ABSTRACT
Objective To analyze the clinicopathological features and prognostic factors of common subtypes of non-transparent renal cell carcinoma.Methods Retrospective analysis of 115 patients with pathologically confirmed non-transparent renal cell carcinoma from January 2003 to December 2017,including 67 males and 48 females,with a male to female ratio of 1.4∶ 1.The average age is (51.2 ± 13.4)years old.71 cases were asymptomatic renal cancer,44 cases had clinical symptoms,including 10 cases of gross hematuria,28 cases of low back pain,4 cases of hematuria with low back pain,and 2 cases of abdominal mass.There were 49 open surgery and 66 laparoscopic surgery.58 patients underwent radical nephrectomy and 57 underwent partial nephrectomy.Of the 115 patients,17 (14.9％) had abnormal hemoglobin (Hb),22 (19.1％) had abnormal platelet (PLT) count,18 (15.7％) had abnormal alkaline phosphatase,and abnormal lactate dehydrogenase 16 cases (13.9％).The Kaplan-Meier survival analysis method was used to calculate the survival rate of patients,and the Cox proportional regression risk model was used to analyze the prognostic factors.Results The postoperative pathological stage was 57 cases in T1a stage,38 cases in T1b stage,12 cases in T2a stage,8 cases in T2b stage,2 cases of regional lymph node positive,and 113 cases negative;no distant metastasis.Pathological types:42 cases of renal chromophobe cell carcinoma,37 cases of papillary renal cell carcinoma type Ⅰ,36 cases of type Ⅱ.The average follow-up time was 38.6 months,and the rate of loss of follow-up was 3.5％ (4/115).The 1,3,and 5 year overall survival rates of 115 patients with common subtypes of non-transparent renal cell carcinoma were 99.1％,95.8％,and 81.1％,respectively.Multivariate Cox regression analysis found that the pathological type (OR =4.625,P =0.014),four indicators ≥ 3 abnormalities (OR =30.853,P =0.024),lymph node metastasis (OR =35.663,P =0.006) were the group.An independent factor in the survival time of patients with common subtypes of non-transparent renal cell carcinoma.Conclusions Compared with papillary renal cell carcinoma type Ⅰ and renal chromophobe cell carcinoma,papillary renal cell carcinoma type Ⅱ has a higher degree of malignancy and a poor prognosis.The pathological types of the common subtypes of nontransparent renal cell carcinoma,four indicators (Hb,PLT count,alkaline phosphatase,and lactate dehydrogenase) ≥3 abnormalities and lymph node metastasis are independent prognostic factors for overall survival.
ABSTRACT
Objective To investigate the clinical value of serum metabolomic profile of prostate cancer using nuclear magnetic resonance-based metabolomics.Methods The retrospective case control study was adopted.The clinical data of 31 patients with prostate cancer,28 patients of prostatic hyperplasia and 31 healthy volunteers were enrolled in this study from May 2016 to May 2017 at the first affiliated hospital of Xinjiang medical university.In PCa group,the mean age was 66.3 years old,ranging 53-80 years old.In BPH group,the mean age was 59.3 years old,ranging 46-75 years old.In volunteer group,the mean age was 47.8 years old,ranging 35-62 years old..The serum of the 3 groups was measured by 1H-NMR spectroscopy.Multivariate statistical analysis was used to analyze the serum differential metabolism of the 3 groups,including principal components analysis (PCA),partial least squares discriminant analysis (PLS-DA) and orthogonal partial least squares discriminant analysis (OPLS-DA).Results The multivariate statistical analysis of PCA that the rate of the first principal component 1 (PC1) was 53.24％,the second principal component 2 (PC2) was 25.31％ and the cumulative contribution rate was 78.55 ％.Results of PLS -DA showed that partial data overlap of the three groups,but the separation trend was appeared.The variance of X(R2X) and Y(R2Y) matrixes and predictive value Q2 were 0.67,0.60,and 0.42.The results of OPLS-DA showed that the difference among the PCa group and BPH group,healthy group were obvious.The separation trend were appeared and the differential metabolites could be screened effectively.The R2X、R2Y and Q2 was 0.24,0.57,0.21 and 0.30,0.65,0.36.26 different serum metabolites were detected in the 3 groups,including citric acid,arginine,threonine,citrulline,glutamine,lactic acid,alanine,unsaturated fats,glycoprotein etc.Conclusions Compared with BPH group and healthy group,the serum of prostate cancer patients showed significant differences in metabolism.Nuclear magnetic resonance metabolomics analysis can effectively distinguish these serum metabolic differences.