ABSTRACT
Objective To evaluate the prognosis and immunotherapy response of patients with bladder cancer by constructing a risk-score model of cellular senescence-related signature (SRS), as well as to explore the clinical application value of SRS in bladder cancer. Methods Senescence genes were screened from TCGA-BLCA, and cellular SRS genes were screened according to LASSO regression. A bladder cancer risk-score model was constructed based on the SRS genes to analyze the survival difference and model-fit degree of TCGA-BLCA high- and low-risk groups. Univariable and multivariable Cox regression was used to analyze the prognostic risk factors of bladder cancer. Overall survival differences of high- and low-risk groups in GEO-BLCA database were verified, and variations in immunotherapy responses were analyzed in IMvigor210 databases. According to the result of β-gal chromogenic reaction in bladder cancer and normal paracancer tissues, the existence of cell senescence was determined. Results Eight marker genes were screened, and patients were divided into high- and low-risk groups according to the median risk score constructed by the marker genes. The 5-year survival rate of high risk group was lower than that of low risk group (training and validation sets P < 0.05). The area under the ROC curve of TCGA-BLCA in 1-, 3-, and 5-year were 0.657, 0.660, and 0.688, and those for GSE13507 were 0.665, 0.665, and 0.613, respectively. SRS risk score can be used as an independent risk factor for the prognosis of patients with bladder cancer. The SRS risk score in the response group was lower than that in the non-response group during bladder cancer immunotherapy (P < 0.05). The β-gal staining of bladder cancer tissue was positive, but the β-gal staining of adjacent normal tissue was negative. Conclusion Cell senescence occurs in bladder cancer tissues. SRS risk score can predict the clinical prognosis of patients with bladder cancer, and patients with low score can benefit from immunotherapy. SRS is a reliable biomarker for the prognosis and immunotherapy response of bladder cancer.
ABSTRACT
Objective To compare of flexible ureteroscope holmium laser lithotripsy and percutaneous nephrolithotomy in treating renal stones of ≤2cm.Methods In this retrospective study,we compared 120 patients of renal pelvic stones of ≤2cm size treated with FURS(n=62)or PCNL(n=58).Factors such as operation time,hospitalization time,stone-free rate(SFR),drop in haemoglobin level,and complications were analyzed.Results The stone burden of the FURS group and PCNL group was(1.4±0.2)cm and(1.6±0.3)cm respectively.In FURS group,The operation time was(28±12)min with postoperatlve fever in 3 cases;he hospitalization time was(3.7±1.8)days.The decrease of hemoglobin was(0.18±0.06)g/L.No major complication was recorded.The SFR was 85.5%(53/62)one week postoperatively and 95.2%(59/62)one month postoperatively.In PCNL group,the operation time was (42±15)min with postoperative fever in 2 cases and bleeding in 2 case.The hospitalization time was 6.8±1.5 days.The decrease of hemoglobin was(14.30±3.50)g/L.The SFR was 91.4%(53/58)one week postoperatively and 96.6%(56/58)one month postoperatively.Conclusion For renal stones≤2cm,FURS has the advantages of shortening operation time,reducing blood transfusion requirements,decreasing postoperative complications with a farely SFR compared with PCNL.FURS is a good alternative.