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Objective To evaluate a modified pyelo-u re teroplasty in treating long segment of ureteropelvic junction (UPJ) stenosis. Methods 26 cases were treated with the designed pyelo-ur eteroplasty,on which the dilated pelvic was incised vertically and the pelvic fl ap was turned down to form a new infundibulas tube with running suture and was a nastomosed to the ureter stem,the long stenosis segment being cut off. Results The symptoms vanished in the follow-up period of 1～3 ye ars.It was showed by B-ultrasonography,IVU and RP (retrograde pyelography)that the anastomosis site in all the cases was smooth.3～12 months after operation,G FR(glomerulus filtration rate) was found to be improved markedly,and 20 minutes excretive rate in the operated kidneys was all above 50%. Conclusio ns The troublesome hydronephrosis due to complicated long stenosis o f UPJ and upper ureter can be effectively treated by the modified pyelo-uretero plasty.
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Objective To study the diagnosis and treatment of renal cell carcinoma. Methods 369 cases of renal cell carcinoma were reviewed for their incidence,diagnosis,treatment and prognosis. Results 281 cases(76.2%) were clear cell carcinoma ,39 cases (10.6%) of granular cell carcinoma,42 cases(11.4%) being a combination of the above two varieties and 7 cases being of other cell types. Radical nephrectomy was performed for 301 cases (81.6%) and other procedures for 45 cases. 297 cases have been followed up:three-year,five-year and ten-year survival rates were 74.6%、56.2% and 28.2% respectively. Conclusions B type ultrasonography and computerized tomography (CT) are important means in the diagnosis of renal cell carcinoma.The most effective treatment is radical nephrectomy at early stage,wherea sbiological treatment works in certain degree.
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Objective To investigate the expression of Uroplakin Ⅱ (UPⅡ) gene together with other conventional parameters in the patients with transitional cell carcinoma(TCC). Methods Total RNAs extracted from solid tumor tissues and blood samples of patients with TCC were reverse transcribed and subjected to polymerase chain reaction amplification (RT PCR).The products of RT PCR were analyzed by agarose gel electrophoresis. The expressions in solid tissues of other kinds of tumors and blood samples of non neoplasm patients served as controls. Results UPⅡ gene were expressed in all the solid tumor tissues of TCC(100%) and in the blood samples of 5 patients of T 3～T 4 neogrowth(39%), 2 of the 5 cases had hematogenous metastasis which became nondetectable after chemotherapy; UPⅡ gene has not been detected in the blood samples of T 1～T 2 TCC patients, the non neoplasm patients and other kinds of solid tumor tissues. Conclusions UPⅡ is one of the specific markers of urothelium.It can be found in TCC patients of stage T 3～T 4 and in patients with metastasis. The detection of UPⅡ in the blood sample might serve as a marker for chemotherapeutic efficacy.
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Objective To study the significance of microvascular invasion to the neogrow in clinically nonmetastatic renal cell carcinoma (RCC). Methods Between 1989 and 1996,70 patients (mean age 54) were followed up for 1 to 7 years after radical nephrectomy for clinically localized RCC. Among them,there were 5 PT 1,50 PT 2,14 PT 3 and 1 PT 4 and histologically 7 G 1,38 G 2,19 G 3 and 6 G 4.The mean tumor diameter was 7.2 cm.The slides were stained with hematoxylin and eosin,elastin stains and periodic acid Schiff. then,the presence or absence of clinically inapparent vascular invasion,the relevance of microscopic vascular invasion to conventional tumor stage,grade and tumor diameter,et al were studied. Results Of the 70 patients analyzed,24(34.3%) had microvascular invasion,while 46 had none on microscopic examination.Of the microscopic vascular invasion group (11/24,45.8%),7 subsequently died of cancer recurrence,2 noncancer related death,4 alive with metastatic disease while only 4/46(8.7%) without microscopic vascular invasion presented with disease progression.Chi-square test showed statisticaly significant difference between stage,grade,tumor diameter and presence or absence of microscopic vascular invasion. A multivarite analysis was performed considering the impacts of age,PT stage,tumor grade,tumor diameter and microscopic vascular invasion on disease progression,an increase in statistical significance was confirmed with Coxs proportional hazards model(P=0.0062,RR=0.378). So, microscopic vascular invasion seems to be the most important predictor of progression in RCC. Conclusions In patients underwent radical nephrectomy for clinically nonmetastatic RCC,microvascular invasion may be another important prognostic marker and this makes us considering the presence of microscopic vascular invasion in RCC might be another pathological subcategory to predict the prognosis of RCC and can be used to choose whether early adjuvant therapy is necessary.
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Objective To evaluate the role of detecting circulating UP Ⅱ mRNA positive cells in patients with transitional cell carcinoma (TCC). Methods Expression of UP Ⅱ mRNA was examined with nested reverse transcriptase polymerase chain reaction (RT PCR) assay. Results UP Ⅱ mRNA positive cells were detected in 0% (0/26) of patients with superficial urothelial cancers (pT a～1 N 0M 0), 20.8% (5/24) of patients with invasive cancers (pT 2～4 N 0M 0), 50.0% (1/2) of regional node positive patients (pN 1～2 M 0),and 100.0% (2/2) of patients with distant metastases. Positive rates increased with tumor extension ( P