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<p><b>OBJECTIVE</b>To define the clinicopathological risk factors of intravesical recurrence of primary transitional cell carcinoma of the ureter after surgical intervention.</p><p><b>METHODS</b>Patients with primary carcinoma of the ureter treated between January 2000 and December 2010 were retrospectively analyzed. The intravesical recurrence-free survival rate was calculated using Kaplan-Meier method. Multivariate analysis was conducted with Cox's regression.</p><p><b>RESULTS</b>A total of 104 patients were enrolled, who were followed up for a median of 46 months (13-89 months). Thirty-nine of the patients showed postoperative intravesical recurrence. Urine exfoliative cytology (P=0.000), number of tumors (P=0.006), tumor grade (P=0.039) and co-existence of bladder tumor (P=0.014) were found to independently influence the postoperative intravesical recurrence. Patients with more risk factors had poorer intravesical recurrence-free survival.</p><p><b>CONCLUSION</b>Urine exfoliative cytology, number of tumors, tumor grade and co-existence of bladder tumor are independent risk factors for postoperative intravesical recurrence of primary transitional cell carcinoma of the ureter. Close follow-up and rigorous treatment are essential for patients with high risk factors.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Carcinoma, Transitional Cell , Pathology , General Surgery , Causality , Neoplasm Recurrence, Local , Regression Analysis , Retrospective Studies , Risk Factors , Ureteral Neoplasms , Pathology , General Surgery , Urinary Bladder Neoplasms , PathologyABSTRACT
Objective To compare WHO 2004 and WHO 1973 pathological grading methods of non-muscle invasive urothelial neoplasms. Methods The clinical pathological features of 160 non-muscle invasive urothelial neoplasms patients, treated in our hospital from February, 1998 to Decem-ber, 2008, were re-graded according to WHO 2004 and WHO 1973 classification system. To evaluate recurrence and progression of all the patients during the follow up period, we used statistical method to analyses the differences between two classification system. Results There were 160 patients, ac-cording to WHO 1973 classification methods: 5 cases of papilloma, 52 cases of grade 1 tumors, 83 ca-ses of grade 2 and 20 cases of grade 3;By WHO 2004 classification method: 7 cases of papilloma, 31 cases of low-grade malignant potential of urothelial papilloma, 99 cases of low-grade papillary urotheli-al carcinoma and 23 cases of high-grade papillary urothelial carcinoma. There was no difference in re-currence among the grades of WHO 2004 and WHO 1973 pathological grading system (both P>0.05). Regarding the progress of non-muscle invasive papillary urothelial neoplasms, no significant difference was found among grades of WHO 1973 classification system(P>0.05)while difference exis-ted among grades of WHO 2004 pathological grading system (P<0.05), especially between papillary neoplasm of low malignant potential (PNLMP) and high grade papillary urothelial carcinomas(HG-PUC) (P<0.01). Moreover, HGPUC grade had more progression rate (30.4%) than G_3 grade (15.0%). Conclusions Compare to G_3 grade, HGPUC grade was more easily to make progress in pa-tients,due to this grade include more high malignant papillary urothelial carcinomas. Therefore, it is necessary for urologists to use a more rigorously follow up and therapy method in connection with HG-PUC grade of new classification system.
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Objective To explore the application of the paries anterior vagina U shape muscularis mucosal flap for the repairing of female complicated urethrovaginal fistula. Methods Fifteen complicated urethrovaginal fistulas patients resulted from severe pelvic frac-ture and with history of failing repairing urethrovaginal fistulas were analyzed retrospectively. The mean diameter of maximum urethrovagi-nal fistula was approximately 2.3 cm. The parias anterior vagina U shape mucosal flaps were used to repair the urethrovaginal fistulas, and the paries anterior vagina muscularis mucosae were used to cover the fistulas surface again. Results Fifteen patients were followed up for 6 to 80 months, and they gained normal voiding, with no urine leakage, urinary incontinence and urethra] stricture occurring. Conclusion The paries anterior vagina U shape mucosal flap is an effective technique for repairing complicated urethrovaginal fistula.
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Objective To investigate the diagnosis and treatment outcomes of testieulax endodermal sinus tumor. Methods Twenty-four cases diagnosed with testieular endodermal sinus tumors from November 1996 to April 2007 were retruspeetively reviewed. Eighteen patients presented with stage Ⅰ disease, 4 presented with stage Ⅰ , and 2 presented with stage Ⅲ. Inguinal radical or-chieetomy were performed in all patients. Retroperitoneal lymph node dissection was performed in 8 ea-ses. Results The histological structures were rather complicated in 24 tumors. Twenty-three eases (96%) were found with reticular pattern, 22(92%) with hyaline body, 20(83%) with glandlike structure, 16(67%) with Shiller-Dural body, and 13(54%) with solid formation. The former 3 kinds were regarded as the main diagnostic criteria. Twenty-one eases were followed up for 20 months to 12 years. During the follow-up, 2 patients died of the disease. Condesions Early diagnosis and combi-nation therapy, including radical orehieetomy and chemotherapy, are the keys to improve the curative effect of testieular endodermal sinus tumors. Active surveillance of AFP is critical for monitoring the recurrence and metastasis of this tumor.
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6.2 mmol/L) who underwent renal transplantation accepted pravastatin therapy 10 mg once evening for 8 weeks. Total cholesterol(TC),low-density lipoprotein-cholesterol (LDL-C),high-density lipoprotein-cholesterol (HDL-C),triglyceride(TG),endothelin(ET) and nitrous oxide(NO) were measured before and after pravastatin therapy. The endothelium-dependent relaxing function was measured before and post pravastatin therapy by high-resolution ultrasound. Thirty people with normal blood cholesterol accepted same examination as control. Results The level of ET in renal transplantation group was significantly higher than that of control group,and the level of NO in renal transplantation group was significantly lower than that of control group. After 8 week′s therapy,the level of NO rose significantly,and the level of ET,TC,LDL-C,TG decreased significantly. The level of HDL-C increased but there was no significant difference between two groups. Flow-mediated vasodilations were improved after pravastatin therapy,while the level in transplantation group was lower than that of control group. Conclusion Pravastatin is effective in treatment of dyslipidemia after renal transplantation,which can improve the endothelium-dependent vasodilation.
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Objective To explore the application of the paries anterior vagina U shape muscularis mucosal flap for the repairing of female complicated urethrovaginal fistula.Methods Fifteen complicated urethrovaginal fistulas patients resulted from severe pelvic fracture and with history of failing repairing urethrovaginal fistulas were analyzed retrospectively.The mean diameter of maximum urethrovaginal fistula was approximately 2.3 cm.The paries anterior vagina U shape mucosal flaps were used to repair the urethrovaginal fistulas,and the paries anterior vagina muscularis mucosae were used to cover the fistulas surface again.Results Fifteen patients were followed up for 6 to 80 months,and they gained normal voiding,with no urine leakage,urinary incontinence and urethral stricture occurring.Conclusion The paries anterior vagina U shape mucosal flap is an effective technique for repairing complicated urethrovaginal fistula.
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Objective To evaluate the late complications of continent ileocolic reservoir with an unaltered in situ appendix conduit and the management. Methods Thirty patients with bladder cancer who had undergone the surgery of continent ileocolic diversion with an unaltered in situ appendix conduit were followed up for 108 to 126 months (mean 118 months).The long-term post-operative complications were documented. Results The complications occurred as follows:urinary pouch superdistention in 5 cases,calculus formation in the urinary pouch in 6,difficulty with catheterization in 4,uerteral obstruction in 3,hemorrhage of the pouch in 1 and mild hyperchloremic acidosis in 1.These complications were managed accordingly and good results achieved. Conclusions Although continent ileocolic diversion with an unaltered in situ appendix conduit has a long-term efficacy,the complications occur frequently.The procedure needs further improvement.
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Objective To study the cellular apoptosis and telomerase activity in bladder cancer before and after treatment with cell wall skeleton of bacillus Calmett Guerin(BCG CWS) and interleukin 2(IL 2). Methods The cellular apoptosis and telomerase activity of 33 cases of bladder cancer tissues were detected by terminal deoxynucleotidyl transferase mediated dUTP biotin nick end labeling(TUNEL) and telomeric repeat amplification protocol(TRAP) assay both before and after treated with BCG CWS and IL 2. Results The apoptosis index for bladder cancers before and after treatment with BCG CWS and IL 2 was (35.6?12.7)% and (79.1?11.3)% respectively, the apoptosis index being obviously increased after the treatments, P
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Objective To investigate the effects of kidney transplantation in sensitized recipients receiving conventional human leukocyte antigen(HLA) and cross-reactive groups(CREG) matching.Methods The HLA and CREG matching were used to select the best donors for 82 recipients with high titer of panel reactive antibody(PRA),and adjunctive application of plasma exchange and intravenous immunoglublin were conducted.Results The successful rate was 90%(74/82) and mortality rate was 1%(1/82).The incidence of hyperacute rejection,accelerated acute rejection,acute rejection and delayed graft function was 4%(3/82),6%(5/82),28%(23/82) and 21%(17/82),respectively.The incidences of acute rejection in groups of broad sensitized,HLA class Ⅰantibody positive recipients,HLA antibody positive recipients of post-transplantation and donor specific antibody were higher than those in groups of mild sensitized,HLA classⅡantibody positive recipients,HLA antibody positive recipients of pre-transplantation non-donor and specific antibody respectively(all P