Value of detection of preoperative urinary soluble Fas expression in predicting the recurrence of non-muscle invasive bladder cancer / 中南大学学报(医学版)

OBJECTIVE@#To investigate the clinical value of detection of preoperative urinary soluble Fas (sFas) expression in predicting the recurrence of non-muscle invasive bladder cancer (NMIBC).
@*METHODS@#We performed a prospective research, which included 128 cases with NMIBC from January 2008 to April 2011. Expression levels of sFas in urine, which was saved at the first morning from preoperative NMIBC patients, were analyzed by ELISA. Clinical and pathological data, European Organization for Research and Treatment of Cancer (EORTC) risk group category, follow-up data and urinary sFas values were collected from each patient, and each prognostic outcome was evaluated by statistical analysis of non-parametric test. Urinary sFas values and recurrence-free probabilities were estimated by the Kaplan-Meier method and compared by the log rank test. Cox proportional hazards regression models were performed to determine the independent predictors of NMIBC recurrence. The prognosis index (PI) was established.
@*RESULTS@#The urinary sFas level was significantly elevated in the NMIBC cases with a higher stage or grade or high-risk EORTC group category than in those with a lower stage or grade or low-risk EORTC group category (each P0.05). Kaplan-Meier analysis revealed a significant increase in incidence of recurrence in the NMIBC patients with high sFas levels in the urine (P<0.001). According to Cox regression analysis, the urinary sFas level and EORTC risk group category (each P<0.05) were the independent predictors of NMIBC recurrence. Based on the outcome of Cox regression, the formula of PI=(0.004×sFas value+1.179×EORTC score) was established.
@*CONCLUSION@#Our study indicates that urinary sFas test may help to identify NMIBC patients at risk of tumor recurrence and it deserves further research.

Primary ureteral cancer (report of 36 cases) / 中华泌尿外科杂志

Objective To improve the diagnosis and treatment of primary ureteral cancer. Methods Thirty-six cases of primary ureteral cancer ascertained by pathological studies were reviewed.There were 22 men and 14 women with the mean age of 63 years.All patients underwent operation. Results Thirty-four cases (94%) were followed up for 6 to 180 months.Among them,6 died of metastasis,6 died of other diseases and 22 survived.Local recurrence in ureter or bladder occured in 3 patients 1～5 years after partial ureterectomy. Conclusions Nephroureterectomy and bladder cuff resection is the best treatment for primary carcinoma of ureter.Ureterectomy and bladder cuff resection should be carried out prior to nephrectomy for the lower segment ureteral carcinoma in order to lessen carcinoma cell transplantation in bladder.