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Objective:To investigate the prognostic value of preoperative peripheral blood albumin-to-globulin ratio (AGR) for patients with non-metastatic clear cell renal cell carcinoma (NMCCRCC).Methods:The clinicopathological and postoperative follow-up data of 61 patients with NMCCRCC confirmed by postoperative pathology who were admitted to Zhongshan Hospital of Dalian University from January 2012 to December 2014 was retrospectively analyzed. According to the receiver operating characteristic curve (ROC), the optimal cut-off value of AGR was determined. According to the cut-off value, the patients were divided into high AGR group (AGR≥1.59) and low AGR group (AGR<1.59). The factors affecting the prognosis of NMCCRCC patients were analyzed by using univariate and multivariate analyses.Results:Among 61 patients with NMCCRCC, 38 cases (62.3%) were in high AGR group and 23 cases (37.7%) were in low AGR group. The differences in age, globulin level, clinical staging, and recurrence status between the two groups were statistically significant (all P < 0.05). The overall survival time and disease-free survival time in low AGR group were shorter than those in high AGR group, and the differences were statistically significant (both P < 0.05). Multivariate Cox regression analysis showed that AGR < 1.59 was the independent influencing factor for overall survival and recurrence ( HR = 0.233, 95% CI 0.073-0.742, P = 0.014; HR = 0.343, 95% CI 0.134-0.873, P = 0.025). Conclusion:Preoperative AGR is valuable in predicting the prognosis of NMCCRCC patients.
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High mobility group protein A2 (HMGA2) is a non-histone protein that does not have transcriptional activity by itself, but it changes its structure by binding to chromatin, which in turn regulates the transcription of other genes, thereby promoting tumor invasion and metastasis. The related RNA gene can regulate the role of HMGA2 in tumors, and the invasiveness of tumors is closely related to epithelial-mesenchymal transition (EMT), which can treat the related tumors by targeting HMGA2 gene. This article reviews the progress of the relationship between HMGA2 and tumors.
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Objective To assess the efficacy and side effects of intravesical instillation of BCG after transurethral resection of the bladder tumor (TURBT) in non-muscle invasive bladder cancer (NMIBC) patients.Methods The clinical data of patients treated with BCG 120 mg per course induced perfusion or more after TURBT from December 2013 to October 2016 in 18 hospitals of northeast China region,were analyzed retrospectively.The first part,data of 106 patients with moderate,high-risk NMIBC were collected.A total of 83 patients were male,while the other 23 patients were female.The average age was 66.7 years old.The clinical staging were T1 in 86(81.1％) cases,Ta in 20(18.9％) cases and carcinoma in situ in 6 (5.7％) patients.Intravesical instillation of BCG was executed after transurethral resection of the bladder tumor.The incidence rate of recurrence and progression during more than 6 months' follow-up time were observed.Multivariate analyses were done by using logistic analysis and Cox proportional hazards regression model with Kaplan-Meier method.The second part,treatment compliance of 276 patients with bladder cancer,including moderate/high-risk NMIBC in 263 cases,moderate/high-risk NMIBC followed with renal pelvis/ureteral carcinoma in 8 cases were and moderate/high-risk NMIBC with renal pelvis/ureteral carcinoma in 5 cases who treated with BCG after the surgeries,were observed.Patients consisted of 211 males and 65 females with average age of 68.3 years.Results With a median follow-up of 12 months,9 (8.5％) patients experienced tumor recurrence and 2 (1.9％) patients were found progression in the first part.The one-year cancer free recurrence rate of the patients was 91.5％.Statistically significant prognostic factors for recurrence identified by multivariable analyses were prior recurrence of the tumors (OR =3.214,95％CI0.804-12.845,P =0.099).In the second port,an incidence rate of adverse effects was 64.1％ (177/276).The Ⅲ/Ⅳ degree complications were occurred in 11 patients and satisfactory outcomes achieved with active treatment.A total of 36 patients withdrawal with the major causes were recurrence and progression of bladder tumor in 12 cases (4.4 ％),9 cases (3.3 ％) with economic reasons and 11 cases (4.0％) with serious complications.Conclusions NMIBC patients treated with intravesical BCG therapy have approving cancer free recurrence rates and acceptable adverse effects.Prior recurrence may be prognostic factor of recurrence after intravesical BCG therapy.
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Objective@#To detect the high mobility group A2 (HMGA2) expression in renal carcinoma, and to explore the relationship with clinicopathological features and its significance for prognosis.@*Methods@#50 renal carcinoma specimens, 50 corresponding adjacent normal kidney tissue samples, and 40 benign renal tumor specimens were used in this study. The expressions of HMGA2 mRNA and protein were detected by RT-PCR, Western blot and immunohistochemical assays, and its relationship with clinicopathological features and prognosis in the renal carcinoma patients was analyzed.@*Results@#The RT-PCR results showed that the relative expression levels of HMGA2 mRNA in the renal carcinoma, benign renal tumor tissues, and adjacent normal renal tissues were 0.84±0.23, 0.19± 0.06 and 0.08±0.04, respectively, and the expression in renal carcinoma tissue was significantly higher than those of the other 2 groups (P<0.01). The Western blot results showed that the relative expression levels of HMGA2 protein in the renal carcinoma, benign renal tumor tissues, and adjacent normal renal tissues were 0.91±0.24, 0.12±0.04 and 0.03±0.01, respectively, and the expression in renal carcinoma tissue was significantly higher than those of the other 2 groups (P<0.01). Immunohistochemical results showed that the expression of HMGA2 protein exhibited brown and tan granular, which mainly distributed in the cell nuclei. Among the 50 cases of renal carcinoma, 34 cases exhibited positive expression, with a positive rate of 68.0%. Among the 40 cases of benign tumor tissues, 3 cases had positive expression, with a positive rate of 7.5%, while among the 50 cases of adjacent normal renal tissues, there was only 1 case exhibiting positive expression of HMGA2 protein, with a positive rate of 2.0%. The protein expression of HMGA2 was significantly higher in the renal carcinoma than in the benign tumors and normal renal tissues (P=0.004). There was no statistically significant difference in the association of HMGA2 protein expressions with age, sex, tumor size and histological type (P>0.05), while significant difference did exist in the association with different statuses of TNM staging and lymph node metastasis (P<0.05). The median time to progression (TTP) in 34 HMGA2 protein-positive patients was (22.36±1.48) months and that of 16 HMGA2 protein-negative patients was (34.55±1.87) months (P<0.05).@*Conclusions@#HMGA2 plays an important role in the tumorigenesis and development of renal carcinoma, and may be used as an important predictor for estimating the prognosis of renal carcinoma. HMGA2 might become a new diagnostic and prognostic marker for renal carcinoma.
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Eighty six patients with renal masses≤4.0 cm underwent ultrasound or CT-guided core needle biopsies.The clinical data including the initial biopsy technique,pathologic findings,and the clinical outcome were retrospectively reviewed. Biopsies were failed for diagnosis in 6 cases ( 7％ ) because of necrosis or hemorrhage of the tissue specimens.Of 80 successful biopsies,52 cases (65％) were diagnosed as malignant tumor and 28 cases (35％) as benign. Five patients had biopsy complications (6％),including postoperative hypotension,hemouria and perirenal hematoma. Forty-seven patients underwent surgical extirpation ; the consistency rate of histopathological diagnosis between biopsy and surgical specimens was 100％ in these patients.The results indicate that ultrasound or CT-guided core needle biopsy is an effective and safe procedure for diagnosis of renal small masses.
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Objective To discuss the diagnosis and treatment of acquired cystic kidney disease complicated by kidney cancer. Methods Clinical data of 11 patients with acquired cystic kidney disease complicated by kidney cancer were analyzed retrospectively. Eight patients were male and three were female. The mean age was 55 years old (range 37 to 68). The time of hemodialysis ranged from 2.8 to 7. 4 years, mean 4. 8 years. Results Follow-up ranged from 17- 83 months, mean 55 months. One patient died of cardiovascular disease. Lung metastasis was detected in one patient two years after surgery. Seven patients survived free of tumor recurrence and there was no follow-up on one patient. Conclusions Increased incidence of cancer was observed in patients with end-stage renal disease who have undergone long-term dialysis. In particular, renal cell carcinoma (RCC) showed an excess incidence in ACKD patients. RCC showed an increased prevalence compared with the general population. Patients with predialysis azotemia or a dialysis duration of longer than 3 years should be screened for ACKD. Sonegraphy or CT scanning are useful for early diagnosis of ACKD. We should pay close attention to complications, including ACKD malignant tendency, in patients who have been taking long-term dialysis and positive therapy.
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iple occurrence of the tumor, which can decline its recurrence and postpone its progression.