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As the end-stage of prostate cancer, metastatic castration-resistant prostate cancer(mCRPC) complicates the disease and therefore challenges the doctors. In October 2018, an 87-year-old patient diagnosed with metastatic prostate cancer was admitted to Shanghai General Hospital for evaluation and treatment. Poor basic health condition plus severe side effect resulted in patient’s poor compliance with treatment and irregular follow-up. The patient progressed to mCRPC in September 2020, and was given enzalutamide as first-line therapy, after which the patient’s PSA level was under control with no side effect.
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Currently, invasive urodynamic testing is the " gold standard" for the diagnosis of bladder outlet obstruction (BOO). However, this test is invasive, easy to cause hematuria, urinary tract infection and other complications, the application conditions are limited.In order to solve this problem, various non-invasive methods to diagnose or predict BOO have been studied.The use of existing inspection indicators such as ultrasound measurement, penile cuff test, near infrared spectroscopy and other new non-invasive methods provide a new research direction for the non-invasive diagnosis of bladder outlet obstruction.
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Background and purpose:The previous research has found that the prostate stromal cells derived from different prostate zones have distinct effect on prostate epithelial cells. We also revealed that LMO2 protein was highly expressed in PZ stromal cells (PZSCs) and prostate cancer associated fibroblasts (CAFs) compared with TZ stromal cells. This study investigated the effect of LMO2 protein in prostate stromal cells on proliferation and invasion of prostate cancer PC-3 cells and its mechanisms. Methods:Lentivirus overexpression vectors were used to establish LMO2-overexpressed prostate WPMY-1 stromal cell line. shRNA plasmids were used to suppress LMO2 in CAFs. LMO2 mRNA and protein level of both WPMY-1 and CAFs were evaluated by real-time fluorescent quantitative polymerase chain reaction (RTFQ-PCR) and Western blot. Then, PC-3 cells were co-cultured with different prostate stromal cells and the in vitro proliferation and invasion of PC-3 were measured by CCK-8 and matrigel invasion assays respectively. Results:When co-cultured with LMO2-overexpressed prostate stromal cells, both proliferation and in-vasion of PC-3 were improved. However, when co-cultured with CAFs which have inhibited expression of LMO2, the proliferation and invasion of PC-3 were reduced. The protein array proifling found that both interleukin-11 (IL-11) and ifbroblast growth factor-9 (FGF-9) were enhanced extensively in the supernatant collected from LMO2-overexpressed WPMY-1 cells. Conclusion:The expression of LMO2 in prostate stromal cells could be responsible for development of prostate cancer. Paracrine of cytokines, such as IL-11 and FGF-9, from LMO2-overexpressed stromal cells had effects on the proliferation and invasion of prostate cancer cells.
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Objective To explore the effects of second biopsy and resection on tumor recurrence and progression in patients with high risk non-muscle invasive bladder cancer. Methods The second biopsy and resections were performed 4-6 weeks after the first transurethral resection in 52 patients. Routine follow-up was done in another 71 patients. The tumor recurrence and progression rates were compared. Results Residual tumors were found in 54%(28/52) of patients underwent second biop-sy and resection, including muscle-invasive tumors in 5 patients. Two patients underwent radical cys-tectomy due to resection findings. During same period, 71 patients were routinely followed. After a median observation of 27 months, patients underwent second biopsy and resection showed lower recur-rence rate (P<0.05). The progression rate was no difference between the 2 groups(P0.05). Conclusion Second biopsy and resection may reduce recurrence rate in high risk non-muscle invasive bladder cancers, but may not change the tumor progression rate.
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Objective To compare the long-term outcomes in patients with newly diagnosed stage T1G3 bladder cancer treated with bladder preserving approach and intravesical instillation or im-mediate cystectomy.Methods of 113 patients with a median age of 64 years (range 27 to 88) diag-nosed with T1G3 bladder cancer from January 1993 to February 2007,81 cases were treated by tran-sureteral resection with additional intravesieal instillation and 32 were treated with immediate cystecto-my.Differences between the 2 groups in 5-year overall survival and tumor specific survival were calcu-lated using the Kaplan-Meier survival function and analyzed by the log rank test.Results of 81 pa-tients treated with organ preserving approach and postoperative intravesical instillation,53 patients developed local recurrence and 21 patients underwent deferred cysteetomy in a median 64 (range 6-140) months follow-up.The overall and tumor specific survival at 5 years was 64.2% (52/81) and 77.8%(63/81),and in those who had deferred cystectomy it was 61.9% (13/21) and 76.2% (16/21),respectively.Of the 32 patients treated with immediate cystectomy,the 5-year overall and tumor specific survival was 59.4%(19/32) and 75.0%(24/32) within a median follow-up of 62(range 4-141)months.There was no statistical difference of the 5-year overall and tumor specific survival be-tween patients treated with bladder preserving approach or immediate cystectomy.Conclusion Blad-der preserving approach and immediate eystectomy might have similar 5-year overall and tumor specific survival for primary T1G3 bladder cancers.
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Objective To explore the effects of ureteral stent on renal pelvic pressure and other urodynamic parameters. Methods Forty-one patients, 28 males and 13 females, with unilateral renal calculi and/or ureteral calculi were recruited in this study. The mean patient age was 47 years old (ranging from 20 to 72 years old). All cases were placed a 4.7 F ureteral stent and 16 F nephrostomy tube after minimal invasive pereutaneona nephrolithotomy (MPCNL). There was no hydronephrosis and residual crushed stone in the ureter after MPCNL in all cases. Renal pelvic pressure, intra-abdo minal pressure, detrusor pressure, bladder pressure changes during the filling and voiding phases with intravesical perfusion flow rate of 40 ml/min were recorded and analyzed. Results At the baseline, IPP0, IAP0, DP0 and BP0 were (33.1±17.0)cm H2O, (27.5±7.0)cm H2O, (3.3±2.9)cm H2O and (30. 9±7.2)cm H2O, respectively; At the maximum cystometric capacity during the filling phase, IPPvol, IAPvol Dpvol and Bpvol were (39.4±67. 3)cm H2O, (31.1±7.3)cm H2O, (10.7±6. 6) cm H2O and (41.6±10.3)cm H2O, respectively; At the maximum bladder pressure during the voiding phase, IPPmax, IAPmax Dpmax and Bpmax were (65.7±17.0)cm H2O, (33.7±9. 7)cm H2O, (41.9±7.8)cm H2O and (75.0±12. 8)cm H2O, respectively;There were statistical significance comparing between any of IPP0, IPPvol and IPPmax(P<0. 01). 27% (11/41)patients were with the pain in kidney area at voiding IPPmax (87.1±14.6) cm H2O, which was significantly higher than IPPmax (57.8±9.5)cm H2O of asyrnptomatic group (30 patients)(P<0. 01). In all cases, the renal pelvic pressure was higher than 40 cm H2O during the voiding phase. Conclusions Renal pelvic pressure increases during the filling phase after placing the ureteral stent, especially during the voiding phase. As renal function will be damaged by the high renal pelvic pressure, we should decrease the utilization of ureteral stent if possible. It is encouraged to remove the ureteral stent as early as possible.