Application of DNA-image cytometry in the diagnose of urothelial cell carcinomas / 实用医学杂志

Objective To investigate the value of DNA-image cyt-ometry (DNA-ICM) in the diagnosis of urothelial cell carcinomas (UCC). Methods Totally 162 voided urine specimens (92 cases from urothel-ial car-cinomas patients and 70 cases from benign urinary system diseases patients ) were detected with DNA-ICM and liquid-based cytology (LBC), respectively. Results The sensitivity and specificity of DNA-ICM were 65.2%and 100% respectively in the diagnosis of UCC but those of LBC were 27.2% and 98.6%, respectively. The sensitivity of DNA-ICM was significantly higher than that of LBC in the diagnosis of UCC (P 0.01). Conclusion DNA-ICM, which improves the positive rate of urinary cytology, has great application value in the diagnosis of urothelial cell carcinomas and it is an effective screening method for urothelial cancer in diag-nosis and follow-up.

Leukemoid Reaction, a Rare Paraneoplastic Syndrome in Urothelial Cell Carcinoma: Is It an Indicator of a Poor Prognosis?

A leukemoid reaction is usually associated with malignancies of the lung, stomach, and thyroid. In contrast, urothelial cell carcinoma is rarely associated with leukemoid reactions, with few cases reported over the past 30 years. Here, we describe a patient with urothelial cell carcinoma who exhibited a leukemoid reaction. The patient had an elevated white blood cell count and experienced a rapid and aggressive clinical course, terminating in death. For urothelial cell carcinoma patients exhibiting a leukemoid reaction, removal of the inciting tumor is the definitive treatment. However, considering the aggressive nature of these tumors, if the patient is unsuitable for radical surgical management, palliative chemotherapy should be considered.

Effect of Overexpression of Glucose-Regulated Protein 78 and Bcl-2 on Recurrence and Survival in Patients With Ureter Tumors

PURPOSE: The utility of the expression of glucose-regulated protein 78 (GRP78) in the evaluation of prognosis depends on the type of tumor. Hence, we aimed to examine the impact of expression of GRP78 and Bcl-2, which are used in the existing prognostic evaluation of ureter tumors, in the evaluation of recurrence and survival rates of ureter tumors. MATERIALS AND METHODS: In 53 patients who had undergone radical nephroureterectomy for a ureter tumor from March 2002 to March 2012, age, sex, T stage, nuclear grade, bladder recurrence, and survival rate were analyzed at the time of the patient's surgery depending on the extent of immunohistochemical expression of GRP78 and Bcl-2. RESULTS: GRP78 was overexpressed in 25 patients (47.2%). When GRP78 was overexpressed, there was a high T stage (p=0.001) and nuclear grade (p=0.007) and a lot of bladder recurrence (40.0%, p=0.034). Bcl-2 was overexpressed in 16 patients (30.1%), and there were no significant associations with any risk factors (p>0.05, respectively). In the multivariate analysis regarding bladder recurrence, the recurrence rate was higher with higher pT stage (p=0.048) and when GRP78 (p=0.033) was overexpressed. In the Kaplan-Meier survival analysis, although the survival rate was significantly lower in the group in which GRP78 was overexpressed (p=0.03), there was no correlation between Bcl-2 overexpression and survival rate (p=0.07). CONCLUSIONS: Patients with ureter tumors who had overexpression of GRP78 had a high T stage and nuclear grade, a lot of bladder recurrence, and a low survival rate. Therefore, if GRP78 is overexpressed in ureter tumor patients, active postoperative follow-up should be carried out.

Clinical study of Gemcitabine and Cisplatin combination chemotherapy in treatment of 72 cases of patients with urothelial cell carcinoma / 国际外科学杂志

Objective To explore the efficacy and safety of Gemcitabine and Cisplatin combination chemotherapy in treatment of muscle-invasive urothelial cell carcinoma.Methods Analyse of 72 cases of patients with muscle-invasive urothelial cell carcinoma receiving chemotherapy from September 2010 to September 2012,including 47 male and 25 female,the avarage age was 65 (86-33).All patients were received GC chemotherapy (Gemcitabine 800-1 000 mg/m2,ivgtt,dl,d8,d15; Cisplatin 70 mg/m2,ivgtt,d2).Efficacy was reviewed after 1 cycle of chemotherapy.Results Fifty-one cases in all the patients completed two or more chemotherapy cycles and CR 10 cases,PR 27 cases,total effective rate was 51.39％ (37/72).The main toxic reactions included nausea,vomit,myelosuppression,and then damage of liver and renal function.Cconclusion GC regimen is a good choice for urothelial cell carcinoma.Close follow-up and the usage of adjuvant drugs can contribute to reduce the side effect of chemotherapy.

Skeletal Muscle Metastases from Urothelial Cell Carcinoma

Hematogenous metastasis to skeletal muscle from urothelial carcinoma is extremely rare and metastatic disease to skeletal muscle tends to be found in people with advanced-stage neoplasm. We report in this paper a case of left sartorius muscle metastasis from urothelial cell carcinoma. A left nephroureterectomy with bladder cuff excision was performed and revealed a high-grade papillary transitional cell carcinoma (TCC) of the pelvis. And 6 month later, recurrent bladder cancer was found regular cystoscopy and then treated with transurethral resection of the bladder. After 6 times resection of bladder, an invasion into the bladder muscle layer was found. We recommended additional radical cystectomy to prevent the disease from advancing. However, the patient refused additional surgery. 6 month later, the patient complained of left thigh pain, so ultrasonography-guided biopsy of the nodular mass lesion in the left sartorius muscle was performed. The pathological analysis of the biopsy specimen revealed poorly differentiated metastatic urothelial carcinoma.

Evaluation of smoking genotoxicity in Turkish young adults.

BACKGROUND: For the past few decades, it has been widely known in developed countries that tobacco is dangerous, but it is still insufficiently realized how big these dangers really are. AIMS: To determine and evaluate micronuclei (MN) frequencies of young smokers and nonsmokers in three different tissues (peripheric blood lymphoctes, buccal mucosa, and exfoliative urothelial cells) at the same time. MATERIALS AND METHODS: MN assay was performed on buccal mucosa, urothelial cells, and peripheric blood lymphocyte samples obtained from 15 healthy male smokers (>5 pack-years) and 15 healthy male nonsmoker controls who had not been exposed to any known genotoxic agent. STATISTICAL ANALYSIS USED: The statistical differences between smoker and nonsmoker groups were calculated by using student t test. The differences between smoker-group tissues were compared by ANOVA. RESULTS: It was found that MN frequency (mean value ± standard deviation) in oral mucosa cells from smokers and controls were 1.20 ± 0.22% and 0.26 ± 0.10%; in urothelial exfoliative cells, 1.29 ± 0.28% and 0.12 ± 0.08%; in peripheric blood lymphocytes, 1.53 ± 0.23% and 0.38 ± 0.12%, respectively. The mean MN frequencies in buccal mucosa, urothelial exfoliative cells, and peripheric blood lymphocytes were significantly higher in smokers than in those of controls (P<0.05). All tissues were affected from smoking, but the most destructive effect was seen in urothelial cells of smokers (P<0.05). CONCLUSIONS: Our data showed that cigarette smoke is a DNA damage causitive agent on exfoliative buccal mucosa and urothelial cells and peripheric blood lymphocytes of young smokers, but it has most destructive effect on urothelial cells.

Successful reinstitution of peritoneal dialysis after retroperitoneal nephroureterectomy / 대한내과학회지

Peritoneal dialysis is an important therapeutic option for patients with end-stage renal disease, and the peritoneal membrane is the lifeline for peritoneal dialysis patients. Therefore, strategies to maintain the health of the peritoneal membrane are very important. A 64-year-old female who had been undergoing continuous ambulatory peritoneal dialysis (CAPD) for the past 6 years was admitted because of painless gross hematuria. On abdominal computed tomography (CT), a mass was found in her left renal pelvis. A nephroureterectomy was performed via a retroperitoneal approach without any complications. Peritoneal dialysis was resumed 4 hours later. We report peritoneum-preserving nephroureterectomy via a retroperitoneal approach in a patient on CAPD.

Role of Akt in Tumorigenesis and Angiogenesis of MC-SV-HUC T2 Cell Line / 대한해부학회지

Protein Kinase B (PKB/Akt) is a serine/threonine kinase that plays important roles in multiple physiological and pathological processes. Specially, Akt activation induces tumorigenesis in many cancers. However, molecular mechanism related in tumorigenesis is unclear in urothelial cell carcinoma. This study investigated Akt functions in the tumorigenesis and angiogenesis of tumorigenic human urothelial cell line, MC-SV-HUC T2. For this study, stable clonal cells were established by introducing myristrated Akt (Myr-Akt) or dominant-negative Akt (DNAkt) into MC-SV-HUC T2. As for the underlying mechanism, Western blot analysis for Akt and its related proteins and kinase activity assay were used. And BrdU incorporation and immunohistochemistry revealed cell proliferation and angiogenesis. DN-Akt expression decreased in vitro cell growth and proliferation. Akt inactivation decreased the phosphorylation of glycogen synthase kinase 3beta and retinoblastoma proteins and the expression of Cyclin D1 protein as well as cyclin dependent kinase 4 activity. A mouse xenograft model showed that DN-Akt overexpression reduced tumor growth and microvessel formation. Since these findings indicate that Akt is involved in a part of the mechanisms of tumorigenesis and angiogenesis, Akt may be useful as a target molecule for bladder cancer therapy.

Cytological Study on the Effect of Industrial Hygiene affecting Urothelial Cells / 대한비뇨기과학회지

It has been recognized for many years that a proportion of patients with bladder cancer have their tumors caused by past exposure at work to carcinogenic aromatic amines. All patients attending the Department of Urology Yonsei University Hospital with bladder cancer during the period from August, 1981 to July, 1983 are routinely interviewed and full occupational histories are taken. One use of the histories collected has been to identify patients with occupational tumors. This study has designed to provide information regarding the value of cytologic examination of urinary tract specimen in the early detection and mass screening in cases of bladder cancer. Two hundred fifty two patients were subjected to this study. These patients have taken cytologic examinations at the Department of Urology, Yonsei University Hospital during the same period. The series compromised 156 consecutive cases without clinically or histologically verified bladder cancer and 96 consecutive cases of histologically verified transitional cell neoplasms of the bladder. Following results were obtained according to the various analyses. 1) There were 75 positive tests from patients with proved cancer(78.1%). 13 false positive cytological diagnoses malignancy were made in the 156 patients without bladder cancer(8.3%). It showed that cytological study is useful in the early detection and mass screening of bladder cancer. 2) The diagnostic accuracy of urinary cytology appears to be related to the quality of cytological preparations and the histological grade of bladder cancer. The frequency of positive findings in cases of grade II(79.6%) was much higher than that of grade I (42.9%). 3) 10.4% of patients gave their histories which suggested relevant occupations with possible exposure to carcinogen.