title: Molecular markers and Schistosoma-associated bladder carcinoma: A systematic review and meta-analysis.
abstract: BACKGROUND
  Molecular mechanisms and pathogenesis of schistosomal-associated bladder cancer (SABC), one of the most common malignancies in Africa and parts of the Middle East, is still unclear. Identification of host molecular markers involved in schistosomal related bladder carcinogenesis is of value in prediction of high-risk group, early detection and timely intervention.
  
  
  METHODS
  PubMed, Scopus, Google Scholar, Cochrane Library and African Journals Online databases were systematically searched and reviewed. A total of 63 articles reporting 41 host molecular factors were included in the meta-analysis.
  
  
  RESULTS
  Pooled odds ratio demonstrated associations of p53 expression, telomerase activity and sFas with SABC as compared to other schistosomal patients (p53 expression: OR=9.46, 95%CI=1.14-78.55, p=0.04; telomerase by TERT: OR=37.38, 95%CI=4.17-334.85, p=0.001; telomerase by TRAP: OR=10.36, 95%CI=6.08-17.64, p<0.00001; sFas: OR=34.37, 95%CI=3.32-355.51, p=0.003). In comparison to bladder cancers of other etiology, positive associations were found between SABC and p15 deletion, p16 deletion, telomerase activity and sFas (p15 deletion: OR=4.20, 95%CI=2.58-6.82, p<0.00001; p16 deletion: OR=4.93, 95%CI=2.52-9.65, p<0.00001; telomerase by TERT: OR=3.01, 95%CI=1.51-5.97, p=0.002; telomerase by TRAP: OR=2.66, 95%CI=1.18-6.01, p=0.02; sFas: OR=4.50, 95%CI=1.78-11.40, p=0.001). Other identified associations were reported by few numbers of studies to enable reliable interpretation.
  
  
  CONCLUSIONS
  Variations in gene expression or genomic alterations of some molecular markers in SABC as compared to non-SABC or other schistosomal patients were identified. These suggest minute differences in the pathogenesis and physiological profile of SABC, in relation to non-SABC.
authors.affiliation: Department of Clinical Product Development, Institute of Tropical Medicine (NEKKEN), Nagasaki University, 1-12-4 Sakamoto, 852-8523, Japan. Electronic address: nkoonrung@gmail.com.
authors.forename: Nut
authors.initials: N
authors.lastname: Koonrungsesomboon
authors.affiliation: Centre for Buruli Ulcer Screening and Treatment, Ministry of Health, Cotonou, BP 03, Allada, Benin. Electronic address: awadagni@gmail.com.
authors.forename: Anita Carolle
authors.initials: AC
authors.lastname: Wadagni
authors.affiliation: Department of Parasitology and Entomology, Faculty of Bioscience, Nnamdi Azikiwe University, P.M.B. 5025, Awka, Nigeria; Department of Immunogenetics, Institute of Tropical Medicine (NEKKEN), Nagasaki University, 1-12-4 Sakamoto, 852-8523, Japan. Electronic address: evambanefo@yahoo.com.
authors.forename: Evaristus Chibunna
authors.initials: EC
authors.lastname: Mbanefo
mesh_terms: D000349:Africa; D000818:Animals; D014408:Biomarkers, Tumor / Q000032:analysis*; D006801:Humans; D008877:Middle East; D012547:Schistosoma; D012553:Schistosomiasis haematobia / Q000150:complications* / Q000469:parasitology / Q000473:pathology; D001749:Urinary Bladder Neoplasms / Q000469:parasitology* / Q000473:pathology
chemical_list: D014408:Biomarkers, Tumor
keywords: Apoptotic markers; Bilharziasis; Bladder cancer; Cell cycle regulators; Host factor; Molecular marker; Schistosoma; Schistosomiasis; p15 deletion; p16 deletion