Serum Levels of Vascular Endothelial Growth Factor(VEGF) as a Prognostic Factor in Renal Cell Carcinoma / 대한비뇨기과학회지

PURPOSE: Vascular endothelial growth factor(VEGF) is recognized as a potent constituent of the vascularization and growth of solid tumors. We assessed the serum levels of VEGF and we evaluated its correlation to the clinicopathologic findings and clinical outcome of patients with renal cell carcinoma(RCC). MATERIALS AND METHODS: Serum samples were collected before surgery from patients with RCC. The levels of serum VEGF were assessed by using quantitative enzyme immunoassay. Comparison of the serum VEGF level with the tumor stage, grade, cell type and clinical outcome was performed, and the survival rate between the RCC patients above and below the mean VEGF level was evaluated. RESULTS: The mean follow-up was 5.1 years. The serum VEGF level was significantly higher in the patients with RCC(mean: 497pg/ml) than that in the controls(mean: 211pg/ml)(p<0.001). The serum VEGF level was correlated with the tumor size, the pathologic T stage and the clinical stage and histologic nuclear grade, but not with the histologic subtype. Patients with a lower VEGF level(<497pg/ml) showed longer survival(p=0.0207 on univariate analysis, p=0.04 on multivariate analysis). CONCLUSIONS: Our study indicated that the serum VEGF level was significantly correlated with the clinical or pathologic stage, the nuclear grade and adverse survival. These results suggest that the serum VEGF level could be a comparable prognostic factor to the tumor stage and grade.

The Relationship between the Metabolic Syndrome and the Risk of Benign Prostatic Hyperplasia: a Hospital-Based Study from a Health Screening Population / 대한비뇨기과학회지

PURPOSE: This case-control study was designed to investigate the possible association of the metabolic syndrome(MS) with benign prostatic hyperplasia(BPH) in healthy males. MATERIALS AND METHODS: We reviewed the data of 702 men who had a general health check-up without significant evidence of disease. The database for health check-ups included demographic, anthropometric, serum-related and prostate-related data. The presence of the MS was determined according to the NCEP-ATPIII criteria. We compared prostate- related data between the MS and the non-MS group. Testing for linear trends and logistic regression were performed to determine whether the presence of the MS was associated with an increased risk for BPH. RESULTS: The MS was identified in 166 men(23.6%). There was an increased prevalence of both the MS and BPH along with increasing age. There was a tendency for the total prostate volume and the PSA to increase along with the an increasing number of factors related to the metabolic syndrome. In a comparison between the MS and non-MS group, there were no differences in the prostate-related variables. However, subgroup analysis in men less than 50 showed significant differences in the PSA, total volume and calculated annual growth rate. In addition, only in this group was the presence of the MS a significant risk factor for BPH(odd ratio; OR=2.21, 95% confidence interval; CI 1.28-4.75). CONCLUSIONS: The results of this study showed a weak but significant relationship between the MS and BPH, especially in men less than 50. Further longitudinal studies with a larger patient population are required to confirm our findings.

Sclerosing Epithelioid Fibrosarcoma of the Kidney / 대한비뇨기과학회지

Sclerosing epithelioid fibrosarcoma(SEF) is an uncommon tumor of the deep soft tissue. It was first described in 1995 by Meis-Kindblom et al. Histologically, this tumor is characterized by uniform, small, round to ovoid epithelioid cells with clear cytoplasm, and the cells are arranged in distinct nests and cords. On immunohistochemistry, the most consistently positive marker is vimentin, although other antigens(cytokeratin, epithelial membrane antigen, S100 protein and neuron specific enolase) have been recorded as being inconsistently positive. We report here on a case of a 46-year-old woman who presented with back pain. The radiologic findings revealed a right renal mass and multiple bone metastases. The patient underwent radical nephrectomy and the pathologic finding was primary SEF of the kidney.

Primary Urethral Adenocarcinoma in a Young Man Who Presented with Voiding Dysfunction / 대한비뇨기과학회지

Primary urethral carcinoma accounts for less than 1% of the malignancies in males and adenocarcinoma accounts for 5% of all urethral carcinomas. A 36-year-old man with a history suggestive of urethral stricture was scheduled to undergo retrograde urethrography and visual urethrotomy. On urethroscopic examination, an abnormal polypoid mass was found in the proximal bulbous urethra, so transurethral resection biopsy was added to the urethrotomy. Histopathologic examination demonstrated urethral adenocarcinoma with no invasion to the corpus spongiosum and cavernosa on the magnetic resonance imaging. There was no evidence of metastasis and the search for the primary focus of adenocarcinoma revealed that the tumor originated from the urethra. The patient underwent segmental urethral resection and there has been no recurrence for 1-year follow-up.