothelial carcinoma, but it is associated with high rate of recurrence and/or progression and this arouses the need for adjuvant therapy. Topoisomerase II (Top II), KI-67, and P53 are proliferation and cell cycle regulation markers that may predict tumor response to therapy. Aim: This study aimed to assess Top II, KI-67, and P53 expression and their effect on clinical outcome and response to therapy of non-muscle-invasive urothelial carcinoma. Materials and Methods: Fifty cases of non-muscle invasive urothelial carcinoma were collected; Top II, KI-67, and P53 expression was evaluated. Patients received treatment then tumor recurrence was correlated with the expression of previous markers. Results: There was a significant association between high Top II score, P53, and KI-67 and high tumor grade (P = 0.0001, 0.001, and 0.0001), submucosal infiltration (P = 0.0001 and 0.01), and recurrence (P = 0.01, 0.001, and 0.001). Conclusion: Top II, P53, and KI-67 may predict tumor response to therapy and the clinical outcome in non-muscle-invasive urothelial carcinoma.

Research paper thumbnail of Cyclooxygenase-2 expression in chronic gastritis and gastric carcinoma, correlation with prognostic parameters

Journal of the Egyptian National Cancer Institute, 2006

Cyclooxygenase-2 (Cox-2) is the inducible form of cyclooxygenase enzyme. Cox-2 is induced in nume... more Cyclooxygenase-2 (Cox-2) is the inducible form of cyclooxygenase enzyme. Cox-2 is induced in numerous processes such as cellular growth, differentiation, inflammation and tumorogenesis. Assessment of Cox-2 expression in chronic gastritis and gastric carcinoma. Sixteen chronic gastritis (CG) and 43 gastric carcinoma cases were subjected to an immunohistochemical approach using anti Cox-2 antibody. All CG cases displayed positive epithelial Cox-2 expression with only 25% positivity for stromal expression. Eighty six percent of gastric carcinoma showed epithelial Cox-2 expression that was significantly correlated with lymph node involvement (p<0.01), advanced stage (p=0.01), high microvessel density (MVD) (p=0.0001), vascular invasion (p=0.002), perineural invasion (p=0.01) and low apoptotic count (p<0.0001). Stromal Cox-2 expression was seen in 79% of gastric carcinoma cases and was significantly associated with low apoptotic count (p=0.0007), vascular invasion (p=0.001) and hig...

Research paper thumbnail of Evaluation of β-catenin expression in muscle-invasive urothelial bladder carcinoma

Menoufia Medical Journal, 2014

Objectives This study aimed at evaluation of the expression of β-catenin in muscle-invasive uroth... more Objectives This study aimed at evaluation of the expression of β-catenin in muscle-invasive urothelial bladder carcinoma and its correlation with other clinicopathological parameters of prognostic importance. Background β-Catenin is a protein that is encoded by the CTNNB1 gene that can function as an oncogene. Activation of the Wnt/β-catenin signaling pathway by aberrant accumulation of stabilized β-catenin contributes to the progression of several human cancers. Therefore, inhibition of the Wnt pathway may have a major therapeutic potential. Patients and methods This study was conducted as a retrospective study at Urology and Pathology Departments, Faculty of Medicine, Menoufia University, during the period between May 2011 and May 2013. A total of 40 patients were included and divided into two groups. The first one included 10 patients with chronic nonspecific cystitis as a control group and the second one included 30 patients with muscle-invasive urothelial bladder carcinoma who underwent radical cystectomy. The pathological blocks of both groups were investigated for the expression of β-catenin using immunohistochemical staining. Results β-Catenin expression was noticed in 100% (30 cases) of muscle-invasive bladder carcinoma and in 70% (seven cases) of nonmalignant cases. In the malignant group, 26 (87%) cases showed nucleocytoplasmic expression and four (13%) cases showed membranous expression only. There was a significant correlation between nucleocytoplasmic localization of β-catenin and some pathological parameters such as tumor grade, stage, and mitosis. Furthermore, the study showed statistically significant correlation between intensity of β-catenin expression and tumor grade, stage, lymph node metastasis, vascular and perineural invasion, mitosis, and microvessel density. Conclusion Nucleocytoplasmic expression of β-catenin and high intensity of its expression was associated with poor prognostic parameters.

Research paper thumbnail of Effect of atorvastatin and erythropoietin on renal fibrosis induced by partial unilateral ureteral obstruction in rats

Menoufia Medical Journal, 2014

Objective This work aims at investigating the effects of atorvastatin and erythropoietin (EPO) on... more Objective This work aims at investigating the effects of atorvastatin and erythropoietin (EPO) on tubulointerstitial fibrosis induced by partial unilateral ureteral obstruction (PUUO) in rats. Background Renal fibrosis is the final manifestation of chronic kidney disease. It is one of the biggest problems in nephrology, indicating that patients inevitably reach end-stage renal disease. Atorvastatin has anti-inflammatory, antiproliferative, and immunomodulatory potential. EPO has been demonstrated to play an important cytoprotective role. Methods Fifty adult albino rats were divided into five equal groups: group 1 received saline intraperitoneally and methylcellulose orally for 14 days and served as the negative control; group 2 (sham-operated group) rats underwent the same surgical procedures as group 3 without ureteral obstruction; group 3 rats underwent PUUO without any medication; group 4 rats underwent PUUO and received atorvastatin at a dose of 50 mg/kg orally; group 5 rats underwent PUUO and received EPO at a dose of 3.000 IU/kg daily intraperitoneally. After 14 days, systolic blood pressure was measured. Blood and urine samples were also collected for measurement of serum transforming growth factor-β1, tumor necrosis factor-, urea and creatinine, and urinary protein and albumin levels. Renal tissue samples were collected for determination of malondialdehyde and -smooth muscle actin levels, as well as for histopathological and immuonohistochemical examination. Results Our results showed that systolic blood pressure; serum levels of transforming growth factor-β1, tumor necrosis factor-α, and malondialdehyde; and biochemical parameters were significantly elevated. Histopathological examination of kidney tissue revealed marked degenerative changes and increased expression of α-smooth muscle actin in group 3 compared with groups 1 and 2. In contrast, biochemical, histological, and immuonohistochemical features in groups 4 and 5 showed significant improvement compared with group 3. Conclusion It is concluded that both atorvastatin and EPO have renoprotective effects against renal fibrosis, shown by improvement in kidney functions and using fibrosis markers.

Research paper thumbnail of Evaluation of the diagnostic utility of NCOA3, Maspin and VHL protein expression in pancreatic ductal adenocarcinoma: An immunohistochemical study

Annals of diagnostic pathology, Jun 1, 2024

Research paper thumbnail of Reappraisal of psoriasis pathogenesis: the role of <scp>TEAD4</scp> expression in keratinocytes

International Journal of Dermatology, Apr 18, 2024

Research paper thumbnail of The Role of P4HB and SOX4 in Prostatic Carcinoma and Their Clinical Significance

Iranian journal of pathology, Feb 15, 2024

Research paper thumbnail of The Role of Galectin3, Tubulinβ, and Maspin in Promoting Tumor Budding in Colorectal Carcinoma and Their Clinical Implication

Research paper thumbnail of Evaluation of ARK5 and SIRT3 expression in renal cell carcinoma and their clinical significance

Diagnostic Pathology, Nov 22, 2023

Background Globally Renal Cell Carcinoma (RCC) represents 3% of malignant tumours in adults and 1... more Background Globally Renal Cell Carcinoma (RCC) represents 3% of malignant tumours in adults and 1.78% in Egypt. AMPK-related protein kinase 5 (ARK5) is mainly associated with a hypoxic microenvironment which is a feature of the major RCC subtypes. Additionally, it displays decreased mitochondrial respiration. SIRT3 is a mitochondrial deacetylase that modifies multiple mitochondrial proteins. Material and methods Fifty eight cases of RCC, and 30 non-neoplastic cases (of End-Stage Kidney Disease (ESKD) were subjected to immunohistochemistry by ARK5 and SIRT3. The results of IHC were correlated together and correlated with the available clinicopathologic and survival data. Results Although no significant difference was detected between RCC and ESKD groups regarding ARK5 expression, there was a significant association with RCC regarding H-score and nucleocytoplasmic expression (both P = 0.001). Also, SIRT3 was highly expressed in RCC in comparison to the ESKD group (H-score: P = 0.001). There were significant associations between nucleocytoplasmic ARK5 expression and higher tumour grade, low apoptotic and high mitotic indices, tumour extent, advanced tumour stage, and impaired response of tumours to chemotherapeutic drugs (P = 0.039, P = 0.001, P = 0.027, P = 0.011, P = 0.009, and P = 0.014 respectively). Moreover, the H score of ARK5 expression showed significant associations with tumour grade, apoptotic and mitotic indices, tumour extension, tumour stage, and response to therapy (P = 0.01, 0.035, 0.001, 0.004. 0.003 and 0.013). Regarding SIRT3 expression, it showed significant associations with apoptotic and mitotic indices, tumour extent, tumour stage and response to therapy (P = 0.022, 0.02, 0.042, 0.039 and 0.027). Interestingly, there was a highly significant correlation between the expression of ARK5 and SIRT3 (P = 0.009). Univariate survival analysis revealed a significant association between short survival duration and both nucleocytoplasmic expression of ARK5 and positive SIRT3 expression (P = 0.014 and 0.035). Conclusion ARK5 and SIRT3 are overexpressed in RCC and associated with parameters of poor prognosis as well as short survival. Both seem to influence response to therapy in RCC. So, they could be new targets for therapy that may improve tumour response and patients' survival. There is a postulated relationship that needs more extensive investigation.

Research paper thumbnail of Comparison between endobronchial forceps-biopsy and cryo-biopsy by flexible bronchoscopy

Egyptian Journal of Chest Diseases and Tuberculosis, 2016

Background: Invasive procedures such as bronchoscopic biopsy, bronchial washing, and bronchial br... more Background: Invasive procedures such as bronchoscopic biopsy, bronchial washing, and bronchial brushing are widely used in the diagnosis of lung cancers. The mean diagnostic rate with bronchoscopic forceps biopsy is 74% in central tumors; the new biopsy technique of cryobiopsy appears to provide better diagnostic samples. Aim of the work: To compare the efficacy and diagnostic yield of endobronchial cryobiopsy with forceps biopsy in the diagnosis of lung cancer. Methods: Twenty-five patients who underwent bronchoscopy were included in this study. Three forceps biopsies and one cryobiopsy with ERBE cryo probe were obtained from each subject. Biopsies interpretations were done by one expert pathologist. Results: Hemorrhage was the only complication in both procedures, there was no significant difference between these two procedures in the incidence of hemorrhage (P > 0.05). There is significant difference as regarding crushing and loss of architecture under microscopy (P < 0.001), forceps biopsies shows crushing and loss of architecture more than cryo. Mean diameters of samples taken with forceps biopsy and cryoprobe biopsy were 0.5 and 1.4 cm, respectively (P < 0.001), 20 patients (80%) were diagnosed with forceps biopsies, and 25 patients (100%) were diagnosed with cryoprobe biopsies. Conclusions: We concluded that cryoprobe biopsies were more successful than forceps biopsies in the diagnosis of lung cancer. Nevertheless, further investigations are warranted to determine an efficacy of cryoprobe biopsy procedures and a rationale to use as a part of routine flexible bronchoscopy.

Research paper thumbnail of The diagnostic role of vimentin in differentiation between muscularis propria and muscularis mucosa in urinary bladder carcinoma

Menoufia Medical Journal, 2017

Objective The aim of this study was to evaluate the diagnostic value of vimentin expression for d... more Objective The aim of this study was to evaluate the diagnostic value of vimentin expression for differentiation between muscularis mucosa (MM) and muscularis propria (MP) in urinary bladder carcinoma cases. Background The single most important prognostic factor in urothelial carcinoma is the pathological stage, which includes the anatomic depth of invasion on which major therapeutic decisions are made. Correct assessment of invasion necessitates discrimination between MM and MP. Vimentin is the most widely distributed intermediate filament and is expressed in virtually all mesenchymal tissues. Materials and methods This study was carried out on 70 urinary bladder specimens, including 59 cases of primary urinary bladder carcinoma and 11 cystitis specimens. The specimens were submitted to vimentin immunostaining under the streptavidin–biotin amplified system. Results MM was identified histologically in 40 cases, whereas MP was morphologically designated in all cases (70 cases). Vimentin was negative in MP and showed positive expression in 32/40 (80%) cases of MM with a statistically significant difference (P = 0.000), 80% of sensitivity, and 100% of specificity. Conclusion Negative vimentin expression in MP could be a useful tool for identification of MP with 80% of sensitivity and 100% of specificity in urinary bladder carcinoma cases.

Research paper thumbnail of Effect of atorvastatin and erythropoietin on renal fibrosis induced by partial unilateral ureteral obstruction in rats

Menoufia Medical Journal, 2014

Objective This work aims at investigating the effects of atorvastatin and erythropoietin (EPO) on... more Objective This work aims at investigating the effects of atorvastatin and erythropoietin (EPO) on tubulointerstitial fibrosis induced by partial unilateral ureteral obstruction (PUUO) in rats. Background Renal fibrosis is the final manifestation of chronic kidney disease. It is one of the biggest problems in nephrology, indicating that patients inevitably reach end-stage renal disease. Atorvastatin has anti-inflammatory, antiproliferative, and immunomodulatory potential. EPO has been demonstrated to play an important cytoprotective role. Methods Fifty adult albino rats were divided into five equal groups: group 1 received saline intraperitoneally and methylcellulose orally for 14 days and served as the negative control; group 2 (sham-operated group) rats underwent the same surgical procedures as group 3 without ureteral obstruction; group 3 rats underwent PUUO without any medication; group 4 rats underwent PUUO and received atorvastatin at a dose of 50 mg/kg orally; group 5 rats underwent PUUO and received EPO at a dose of 3.000 IU/kg daily intraperitoneally. After 14 days, systolic blood pressure was measured. Blood and urine samples were also collected for measurement of serum transforming growth factor-β1, tumor necrosis factor-, urea and creatinine, and urinary protein and albumin levels. Renal tissue samples were collected for determination of malondialdehyde and -smooth muscle actin levels, as well as for histopathological and immuonohistochemical examination. Results Our results showed that systolic blood pressure; serum levels of transforming growth factor-β1, tumor necrosis factor-α, and malondialdehyde; and biochemical parameters were significantly elevated. Histopathological examination of kidney tissue revealed marked degenerative changes and increased expression of α-smooth muscle actin in group 3 compared with groups 1 and 2. In contrast, biochemical, histological, and immuonohistochemical features in groups 4 and 5 showed significant improvement compared with group 3. Conclusion It is concluded that both atorvastatin and EPO have renoprotective effects against renal fibrosis, shown by improvement in kidney functions and using fibrosis markers.

Research paper thumbnail of Diagnostic Value of Smoothelin and Vimentin in Differentiating Muscularis Propria from Muscularis Mucosa of Bladder Carcinoma

International Journal of Biological Markers, Jul 1, 2017

The carcinoma may be limited to the epithelium (noninvasive papillary carcinoma [pTa] or carcinom... more The carcinoma may be limited to the epithelium (noninvasive papillary carcinoma [pTa] or carcinoma in situ [pTis]), extend into the subepithelial connective tissue or lamina propria (pT1), have invaded the detrusor muscle or muscularis propria (pT2), or extend into the perivesical soft tissues (pT3) (4). Although this might appear relatively straightforward, there are several well-known pitfalls in the pathological staging of bladder carcinoma (3, 5) which one should be aware of to avoid both understaging and overstaging of bladder carcinoma. Overstaging caused by misdiagnosis of muscularis mucosa as muscularis propria will lead to radical surgical management (cystectomy) for a tumor that would otherwise be treated conservatively (intravesical bacille Calmette-Guérin [BCG] therapy). Understaging will lead to improper treatment, with an increased mortality rate (5, 6). Differentiation between invasion of muscularis mucosa (MM) and of muscularis propria (MP) can be made based on histological form, histological relations or antigenic properties. MM is usually dispersed, has an interrupted layer and is usually associated with vascular plexus (7), whereas MP forms regular bundles (8); however, hyperplastic MM could

Research paper thumbnail of Can β-catenin, Tenascin and Fascin be potential biomarkers for personalized therapy in Gastric carcinoma?

Journal of Immunoassay and Immunochemistry

Research paper thumbnail of Comparison between endobronchial forceps-biopsy and cryo-biopsy by flexible bronchoscopy

Egyptian Journal of Chest Diseases and Tuberculosis, 2016

Background: Invasive procedures such as bronchoscopic biopsy, bronchial washing, and bronchial br... more Background: Invasive procedures such as bronchoscopic biopsy, bronchial washing, and bronchial brushing are widely used in the diagnosis of lung cancers. The mean diagnostic rate with bronchoscopic forceps biopsy is 74% in central tumors; the new biopsy technique of cryobiopsy appears to provide better diagnostic samples. Aim of the work: To compare the efficacy and diagnostic yield of endobronchial cryobiopsy with forceps biopsy in the diagnosis of lung cancer. Methods: Twenty-five patients who underwent bronchoscopy were included in this study. Three forceps biopsies and one cryobiopsy with ERBE cryo probe were obtained from each subject. Biopsies interpretations were done by one expert pathologist. Results: Hemorrhage was the only complication in both procedures, there was no significant difference between these two procedures in the incidence of hemorrhage (P > 0.05). There is significant difference as regarding crushing and loss of architecture under microscopy (P < 0.001), forceps biopsies shows crushing and loss of architecture more than cryo. Mean diameters of samples taken with forceps biopsy and cryoprobe biopsy were 0.5 and 1.4 cm, respectively (P < 0.001), 20 patients (80%) were diagnosed with forceps biopsies, and 25 patients (100%) were diagnosed with cryoprobe biopsies. Conclusions: We concluded that cryoprobe biopsies were more successful than forceps biopsies in the diagnosis of lung cancer. Nevertheless, further investigations are warranted to determine an efficacy of cryoprobe biopsy procedures and a rationale to use as a part of routine flexible bronchoscopy.

Research paper thumbnail of Androgen receptor expression in estrogen receptor-negative breast cancer

Menoufia Medical Journal, 2018

Objective The aim of this study was to estimate the expression of androgen receptors (ARs) in pat... more Objective The aim of this study was to estimate the expression of androgen receptors (ARs) in patients with estrogen receptor (ER)-negative breast cancer. Background Growth of breast cancer is hormone dependent. Estrogen and progesterone play a fundamental role in the pathogenesis and treatment of patients with ER-positive breast cancer and those with progesterone receptor-positive breast cancer. Patients who lack the expression of these receptors receive no benefit from hormonal treatment and are considered to have a poor prognosis. AR is a member of nuclear steroid receptors with ambiguous role in patients with breast cancer. There is growing evidence about its prognostic and predictive value in patients with breast cancer. Patient and methods This study included 56 patients who presented to Department of Clinical Oncology, Menoufia University, between January 2012 and December 2014. We included patients with pathologically proven invasive breast cancer and negatively expressing E...

Research paper thumbnail of Predictive Factors of Positive Circumferential and Longitudinal Margins in Early T3 Colorectal Cancer Resection

International Journal of Surgical Oncology, 2020

Background. Malignant involvement of circumferential resection margin (CRM) and longitudinal rese... more Background. Malignant involvement of circumferential resection margin (CRM) and longitudinal resection margin (LRM) after surgical resection of colorectal cancer (CRC) are associated with higher rates of recurrence and development of distant metastasis. This can influence the overall patient’s prognosis. The aim of the current study was to identify pathological factors as predictors for the involvement of resection margins in early T3 CRC.Patients and Methods.Fifty patients radiologically diagnosed to have cT3a/b (CRC) were included in the study. After resection, the pathological examination was performed to identify patients with positive CRM and/or LRM. Relations between the different pathological parameters and the CMR and LRM involvements were assessed.Results. Positive CRM was present in 17 cases (34%), while positive LRM was found in 6 cases (12%). The involvement of both margins was significantly associated with rectal tumors and tumors with infiltrative gross appearance, gra...

Research paper thumbnail of Evaluation of the role of HIF-1α and GLUT-1 in the pathogenesis of ovarian surface epithelial tumors and their prognostic impact

Egyptian Journal of Pathology, 2018

Objective The study aims to evaluate the role of HIF-1&agr; and GLUT-1 expressions in the pat... more Objective The study aims to evaluate the role of HIF-1&agr; and GLUT-1 expressions in the pathogenesis of ovarian surface epithelial tumors and their prognostic impact. Background Ovarian carcinoma is the most lethal gynecological malignancy. Although many surgical techniques and chemotherapies have been developed, the prognosis remains poor, with a 5-year survival rate of 45%. Patients and methods This retrospective study included 89 surface epithelial ovarian tumors from Egyptian patients, including 16 cases of benign tumors (cystadenoma), 19 cases of borderline tumors, and 54 cases of malignant tumors. The malignant group was divided into types I and II for comparison. Immunohistochemical staining for HIF-1&agr; and GLUT-1 was performed and their expression was correlated with the clinicopathological features of prognostic importance. Results HIF-1&agr; was significantly expressed in borderline and malignant groups as compared with benign groups (P<0.001). The H-score of GLUT-1 immunostaining showed a gradual increase from benign to borderline to malignant groups (P=0.000). A significant association was found between GLUT-1 expression and tumor bilaterality (P=0.004), solid or mixed cut section (P=0.03), presence of vascular invasion (P=0.05), presence of gross and microscopic omental nodules (P=0.003 and 0.001), T3 stage (P=0.01), and FIGO stage III (P=0.01) which indicate poor prognosis. Conclusion HIF-1&agr; and GLUT-1 may play a significant role in the carcinogenesis and progression of ovarian carcinomas.

Research paper thumbnail of Expression of HER2-neu, SKP2, and hypoxia-inducible factor-1 and their role in predicting the response of muscle-invasive urothelial carcinoma to bladder preservation chemotherapy

Egyptian Journal of Pathology, 2018

Background Cystectomy is the primary treatment of muscle-invasive urothelial carcinoma, but it is... more Background Cystectomy is the primary treatment of muscle-invasive urothelial carcinoma, but it is associated with many complications and affects patients' quality of life. Chemotherapy is an alternative modality, but it may not give the expected response. This arouses the need for markers that help to predict the response to chemotherapy. Human epidermal growth factor receptor 2 (HER2-neu), S-phase kinase associated protein 2 (SKP2), and hypoxia-inducible factor-1 (HIF-1) regulate cell cycle progression, tumor adaptation to hypoxic environment, and response to chemotherapy. Aim This study aimed at evaluation of HER2-neu, SKP2, and HIF-1 expressions in muscle-invasive urothelial carcinoma and investigated the association between their expressions and tumor response to chemotherapy. Materials and methods A total of 100 specimens from patients with nonmetastatic muscle-invasive urothelial carcinoma were collected at the pathology Department, and the selected patients received the treatment and follow-up at Clinical Oncology and Urology departments, Menoufia University. HER2-neu, SKP2, and HIF-1 expressions were evaluated using immunohistochemical techniques. The patients received chemotherapy followed by cystoscopic examination. Bladder biopsy was examined to determine tumor response. Results A significant association was found between partial tumor response to chemotherapy and HER2-neu, SKP2, and HIF-1 positive expression (P=0.004, 0.029, and 0.004). SKP2 expression was significantly associated with low apoptotic count and high mitotic one (P=0.008 and 0.01), whereas HIF-1 expression was significantly associated with necrosis (P=0.008). A statistically significant association was found between SKP2 and HR2-neu expression (P=0.018) and between SKP2 and HIF-1 expression as well (P=0.013). Conclusion This study showed that evaluation of HER2-neu, SKP2, and HIF-1 expression can predict poor response to chemotherapy in muscle-invasive urothelial carcinoma and help in selecting patients who will benefit from chemotherapy. In addition, target therapy against these markers can be effective in treatment.

Research paper thumbnail of The diagnostic role of vimentin in differentiation between muscularis propria and muscularis mucosa in urinary bladder carcinoma

Menoufia Medical Journal, 2017

Objective The aim of this study was to evaluate the diagnostic value of vimentin expression for d... more Objective The aim of this study was to evaluate the diagnostic value of vimentin expression for differentiation between muscularis mucosa (MM) and muscularis propria (MP) in urinary bladder carcinoma cases. Background The single most important prognostic factor in urothelial carcinoma is the pathological stage, which includes the anatomic depth of invasion on which major therapeutic decisions are made. Correct assessment of invasion necessitates discrimination between MM and MP. Vimentin is the most widely distributed intermediate filament and is expressed in virtually all mesenchymal tissues. Materials and methods This study was carried out on 70 urinary bladder specimens, including 59 cases of primary urinary bladder carcinoma and 11 cystitis specimens. The specimens were submitted to vimentin immunostaining under the streptavidin–biotin amplified system. Results MM was identified histologically in 40 cases, whereas MP was morphologically designated in all cases (70 cases). Vimentin was negative in MP and showed positive expression in 32/40 (80%) cases of MM with a statistically significant difference (P = 0.000), 80% of sensitivity, and 100% of specificity. Conclusion Negative vimentin expression in MP could be a useful tool for identification of MP with 80% of sensitivity and 100% of specificity in urinary bladder carcinoma cases.

Research paper thumbnail of Evaluation of topoisomerase II, ki-67, and P53 expression in non-muscle-invasive urothelial carcinoma and their clinical significance

Indian Journal of Pathology and Microbiology, 2018

Background: Transurethral resection of tumor is the main treatment of non-muscle-invasive urothel... more Background: Transurethral resection of tumor is the main treatment of non-muscle-invasive urothelial carcinoma, but it is associated with high rate of recurrence and/or progression and this arouses the need for adjuvant therapy. Topoisomerase II (Top II), KI-67, and P53 are proliferation and cell cycle regulation markers that may predict tumor response to therapy. Aim: This study aimed to assess Top II, KI-67, and P53 expression and their effect on clinical outcome and response to therapy of non-muscle-invasive urothelial carcinoma. Materials and Methods: Fifty cases of non-muscle invasive urothelial carcinoma were collected; Top II, KI-67, and P53 expression was evaluated. Patients received treatment then tumor recurrence was correlated with the expression of previous markers. Results: There was a significant association between high Top II score, P53, and KI-67 and high tumor grade (P = 0.0001, 0.001, and 0.0001), submucosal infiltration (P = 0.0001 and 0.01), and recurrence (P = 0.01, 0.001, and 0.001). Conclusion: Top II, P53, and KI-67 may predict tumor response to therapy and the clinical outcome in non-muscle-invasive urothelial carcinoma.

Research paper thumbnail of Cyclooxygenase-2 expression in chronic gastritis and gastric carcinoma, correlation with prognostic parameters

Journal of the Egyptian National Cancer Institute, 2006

Cyclooxygenase-2 (Cox-2) is the inducible form of cyclooxygenase enzyme. Cox-2 is induced in nume... more Cyclooxygenase-2 (Cox-2) is the inducible form of cyclooxygenase enzyme. Cox-2 is induced in numerous processes such as cellular growth, differentiation, inflammation and tumorogenesis. Assessment of Cox-2 expression in chronic gastritis and gastric carcinoma. Sixteen chronic gastritis (CG) and 43 gastric carcinoma cases were subjected to an immunohistochemical approach using anti Cox-2 antibody. All CG cases displayed positive epithelial Cox-2 expression with only 25% positivity for stromal expression. Eighty six percent of gastric carcinoma showed epithelial Cox-2 expression that was significantly correlated with lymph node involvement (p<0.01), advanced stage (p=0.01), high microvessel density (MVD) (p=0.0001), vascular invasion (p=0.002), perineural invasion (p=0.01) and low apoptotic count (p<0.0001). Stromal Cox-2 expression was seen in 79% of gastric carcinoma cases and was significantly associated with low apoptotic count (p=0.0007), vascular invasion (p=0.001) and hig...

Research paper thumbnail of Evaluation of β-catenin expression in muscle-invasive urothelial bladder carcinoma

Menoufia Medical Journal, 2014

Objectives This study aimed at evaluation of the expression of β-catenin in muscle-invasive uroth... more Objectives This study aimed at evaluation of the expression of β-catenin in muscle-invasive urothelial bladder carcinoma and its correlation with other clinicopathological parameters of prognostic importance. Background β-Catenin is a protein that is encoded by the CTNNB1 gene that can function as an oncogene. Activation of the Wnt/β-catenin signaling pathway by aberrant accumulation of stabilized β-catenin contributes to the progression of several human cancers. Therefore, inhibition of the Wnt pathway may have a major therapeutic potential. Patients and methods This study was conducted as a retrospective study at Urology and Pathology Departments, Faculty of Medicine, Menoufia University, during the period between May 2011 and May 2013. A total of 40 patients were included and divided into two groups. The first one included 10 patients with chronic nonspecific cystitis as a control group and the second one included 30 patients with muscle-invasive urothelial bladder carcinoma who underwent radical cystectomy. The pathological blocks of both groups were investigated for the expression of β-catenin using immunohistochemical staining. Results β-Catenin expression was noticed in 100% (30 cases) of muscle-invasive bladder carcinoma and in 70% (seven cases) of nonmalignant cases. In the malignant group, 26 (87%) cases showed nucleocytoplasmic expression and four (13%) cases showed membranous expression only. There was a significant correlation between nucleocytoplasmic localization of β-catenin and some pathological parameters such as tumor grade, stage, and mitosis. Furthermore, the study showed statistically significant correlation between intensity of β-catenin expression and tumor grade, stage, lymph node metastasis, vascular and perineural invasion, mitosis, and microvessel density. Conclusion Nucleocytoplasmic expression of β-catenin and high intensity of its expression was associated with poor prognostic parameters.

Research paper thumbnail of Effect of atorvastatin and erythropoietin on renal fibrosis induced by partial unilateral ureteral obstruction in rats

Menoufia Medical Journal, 2014

Objective This work aims at investigating the effects of atorvastatin and erythropoietin (EPO) on... more Objective This work aims at investigating the effects of atorvastatin and erythropoietin (EPO) on tubulointerstitial fibrosis induced by partial unilateral ureteral obstruction (PUUO) in rats. Background Renal fibrosis is the final manifestation of chronic kidney disease. It is one of the biggest problems in nephrology, indicating that patients inevitably reach end-stage renal disease. Atorvastatin has anti-inflammatory, antiproliferative, and immunomodulatory potential. EPO has been demonstrated to play an important cytoprotective role. Methods Fifty adult albino rats were divided into five equal groups: group 1 received saline intraperitoneally and methylcellulose orally for 14 days and served as the negative control; group 2 (sham-operated group) rats underwent the same surgical procedures as group 3 without ureteral obstruction; group 3 rats underwent PUUO without any medication; group 4 rats underwent PUUO and received atorvastatin at a dose of 50 mg/kg orally; group 5 rats underwent PUUO and received EPO at a dose of 3.000 IU/kg daily intraperitoneally. After 14 days, systolic blood pressure was measured. Blood and urine samples were also collected for measurement of serum transforming growth factor-β1, tumor necrosis factor-, urea and creatinine, and urinary protein and albumin levels. Renal tissue samples were collected for determination of malondialdehyde and -smooth muscle actin levels, as well as for histopathological and immuonohistochemical examination. Results Our results showed that systolic blood pressure; serum levels of transforming growth factor-β1, tumor necrosis factor-α, and malondialdehyde; and biochemical parameters were significantly elevated. Histopathological examination of kidney tissue revealed marked degenerative changes and increased expression of α-smooth muscle actin in group 3 compared with groups 1 and 2. In contrast, biochemical, histological, and immuonohistochemical features in groups 4 and 5 showed significant improvement compared with group 3. Conclusion It is concluded that both atorvastatin and EPO have renoprotective effects against renal fibrosis, shown by improvement in kidney functions and using fibrosis markers.