Résumé
Objective To investigate the nuclear expression of CXC chemokine receptor 4 (CXCR4) in renal cancer, and analyze its relation with renal cancer metastasis and prognosis. Methods A total of 413 patients with renal cancer who were treated in our urologic center from Mar. 2011 to Nov. 2012 were included in the present study. The subcellular expression of CXCR4 was examined by immunofluorescence staining; the correlation between CXCR4 nuclear location and clinical features, prognosis was analyzed. Results We found that 170 of the 413 renal cancer patients were CXCR4 nuclear staining-positive (group A), and the rest 243 cases were CXCR4 nuclear staining-negative (group B); the two groups had matchable baseline data. Compared with group B, group A had significantly higher Robson stage (P <0.01), more frequent cancer embolus (P <0.01), more frequent lymphatic metastasis (P <0.01), and more frequent distant metastasis (P <0.01). The overall survival rate of group A (86.5%, 147/170) was significantly lower than that of group B (97.1%, 236/243; P <0.001). Conclusion Nuclear expression of CXCR4 in renal cancer tissues is associated with higher Robson stage, more frequent cancer embolus, more frequent lymphatic metastasis, more frequent distant metastasis and poor prognosis.
Résumé
Objective To compare the therapeutic outcomes of standard laparoscopic and laparoendoscopic single-site (LESS) nephrectomy for benign nonfunctioning kidney. Methods From September 2009 to August 2013, a single urologist group in our center performed 72 transperitoneal laparoscopic nephrectomies for benign nonfunctioning kidney, with 50 undergoing LESS (group A) and 22 undergoing standard laparoscopic surgery (group B). The clinical data of the two groups were analyzed and the therapeutic outcomes were compared between the two groups. Results The operation was successfully performed in all cases, with no conversion to open surgery. Compared with standard laparoscopic group, the LESS group had significantly lower postoperative pain score (4.3 ± 1.0 vs 3.7 ± 0.8, P = 0.015), quicker bowel function recovery ([58.1 ± 16.1] hvs [49.2 ± 14.0] h, P = 0.032) shorter drainage duration ([3.9 ± 1.5] dvs [2.8 ± 1.1] d, P = 0.003), shorter post-operative hospital stay ([7.3 ± 3.1] d vs [6.3 ± 3.4] d, P = 0.048), and a better cosmetic satisfaction score (7.4 ± 0.9 vs 8.0 ± 0.6, P = 0.001). The operative time and intraoperation blood loss were not significantly different between the two groups. Conclusion Compared to standard laparoscopic nephrectomy, transumbilical LESS nephrectomy offers a quicker recovery of bowel function, shorter drainage duration, a better postoperative pain control, and a better cosmetic satisfaction for benign nonfunctioning kidney, but its long-term therapeutic effect needs to be further verified.