RESUMO
【Objective】 To investigate the feasibility and safety of semiconductor blue laser in the treatment of non-muscle invasive bladder cancer (NMIBC) in the day surgery model. 【Methods】 The clinical data of 22 NMIBC patients (average age 55.8 years and tumor size 1.4 cm) who underwent outpatient screening and accepted blue laser ambulatory surgery in our hospital during Jun.2022 and Sep.2022 were retrospectively analyzed. On the day of admission, transurethral resection of cancer was performed using blue laser en bloc enucleation. On the day of surgery or in the morning of next day, bladder irrigation was stopped, the catheter was removed, and patients were discharged. The baseline data, pre-hospital waiting time, operation time, length of hospital stay, hemoglobin decrease, complications and management, follow-up, medical costs, and patients’ satisfaction rate were recorded. 【Results】 The pre-hospital waiting time was 2 to 7 days, average (4.1±1.3)days. The operation time was 29 to 50 minutes, average (40.8±5.5)minutes. The length of hospital stay was 0.6 to 1.2 days, average (0.9±0.2)days. Hemoglobin decrease was 1 g/L to 8 g/L, average (3.8±1.8)g/L. The catheter was indwelt for 0.5 to 1 day, average (0.7±0.1)day. The medical costs were 13 790 to 16 811 Yuan, average (14 941.5±690.2) Yuan. Patients’ satisfaction rate was 100.0%. Mild intraoperative and postoperative complications occurred in 2 cases. One patient developed symptoms of cystitis which disappeared after 2 days of oral antibiotic cefixime, and another patient developed bladder spasm which was relieved after oral solifenacin succinate tablets. No adverse events such as obturator nerve reflex or bladder perforation occurred. After removal of the catheter, no urinary retention was observed. 【Conclusion】 This study was the first to apply blue laser ambulatory surgery in the treatment of bladder cancer, confirming that it is a safe, feasible, economical and efficient model for selected patients, which can be promoted in suitable hospitals.
RESUMO
【Objective】 To compare the efficacy and safety of blue laser en bloc enucleation and traditional plasmakinetic electrocautery in the treatment of non-muscle invasive bladder cancer (NMIBC). 【Methods】 A total of 50 NMIBC patients treated in our hospital during Oct.2018 and Dec.2019 were enrolled. A randomized, incomplete blinding, parallel control design and non-inferior test method was adopted. The control group (electrocautery group) used plasmakinetic electrocautery for transurethral resection, and the experimental group (blue laser group) used semiconductor blue laser for transurethral en bloc enucleation. The effective resection rate, operation time, postoperative catheter indwelling time, length of hospital stay, perioperative hemoglobin changes and obturator nerve reflex were compared. 【Results】 There were 24 patients in the blue laser group and 26 in the electrocautery group. The effective dissection rate and hemostasis rate in both groups reached 100%. The blue laser group had slightly longer operation time than the electrocautery group (55 min vs.42 min, P=0.009), but lesser hemoglobin decrease (5.7 g/L vs. 10.4 g/L, P=0.007). There were no significant differences in urinary catheter indwelling time, length of hospital stay and reoperation rate between the two groups. The electrocautery group had 3 cases of obturator nerve reflex, while the blue laser group had none. 【Conclusion】 Compared with the traditional electrocautery, blue laser has good vaporization cutting and coagulation hemostatic effects on bladder tumor tissue, and can completely enucleate tumors in a front-firing model with less bleeding and no obturator nerve reflex, which can be used as a new, efficient, safe and easy-to-learn method for NMIBC surgery. However, its effects on postoperative recurrence rate and progression rate still need further studies.
RESUMO
【Objective】 To investigate the expression of Kinesin family member 14 (KIF14), and its correlation with clinical prognosis and immune cell infiltration of clear cell renal cell carcinoma (ccRCC). 【Methods】 The correlation between KIF14 expression in ccRCC and different clinicopathological features were analyzed with TCGA, GEO and Ualcan databases. The correlation between KIF14 expression and prognosis was analzyed with Kaplan-Meier method. The correlation between KIF14 expression and immune cell infiltration was analzyed with TIMER. The protein-protein interaction network of KIF14 was conducted with Genemania. The co-expression genes of KIF14 in TCGA-KIRC were picked out in Linkedomics database and were used to perform GO annotations and KEGG pathway enrichment analysis with R software. The biological functions of KIF14 were verified with in vitro functional assay. 【Results】 KIF14 was highly expressed in ccRCC tissue and was positively correlated with clinical stage, pathological grade, and lymphatic metastasis, but negatively correlated with clinical prognosis. KIF14 expression was an independent risk factor for overall survival of ccRCC patients. GO annotations showed that KIF14 was involved in DNA replication, nuclear division, organelle fission, and cell adhesion. KEGG pathway enrichment analysis showed that KIF14 participated in cell cycle and p53 signaling pathway. Genemania analysis indicated KIF14 interacted with CENPE, CIT, KIF23, and other proteins. Timer showed that KIF14 was positively correlated with immune cell infiltration. Knockdown of KIF14 expression suppressed cell proliferation, migration, and invasion of ccRCC. 【Conclusions】 KIF14 may serve as a novel prognostic marker and a potential therapeutic target of clear cell renal cell carcinoma.
RESUMO
Objective The objective of this study was to investigate the expression of microtubule associated protein 1A (MAP1A)in bladder cancer and its correlation with clinicopathological features. Methods One hundred and thirty seven cases of bladder cancer and adjacent tissues were collected. qRT -PCR and immunohistochemistry were used to analyze the expression of MAP1A in bladder cancer and adjacent tissues. The relationship between the expression of MAP1A and clinicopathological parameters& prognosis of bladder cancer patients was studied. Results The results of qRT-PCR showed that the expression level of MAP1A in 20 cases of bladder cancer was significantly lower than that of the matched adjacent tissues(t=5. 022,P<0. 001). The results of im-munohistochemistry also showed that the positive expression rates of MAP1A in bladder cancer and adjacent tissues were 46. 71% (46/37)and 79. 56% (109/137),respectively,and the difference was statistically significant(χ2 =23. 52,P<0. 0001). The expres-sion of MAP1A was closely related to clinical T stage,lymph node metastasis and TNM stage(χ2 =9. 982,P=0. 0016;χ2 =8. 064,P=0. 0045;χ2 =7. 199,P<0. 0073). Kaplan-Meier survival analysis showed that the overall survival(OS)and disease-free survival (DFS)of patients with low expression of MAP1A were significantly shorter than those with high expression of MAP1A(χ2 =26. 74,P<0. 0001;χ2 =18. 73,P<0. 0001). Cox multivariate regression analysis showed that TNM stage(HR=1. 46,P=0. 038)and MAP1A expression(HR=1. 213,P =0. 030) were independent risk factors for adverse prognosis of bladder cancer patients. Conclusion MAP1A is significantly down-regulated in bladder cancer tissues and is closely related to clinical TNM staging. The low expression of MAP1A may indicate the poor prognosis of bladder cancer patients.
RESUMO
Objective To investigate the risk factors for castrate-resistant prostate cancer (CRPC) after prostate cancer treated with androgen deprivation therapy (ADT) within 1 year.Methods One hundred and thirty-one prostate cancer patients treated with ADT in our institute between Jan.2008 and Jan.2011 were selected for this study.Patients were followed up by telephone or in clinic,including serum testosterone,serum PSA,clinical symptoms,imaging studies,digital rectal examination (DRE),survival data,PSA nadir,time to PSA nadir and et al.We mainly studied the CRPC after prostate cancer treated with ADT within 1 year.In the 131 patients,the median age was 70 (ranged from 44-89) years.There were 13 patients (9.9％) less than 60 years,43 patients (32.8％) between 60 and 69 years,62 patients (47.3％) between 70 and 79 years,13 patients (9.9％) more than 80 years.The average body mass index (BMI) was 23.0 (ranged from 14.4-34.4) kg/m2.There were 10 patients less than 18.5 kg/m2,77 patients between 18.5 and 24.0 kg/m2,34 patients between 24.1 and 28.0 kg/m2,and 10 patients more than 28.0 kg/m2.The initial PSA was between 0.3 and 4 707.0 μg/L,there were 19 patients (14.5％) less than 20 μg/L,45 patients (34.4％) between 20 and 99 μg/L,67 patients (51.1％) more than 100 μg/L.One patient (0.7％) was in T1,39 patients (29.8％) in T2,59 patients (45.0％) in T3,32 patients (24.4％) in T4.5 patients (3.8％) were with Gleason score 4,13 patients (9.9％) were with Gleason score 5,24 patients (18.3％) were with Gleason score 6,51 patients (38.9％) were with Gleason score 7,26 patients (19.8％) were with Gleason score 8,9 patients (6.9％) were with Gleason score 9,3 patients (2.3％) were with Gleason score 10.Results There were 32 of 131 patients (24.4％) progressed to CRPC after treated with ADT within 1 year.In the CRPC group,there were 3 patients less than 60 years,15 patients between 60 and 69 years,12 patients between 70 and 79 years,2 patients more than 79 years; 3 patients were less than 18.5 kg/m2,19 patients were between 18.5 and 24.0 kg/m2,7 patients were between 24.0 and 28.0 kg/m2,3 patients were more than 28.0 kg/m2 ; 4 patients were less than 20 μg/L,6 patients were between 20 and 100 μg/L,22 patients were more than 100 μg/L; 4 patients were in T2,13 patients were in T3,15 patients were in T4; 2 patients were with Gleason score 6,11 patients were with Gleason score 7,11 patients were with Gleason score 8,6 patients were with Gleason score 9,2 patients were with Gleason score 10; 29 patients were with metastasis,3 patients without metastasis.Clinical stage (P =0.001),Gleason score (P＜0.001) and metastasis (P=0.011) were statistically significant between the CRPC within 1 year group and the rest group.Conclusions The clinical stage and Gleason score are the risk factors of CRPC treated with ADT within 1 year.The higher of the clinical stage and Gleason score,the greater risk to be the CRPC within 1 year.
RESUMO
ObjectiveTo investigate the histological features, clinical presentation, treatment and prognosis of small cell carcinoma of the prostate.MethodsThe clinical, pathological and follow-up data of two cases of small cell carcinoma of the prostate were respectively analyzed, and the related literature was reviewed.ResultsTwo cases of small cell carcinoma were diagnosed by transtectal prostate biopsy. Microscopically, the tumor arranged in nest structures and exhibited small round cells with the nuclei extremely hyperchromatic and scanty. Coagulated necrosis was easily observed. The immunohistochemical testing was positive for NSE and negative for PSA 、PAP. Case 1 received palliative surgery and postoperative chemotherapy of EP (VP-16, Cisplatin), and died of recurrence and distant metastasis after six months. Case 2 received palliative surgery and oral bicalutamide treatment, and died of recurrence and liver metastasis after three months.ConclusionsSmall cell carcinoma of the prostate has the biological behavior of invasive growth with an unfavorable prognosis, which is often in an advanced stage at first diagnosis. The ultimate diagnosis depends on histopathology and surgery combined with systemic chemotherapy and radiotherapy is the most effective treatment.
RESUMO
Objective To investigate the expression o f telomerase activity in pheochromacytoma and to assess its utility as a prognos tic marker. Methods Telomerase activity was estimated in 23 samples of pheohromocytoma tissue and 6 samples of normal adrenal medullae by autoradiography-based telomeric repeat amplification protocol. The reaults w ere analized with follow-up findings. Results Of the 2 3 pheochromocytoma samples, 2 had telomerase activity and both the telomerase-p ositive pheochromocytomas apparently arose from extraadrenal tissues. All normal adrenal medullae samples were negative for telomerase activity. During follow- up, we found both of the telomerase positive patients developed mutiple metastat ic lesions after surgery. Only one of 21 telomerase negative patients clinically developed bilateral lung metastases and a local recurrence after surgery. Conclusions Telomerase activity may be used as an important i ndicator of potentially malignant pheochromocytoma and may serve as a prognosti c marker.