Background: bladder cancer develops and spreads due to a combination of 
environmental and inherited causes. Many biomarkers that are useful in 
determining the behavior and prognostic features of the tumour have been 
studied. Bcl-2 overexpression was linked to reduced tumour sensitivity to 
chemo- and radiation. FOXP3 has multiple roles in tumoural–immune system 
interactions, debates over FOXP3's function in immunological responses and 
carcinogenesis at various sites have emerged. Aim of the study: to detect Bcl-2 
& tumoral FOXP3 immunohistochemical expression in urothelial carcinoma 
and its correlation with other clinicopathological data as well as disease free 
survival (DFS) and overall survival (OS). 
Methods: sixty cases of urothelial carcinoma had full clinical and follow-up 
data. Bcl-2 & tumoral FOXP3 immunohistochemical expression in urothelial 
carcinoma cases were investigated. 
Results: Positive Bcl-2 expression was detected in 41.7% of the studied 
urothelial carcinoma cases, while two thirds of cases showed positive FOXP3 
expression. A statistically significant association between loss of Bcl-2 
expression and high grade, advanced T stage, the presence of lymph node 
metastasis and lympho-vascular invasion (p=0.000) was detected. A statistically 
significant association between positive FOXP3 expression and both positive 
lymph node metastasis and lympho-vascular invasion was detected (p= 0.02 and 
p= 0.007 respectively). No significant association between Bcl-2 expression and 
DFS as well as OS, meanwhile, a statistically significant association between 
positive FOXP3 expression and short DFS as well as OS. 
Conclusion: The identification of patients with poor prognostic characteristics 
in urothelial bladder cancer who may be candidates for cancer therapy could be 
facilitated by loss of Bcl-2 expression and positive tumoral FOXP3 expression.