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1.
Cancer Gene Ther ; 2024 May 27.
Article in English | MEDLINE | ID: mdl-38802550

ABSTRACT

Bladder cancer (BC) is one of the most common malignancies in the male urinary system and currently lacks an optimal treatment strategy. To elucidate the pathogenic mechanisms of BC from the perspective of circular RNAs, we conducted this study. Building upon our previous research, a novel circRNA, circPKN2, captured our interest due to its significant downregulation in BC, and its close association with the prognosis of BC patients. Our research findings indicate that circPKN2 can inhibit the proliferation and migration of BC cells in vitro. Furthermore, we discovered that circPKN2 exerts its anti-cancer effects in BC by promoting ferroptosis. Mechanistic studies revealed that circPKN2 recruits STUB1 to facilitate the ubiquitination of SCD1, thereby suppressing the WNT pathway and promoting ferroptosis in BC. Additionally, our research unveiled the regulatory role of the splicing factor QKI in the biogenesis of circPKN2. Animal studies demonstrated that circPKN2 enhances ferroptosis in BC cells in vivo, inhibiting tumor growth and metastasis. The discovery of the anti-cancer factor circPKN2 holds promise for providing new therapeutic targets in the prevention and treatment of BC.

4.
Medicina (Kaunas) ; 58(12)2022 Dec 10.
Article in English | MEDLINE | ID: mdl-36557023

ABSTRACT

Background and Objectives: To evaluate the efficacy of bladder-prostatic muscle reconstruction and bladder neck eversion anastomosis in the recovery of urinary continence after robot-assisted radical prostatectomy (RARP). Materials and Methods: From January 2020 to May 2022, 69 patients who underwent RARP in our hospital were recruited. Thirty-seven patients underwent RARP with the Veil of Aphrodite technique (control group). On the basis of the control group, 32 patients underwent bladder-prostatic muscle reconstruction and bladder neck eversion anastomosis during RARP (observation group). The recovery of urinary continence was followed up at 24 h and 1, 4, 12, and 24 weeks after catheter removal. Results: There were no significant differences in operative time (127.76 ± 21.23 min vs. 118.85 ± 24.71 min), blood loss (118.27 ± 16.75 mL vs. 110.77 ± 19.63 mL), rate of leakage (3.13% vs. 2.70%), rate of positive surgical margin (6.25% vs. 10.81%), or postoperative Gleason score [7 (6−8) vs. 7 (7−8)] between the observation group and the control group (p > 0.05). After catheter removal, the rates of urinary continence at 24 h, 1 week, 4 weeks, 12 weeks, and 24 weeks were 46.88%, 68.75%, 84.38%, 90.63%, and 93.75% in the observation group, respectively. Meanwhile, the rates of urinary continence in the control group were 21.62%, 37.84%, 62.16%, 86.49%, and 91.89%, respectively. There was a significant difference between the two groups (p = 0.034), especially at 24 h, 1 week, and 4 weeks after catheter removal (p < 0.05). Conclusions: Bladder-prostatic muscle reconstruction and bladder neck eversion anastomosis were beneficial to the recovery of urinary continence after RARP, especially early urinary continence.


Subject(s)
Prostatic Neoplasms , Robotics , Urinary Incontinence , Male , Humans , Urinary Bladder/surgery , Urinary Incontinence/etiology , Prostatic Neoplasms/surgery , Prostatectomy/adverse effects , Prostatectomy/methods , Anastomosis, Surgical/adverse effects , Muscles , Treatment Outcome
5.
Front Oncol ; 12: 983805, 2022.
Article in English | MEDLINE | ID: mdl-36313635

ABSTRACT

Objective: To explore the feasibility of single-point prostate biopsy in elderly patients with highly suspected prostate cancer. Methods: Forty-three patients with a prostate imaging reporting and data system score (PI-RADS) of 5, age ≥ 80 years and/or PSA ≥ 100 ng/ml and/or Eastern Cooperative Oncology Group score ≥ 2 were enrolled in our hospital from March 2020 to June 2022. Targeted surgery of these patients was performed using only precise local anesthesia in the biopsy area. The biopsy tissues were examined by intraoperative frozen section examination (IFSE). If the result of IFSE was negative, traditional systematic biopsy and further routine pathological examination were performed. The positive rate of biopsy, operation time, complications and pain score were recorded. Results: The positive rate of prostate biopsy was 94.7%. The results of IFSE in two patients were negative, and the routine pathological results of further systematic biopsy of those patients were also negative. The visual analog scale and visual numeric scale were 2 (2-4) and 3 (2-3), respectively, during the biopsy procedure. The mean time of operation was 8.5 ± 2.1 min from the beginning of anesthesia to the end of biopsy. It took 35.3 ± 18.7 minutes to obtain the pathological report of IFSE. The incidences of complication hematuria and urinary retention were 10.5% and 2.6%, respectively. Conclusion: For elderly patients with highly suspected prostate cancer, single-point prostate biopsy can be used to quickly and safely obtain pathological results.

6.
Medicina (Kaunas) ; 58(10)2022 Oct 02.
Article in English | MEDLINE | ID: mdl-36295548

ABSTRACT

Background and Objectives: To compare the oncological and functional outcomes of brachytherapy (BT) and radical prostatectomy (RP) in patients with localized prostate cancer (PCa). Materials and Methods: We retrospectively analyzed data from 557 patients with localized PCa who were treated with BT (n = 245) or RP (n = 312) at Northern Jiangsu People's Hospital between January 2012 and December 2017. Biochemical relapse-free survival (bRFS) and cancer-specific survival (CSS) were compared by treatment modality. Multivariate Cox regression analysis was used to evaluate bRFS. Health-related quality of life (HRQoL) was measured using the Expanded Prostate Cancer Index Composite (EPIC) questionnaire. Results: The BT group was older and had a higher initial PSA (iPSA). The 5-year bRFS was 82.9% in the BT group versus 80.1% in the RP group (p = 0.570). The 5-year CSS was 96.4% in the BT group versus 96.8% in the RP group (p = 0.967). Based on multivariate Cox regression analysis, Gleason score ≥ 8 was the main independent prognostic factor for bRFS. Regarding the HRQoL, compared with the baseline, both treatments produced a significant decrease in different aspects of HRQoL at 3, 6, and 12 months after treatment. Patients in the BT group had lower HRQoL with regard to urinary irritation/obstruction and bowel function or bother, while patients in the RP group had lower HRQoL concerning urinary incontinence and sexual function or bother. There was no significant difference in HRQoL aspects between the two groups after follow-up for 2 years compared with the baseline. Conclusions: BT provides equivalent oncological control outcomes in terms of bRFS and CSS for patients with localized PCa compared with RP. Gleason score ≥ 8 was the main independent prognostic factor for bRFS. BT had better HRQoL compared with RP, except for urinary irritation/obstruction and bowel function or bother, but returned to baseline after 2 years.


Subject(s)
Brachytherapy , Prostatic Neoplasms , Male , Humans , Brachytherapy/adverse effects , Prostate-Specific Antigen , Quality of Life , Retrospective Studies , Prostatectomy , Prostatic Neoplasms/radiotherapy , Prostatic Neoplasms/surgery
7.
Front Surg ; 9: 967525, 2022.
Article in English | MEDLINE | ID: mdl-36157402

ABSTRACT

Background: The calyceal diverticulum is a rare cystic cavity that communicates with the collecting system via a narrow neck or infundibulum. In clinical practice, part of the calyceal diverticula is difficult to differentiate from simple renal cysts even after contrast-enhanced CT. To date, there have been few kinds of literature works on the diagnosis and treatment of calyceal diverticulum combined with renal pelvis dilatation, especially concerning the treatment of prolonged postoperative urine leakage. Case description: A 53-year-old woman with calyceal diverticulum and renal pelvis dilatation mimicking a simple renal cyst suffered urine leakage after receiving laparoscopic unroofing of the renal cyst. A persistent urine leakage was observed immediately after surgery, with about 200 ml of drainage fluid per day. We first attempted to place a double-J ureteral stent and indwell a catheter. After failing that, conservative treatment was performed. The core idea of the conservative treatment is retaining the drainage tube for more than 1 month, then clamping the drainage tube for 1 week, and finally removing the drainage tube. By 3 weeks of follow-up, the urine leakage disappeared, and the CT scan showed hydronephrosis of the right kidney without perirenal exudation and the lower pole cyst of the right kidney shrank significantly. Conclusion: This case, we reported here, is to attract the attention of clinicians. Renal cysts should exclude the possibility of the calyceal diverticulum. If urine leakage is inevitable after surgical treatment, our conservative treatment strategy is also an alternative method.

9.
Int Urol Nephrol ; 53(9): 1765-1771, 2021 Sep.
Article in English | MEDLINE | ID: mdl-34047898

ABSTRACT

OBJECTIVE: The present study aims to assess the relationship between red blood cell distribution width (RDW) and clinically significant prostate cancer (csPCa). METHODS: A total of 458 patients with prostate-specific antigen (PSA) ≤ 10 ng/ml, who subsequently underwent 11-core transperineal template-guided prostate biopsy from June 15, 2015 to November 24, 2020, were included in the present study. Receiver-operating characteristic (ROC)-derived area under the curve analysis was performed to evaluate the predictive accuracy. In addition, univariate and multivariate logistic regression analysis was carried out to determine the association between RDW and csPCa detection. RESULTS: A total of 89 patients were diagnosed with csPCa, and these patients presented with higher median RDW. The optimal RDW cut-off was set at 12.35%, which gained the maximal Yuden's index. In addition to csPCa, RDW demonstrated a positive correlation with age (r = 0.210, P < 0.001). It was observed that RDW was independent of prostate-specific antigen density for csPCa detection. Compared with the low-RDW group, patients in the high-RDW group had a 1.586-fold increased risk of being diagnosed with csPCa (OR = 2.586, P = 0.007). In the ROC analysis, the accuracy level increased by 3.1% for the prediction of csPCa, when RDW was added to the multivariate logistic model. CONCLUSION: A high-RDW value is an independent risk factor for csPCa detection. However, more large-scale studies are needed to confirm these findings. If validated, RDW can become an inexpensive, non-invasive, and convenient indicator for csPCa prediction.


Subject(s)
Erythrocyte Indices , Prostate/pathology , Prostatic Neoplasms/blood , Prostatic Neoplasms/pathology , Aged , Biopsy , Humans , Male , Middle Aged , Predictive Value of Tests , Retrospective Studies
10.
World J Urol ; 39(7): 2463-2467, 2021 Jul.
Article in English | MEDLINE | ID: mdl-32949254

ABSTRACT

BACKGROUND: To investigate the influence factors of infection complications of transrectal ultrasound-guided transperineal prostate biopsy. METHODS: A total of 2192 patients who underwent prostate biopsy under transperineal prostate biopsy were analyzed retrospectively from December 2010 to May 2020.We collected the clinical characteristics and the incidence of complications, and used univariate and multivariate logistic regression analyses to analyze independent risk factors for infection complications after transperineal prostate biopsy. RESULTS: Univariate analysis showed that the following factors were associated with the infection complications: diabetes, bacterial prostatitis, history of urinary retention, history of urinary infection, and number of cores. Furthermore, multivariate logistic analysis revealed that diabetes (OR 2.037, 95% CI 1.143-3.572, P = 0.021) and history of urinary retention (OR 2.563, 95% CI 1.284-3.901, P = 0.013) were independent risk factors for infection complications after transperineal prostate biopsy. CONCLUSIONS: Patients with diabetes and history of urinary retention were more likely to have infection complications after transperineal prostate biopsy.


Subject(s)
Bacterial Infections/epidemiology , Bacterial Infections/etiology , Image-Guided Biopsy/adverse effects , Postoperative Complications/epidemiology , Postoperative Complications/etiology , Prostate/pathology , Ultrasonography, Interventional/adverse effects , Aged , Humans , Male , Middle Aged , Perineum , Retrospective Studies , Risk Factors
11.
Urol Int ; 105(5-6): 370-379, 2021.
Article in English | MEDLINE | ID: mdl-33302278

ABSTRACT

BACKGROUND: It has been reported that compared with no local therapy (NLT), patients treated with local therapy (LT) using radiotherapy (RT) possess higher survival rate in metastatic prostate cancer (mPCa). The aim of this meta-analysis was to evaluate the impact of RT on prognosis in patients with mPCa. METHODS: We retrieved the literature in PubMed, Embase, and Cochrane Library databases until June 2019 using structured search terms. Several studies were included, which evaluated patients with mPCa who received RT versus NLT. RESULTS: A total of 14,542 patients were analyzed in 7 included papers (2 randomized controlled trials [RCTs] and 5 cohort retrospective studies [CRS]), and 2,232 mPCa patients were treated with RT and 12,310 with NLT. The data of RCTs and CRS were analyzed separately. In RCTs, RT was associated with no significant difference in overall survival (OS) (pooled hazard ratio [HR] = 0.96; 95% confidence interval [CI]: 0.85-1.09; p = 0.55; I2 = 42%) relative to NLT, while survival benefit was observed in the low-metastatic burden group (pooled HR = 0.68; 95% CI: 0.54-0.86; p = 0.001; I2 = 0%), and no survival benefit was observed in the high-metastatic burden group (pooled HR = 1.07; 95% CI: 0.92-1.24; p = 0.39; I2 = 0%). In CRS, RT results in lower cancer-specific mortality (CSM) (pooled HR = 0.49; 95% CI: 0.34-0.75; p < 0.00001; I2 = 0%) and higher OS (pooled HR = 0.61; 95% CI: 0.55-0.68; p < 0.00001; I2 = 0%) relative to NLT. Subsequent analysis demonstrated that high level of M-stage or N-stage was associated with increased CSM (pooled HR = 2.08; 95% CI: 1.69-2.55; p < 0.00001; I2 = 0% and pooled HR = 1.16; 95% CI: 1.03-1.30; p < 0.00001; I2 = 0%; respectively). CONCLUSIONS: Our observations in aggregate indicated that RT at least does not appear to be harmful and may be beneficial for low-metastatic burden patients and better condition patients. More prospective and randomized studies evaluating RT for mPCa are warranted.


Subject(s)
Prostatic Neoplasms/mortality , Prostatic Neoplasms/radiotherapy , Humans , Male , Neoplasm Metastasis , Prognosis , Prostatic Neoplasms/pathology , Survival Rate
12.
Ann Palliat Med ; 9(4): 1708-1717, 2020 Jul.
Article in English | MEDLINE | ID: mdl-32527134

ABSTRACT

BACKGROUND: Emerging data suggest that in patients with low prostate-specific antigen (PSA) and high Gleason score, prostate cancer (PCa) is more aggressive and more likely to be related to genomic characteristics of neuroendocrinology. However, the evidence for the advantages of local treatment (LT) for these men is lacking. Hence, we investigated survival in men with low-PSA values and high-grade (Gleason score 8-10) PCa according to the treatment of the primary tumor. METHODS: Kaplan-Meier survival analysis was applied to analyze the effects on overall survival (OS) and cancer-specific survival (CSS) according to the different treatments of the primary tumor. Multivariable Cox proportional hazards survival regression analysis calculated the CSS after propensity score matching (PSM) in 2 cohorts according to treatment type. The treatment types included the following: (I) LT versus non-LT (NLT) and (II) radical prostatectomy (RP) versus radiotherapy (RT). RESULTS: In the Surveillance, Epidemiology, and End Results (SEER) database [2004-2014], we identified 14,208 patients newly diagnosed with low PSA values (10 ng/mL or less), with a Gleason score 8-10, and cT1-4N0M0 prostate adenocarcinoma. After the first PSM, of the 3,512 PCa patients, 1,576 underwent LT and 1,576 underwent NLT. After the second PSM, of the 792 PCa patients, 396 underwent RP, and 396 underwent RT. The 5- and 10-year OS rates for LT vs. NLT patients were 90% and 73% versus 69% and 39%, respectively, while the 5- and 10-year CSS rates for LT vs. NLT patients were 98% and 94% versus 89% and 79%, respectively. Subsequent multivariate survival analysis showed that LT was associated with lower likelihood of PCa mortality relative to NLT [hazard ratio (HR), 0.19; 95% confidence interval (CI), 0.14-0.26, P<0.001], also in RP versus RT (HR, 0.26; 95% CI, 0.12-0.54, P<0.001). CONCLUSIONS: In patients with low PSA values, Gleason score 8-10, and localized PCa, LT resulted in higher survival compared with NLT. Within LT, RP provided the most benefit relative to RT.


Subject(s)
Prostate-Specific Antigen , Prostatic Neoplasms , Humans , Male , Neoplasm Grading , Propensity Score , Prostatectomy , Prostatic Neoplasms/therapy
13.
BMC Urol ; 19(1): 63, 2019 Jul 09.
Article in English | MEDLINE | ID: mdl-31288778

ABSTRACT

BACKGROUND: To evaluate the efficacy of pelvic plexus block (PPB) in relief pain during transperineal template-guided prostate biopsy (TTPB), compared with conventional periprostatic nerve block (PNB). METHODS: From July 2016 to August 2017, 245 patients who were performed TTPB in Clinical Medical College of Yangzhou University were recruited. The patients were randomized into three groups using a random number table. Group-1 received prostate capsule local anesthesia with 22 ml of 1% lidocaine. Group-2 additionally received PNB on the basis of Group-1. To perform PNB, 5 ml 1% lidocaine was injected into the region of prostatic neurovascular bundle situated in the angle of prostate-bladder-seminal vesicle. Group-3 received prostate capsule local anesthesia plus PPB (5 ml of 1% lidocaine injection into the pelvic plexus which located on lateral to the bilateral seminal vesicle apex). The patients' pain and satisfaction were evaluated by visual analogue scale and visual numerical scale, respectively. RESULTS: The age, total prostate volume, PSA and the number of cores were comparable among the three groups. The visual analog scale scores of group-3 were significantly lower than group-2 during biopsy (P = 0.003). Conversely, the visual numeric scale scores were higher in group-3 (P = 0.039). Both the group-2 and group-3 outperformed the group-1 in alleviating pain and had a higher quantification of satisfaction. There were no significant differences in the pain scores or the satisfaction scores at 30 min after the procedure among the three groups. CONCLUSIONS: The analgesic efficacy of PPB guided by Doppler ultrasound in TTPB was better than that of PNB and both were superior to no nerve block. TRIAL REGISTRATION: ChiCTR-IOR-17013533 , 01/06/2016.


Subject(s)
Anesthesia/methods , Autonomic Nerve Block/methods , Hypogastric Plexus/diagnostic imaging , Prostatic Neoplasms/diagnostic imaging , Aged , Biopsy/methods , Humans , Hypogastric Plexus/drug effects , Male , Middle Aged , Pain/prevention & control , Pain Measurement/methods , Prospective Studies , Prostate/diagnostic imaging , Prostate/pathology , Prostatic Neoplasms/pathology , Ultrasonography, Interventional/methods
14.
Int J Urol ; 26(2): 278-283, 2019 02.
Article in English | MEDLINE | ID: mdl-30515888

ABSTRACT

OBJECTIVE: To evaluate the clinical significance of permanent 125 I prostate brachytherapy in patients with castration-resistant prostate cancer. METHODS: A retrospective study of 45 patients with castration-resistant prostate cancer from the Clinical Medical College, Yangzhou University, Yangzhou, Jiangsu, China was carried out. Patients were divided into two groups according to different treatments: 21 patients received endocrine therapy alone (control group), and 24 patients underwent brachytherapy combined with endocrine therapy (treatment group). Prostate-specific antigen progression-free survival, cancer-specific survival, overall survival and quality of life of the two groups were compared. RESULTS: The median prostate-specific antigen progression-free survival and cancer-specific survival of the treatment group were 29 months (interquartile range 25-37 months) and 37 months (interquartile range 30-50 months), respectively. These were significantly longer than those of the control group (both P < 0.05). Prostate-specific antigen (before androgen deprivation therapy and before brachytherapy), prostate volume, Gleason score, clinical stage and brachytherapy were associated with prostate-specific antigen progression-free survival and cancer-specific survival on univariate analysis. For the quality of life after treatment, urinary symptoms/problems at 1 month after brachytherapy compared with the control group had a statistically significant difference and clinically relevant deterioration, but after 6 months there were no statistically significant differences and clinically relevant deterioration. Compared with the control group, the physical functioning, social functioning, global health and general physical discomfort of the treatment group were significantly improved. CONCLUSIONS: Brachytherapy with 125 I seed implantation can effectively prolong survival of patients with castration-resistant prostate cancer and, to a certain extent, improve patients' quality of life.


Subject(s)
Androgen Antagonists/therapeutic use , Antineoplastic Agents, Hormonal/therapeutic use , Brachytherapy/methods , Iodine Radioisotopes/therapeutic use , Prostatic Neoplasms, Castration-Resistant/therapy , Aged , Aged, 80 and over , Combined Modality Therapy/methods , Disease Progression , Humans , Male , Middle Aged , Neoplasm Grading , Progression-Free Survival , Prostate/pathology , Prostate/radiation effects , Prostate-Specific Antigen/blood , Prostatic Neoplasms, Castration-Resistant/blood , Prostatic Neoplasms, Castration-Resistant/mortality , Prostatic Neoplasms, Castration-Resistant/pathology , Quality of Life , Retrospective Studies
15.
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue ; 30(10): 925-928, 2018 Oct.
Article in Chinese | MEDLINE | ID: mdl-30439309

ABSTRACT

OBJECTIVE: To explore the predictive value of plasma cell-free DNA (cf-DNA) for prognosis in patients with sepsis. METHODS: 105 patients with sepsis admitted to department of emergency of the First Hospital of Quanzhou Affiliated to Fujian Medical University from June 2015 to June 2017 were enrolled. Patients were divided into sepsis group (n = 50) and severe sepsis group (n = 55). At the same time, 50 cases of physical examination center in our hospital were randomly selected as the healthy control group. The differences of cf-DNA, procalcitonin (PCT) and acute physiology and chronic health evaluation II (APACHE II) score among the three groups were compared. The correlation between cf-DNA and PCT or APACHE II were analyzed by Bivarite method. Logistic regression was used to analyze the independent predictors of sepsis. The receiver operating characteristic curve (ROC) was made to evaluate cf-DNA, PCT, APACHE II alone or combined ability to predict the prognosis of sepsis. RESULTS: The PCT, APACHE II and cf-DNA in the sepsis group and severe sepsis group were significantly higher than those in the healthy control group [PCT (µg/L): 5.80 (3.28, 8.85), 17.53 (8.40, 29.61) vs. 0.02 (0.01, 0.03); APACHE II: 13.04±3.03, 23.29±8.02 vs. 2.10±1.05; cf-DNA (µg/L): 1 438.0 (1 154.0, 1 576.0), 2 595.0 (2 162.0, 5 198.0) vs. 17.0 (13.0, 20.5); all P < 0.05], and the indicators in the severe sepsis group were further higher than the sepsis group (all P < 0.05). Correlation analysis showed that cf-DNA was significantly positive correlated with PCT [r = 0.675, 95% confidence interval (95%CI) = 0.575-0.766, P < 0.001] and APACHE II (r = 0.911, 95%CI = 0.874-0.939, P < 0.001). ROC curve analysis showed that the areas under ROC curve (AUC) of PCT, APACHE II, cf-DNA, PCT+APACHE II, cf-DNA+PCT, cf-DNA+APACHE II, cf-DNA+PCT+APACHE II to predict the prognosis of sepsis patients were 0.898, 0.905, 0.961, 0.941, 0.974, 0.976 and 0.982, respectively. It was shown that when predicted alone with PCT, APACHE II and cf-DNA, the AUC of cf-DNA was the largest (0.961), the sensitivity was 100%, and the specificity was 81.43%; the combined prediction of cf-DNA with PCT or APACHE II could further increase AUC, and the combined prediction of cf-DNA, PCT and APACHE II had the highest AUC (0.982), the sensitivity was 94.29%, the specificity was 98.57%. CONCLUSIONS: cf-DNA, PCT and APACHE II have certain predictive value for the prognosis of sepsis. The value of cf-DNA was the highest when predicted alone, but the predictive ability of cf-DNA combined with PCT and APACHE II was the best.


Subject(s)
Cell-Free Nucleic Acids/blood , Sepsis/therapy , APACHE , Humans , Predictive Value of Tests , Procalcitonin/blood , Prognosis
16.
Cancer Manag Res ; 10: 4479-4489, 2018.
Article in English | MEDLINE | ID: mdl-30349380

ABSTRACT

BACKGROUND: Bladder neuroendocrine carcinomas (BNECs) are relatively a rare type of tumor. The aim of this study was to examine the clinicopathological characteristics and predictors of survival outcomes of patients with BNECs based on the analysis of the national Surveillance, Epidemiology, and End Results (SEER) database. MATERIALS AND METHODS: Kaplan-Meier analysis with log-rank test was used for survival comparisons. Multivariate Cox regression model was employed to analyze the effect of different treatments on overall survival (OS) and cancer-specific survival (CSS). RESULTS: A total of 910 patients were identified between 2004 and 2014. Overall, 648 (71.2%) patients had small cell neuroendocrine carcinoma (SCNEC), 35 (3.8%) had large cell neuroendocrine carcinoma (LCNEC), 10 (1.1%) had carcinoid tumor (well-differentiated neuroendocrine tumor), 16 (1.8%) had paraganglioma/pheochromocytoma (PGL/PHEO), 619 (68.0%) had a poorly differentiated or undifferentiated histology grade, 214 (23.5%) presented with metastatic disease, 586 (64.4%) underwent transurethral ablation/destruction for bladder tumor, and 245 (26.9%) had partial/total cystectomy. Cystectomy+chemotherapy+radiotherapy (CCR) has the highest long-term survival rate among various treatments. The 1-, 3-, and 5-years CSS of CCR were 56%, 56%, and 56%, respectively. By using multivariable Cox proportional hazard model, age, histology, N stage, SEER stage, tumor size, radiotherapy, chemotherapy, and local treatment of the primary site were identified as independent predictors for OS and CSS; all P<0.05. CONCLUSION: In BNEC, SCNEC has an absolute advantage in number. SCNEC/LCNEC tend to be older men. PGL/PHEO and carcinoid tumors have younger mean ages, earlier tumor stages, and better prognosis than SCNEC/LCNEC. Surgery, radiotherapy and chemotherapy are better than conservative treatment. However, whatever cystectomy or bladder sparing, chemotherapy should be a major component of treatment.

17.
Medicine (Baltimore) ; 97(29): e11378, 2018 Jul.
Article in English | MEDLINE | ID: mdl-30024509

ABSTRACT

To identify whether marital status is associated with survival in patients with bladder urothelial carcinoma (UC). Using Surveillance, Epidemiology, and End Results population-based data, 133,846 patients diagnosed with bladder UC between 1988 and 2009 were identified. Kaplan-Meier methods and multivariable Cox regression models were used for survival analyses and evaluation of the association between marital status and survival, after controlling for gender, age, race, primary site, tumor (topography), lymph node, metastasis stage, pathological grading, and surgery. Patients in the married group had a higher proportion of men within group comparisons, more often white, older, earlier clinical stage at diagnosis, surgical treatment, all of which were statistically significant (P < .001). Widowed patients had the worst bladder UC cause-specific survival (CSS) compared with married, never married, and so on groups classified by stage and grade. The 5-year CSS of widowed patients compared with that of married patients was, respectively, all (P < .001), 89.8% versus 95.8% at noninvasive papillary carcinoma stage, 84.1% versus 91.6% at occur in situ stage, 74.3% versus 86.1% at I stage, 41.2% versus 61.6% at II stage, 39.2 versus 52.5% at III stage, and 8.8% versus 17.0% at IV stage. Widowed patients tend to have a significantly higher risk of bladder-cancer-specific mortality. Marital status was relevant to improved CSS in patients with bladder UC.


Subject(s)
Marital Status , Urinary Bladder Neoplasms/mortality , Aged , Databases, Factual , Female , Humans , Male , Middle Aged , Neoplasm Staging , Risk Factors , SEER Program , Survival Analysis , Urinary Bladder/pathology , Urinary Bladder Neoplasms/epidemiology , Urinary Bladder Neoplasms/pathology
18.
Funct Integr Genomics ; 18(6): 613-625, 2018 Nov.
Article in English | MEDLINE | ID: mdl-29754269

ABSTRACT

Sweet potato (Ipomoea batatas (L.) Lam.) is one of the most important root crops in the world. Initial formation and development of storage roots (SRs) are key factors affecting its yields. In order to study the molecular mechanism and regulatory networks of the SRs development process, we have analyzed root transcriptomes between the high and low starch content sweet potato accessions at three different developmental stages. In this study, we assembled 46,840 unigenes using Illumina paired-end sequencing reads and identified differentially expressed genes (DEGs) between two accessions. The numbers of DEGs were increased with the development of SRs, indicating that the difference between two accessions is enlarging with the maturation. DEGs were mainly enriched in starch biosynthesis, plant hormones regulatory, and genetic information processing pathways. Then, expression patterns of DEGs that are most significant and starch biosynthesis related were validated using qRT-PCR. Our results provide valuable resources to future study on molecular mechanisms of SRs development and candidate genes for starch content improvement in sweet potato.


Subject(s)
Gene Expression Regulation, Plant , Ipomoea batatas/genetics , Plant Roots/genetics , Starch/genetics , Genes, Plant , Ipomoea batatas/metabolism , Plant Roots/metabolism , Starch/biosynthesis
19.
Oncol Lett ; 15(4): 4737-4744, 2018 Apr.
Article in English | MEDLINE | ID: mdl-29552113

ABSTRACT

Marital status is an independent prognostic factor for survival in several types of cancer, but has not been fully studied in prostate cancer (PCa). A total of 95,846 men diagnosed with PCa were treated with radical prostatectomy (RP) between 2004 and 2009 within 18 Surveillance, Epidemiology and End Results registries. Survival curves were generated using Kaplan-Meier estimates and differences in survival were assessed using the log-rank test. Cox regression models were used to assess the impact of marital status on survival outcomes. The results demonstrated that the 8-year cancer-cause specific survival (CSS) rate of married men was higher than unmarried individuals. Further analyses revealed that divorced/separated men had a higher proportion of high Gleason scores (GS) PCa at diagnosis [hazard ratio (HR), 1.12; P=0.007] and those patients had the worst survival outcomes independent of age, ethnicity, grade, stage and sequence number [HR, 1.61; 95% confidence interval (CI), 1.34-1.93]. Interestingly, it was observed that CSS among divorced/separated men decreased as the GS increased (GS≤6: HR, 2.5; GS=7: HR, 1.71; GS≥8: HR, 1.50; all P<0.05). Apart from that, no significant differences in CSS were observed in those who had never been married (HR, 1.20) or were widowed (HR, 1.13) relative to the married group. The results of the present study support the hypothesis that marital status is an independent prognostic factor among men with PCa who underwent RP. It was demonstrated that the mortality rates of divorced or separated men with PCa were significantly greater compared with the other groups. A further understanding of the potential associations among marital status, psychosocial factors and survival outcomes may help in developing novel, more effective methods of treating different groups of patients with PCa.

20.
Int Urol Nephrol ; 49(5): 825-835, 2017 May.
Article in English | MEDLINE | ID: mdl-28188414

ABSTRACT

PURPOSES: Growing evidences showed that lncRNAs abnormally expressed in cancer tissues and played irreplaceable roles in tumorigenesis, progression and metastasis. In present study, we aimed to identify lncRNA expression signature that can predict biochemical recurrence-free (BCR-free) survival of prostate cancer (PCa) patients. METHODS: A total of 291 patients with pathologic confirmed PCa in The Cancer Genome Atlas dataset were recruited and included. With the specific risk score formula, patients were further classified into high-risk group and low-risk group. Kaplan-Meier survival analyses and Cox regression analyses were performed to determine the association between lncRNA signature and survival outcomes. Gene Set Enrichment Analysis (GSEA) was carried out to identify the potentially associated biological processes and signaling pathway. RESULTS: Overall, 126 differentially expressed lncRNAs were found with more than twofold changes and p value of FDR <0.01. Among which, four lncRNAs were identified to be significantly associated with BCR-free survival. Then, using a risk score based on the signature of these four lncRNAs, we divided the patients into low-risk and high-risk groups with significantly different BCR-free survival and disease-free survival. Further multivariate Cox regression analyses revealed that the four-lncRNA signature was independent of age, AJCC T stage, lymphonodus status, Gleason score, margin and adjuvant postoperative radiotherapy. GSEA suggested that this signature was involved in cell proliferation. CONCLUSIONS: In present study, a novel four-lncRNA signature that is useful in survival prediction in PCa patients was developed. If validated, this lncRNA signature might assist in selecting high-risk subpopulation who need more aggressive therapeutic intervention. The clinical implications and the mechanism of these four lncRNAs deserve further investigation in future studies.


Subject(s)
Gene Expression Regulation, Neoplastic , Neoplasm Recurrence, Local/genetics , Prostatic Neoplasms/genetics , Prostatic Neoplasms/mortality , RNA, Long Noncoding/genetics , Adult , Aged , Biopsy, Needle , Cohort Studies , Databases, Genetic , Disease-Free Survival , Humans , Immunohistochemistry , Japan , Kaplan-Meier Estimate , Male , Middle Aged , Multivariate Analysis , Neoplasm Recurrence, Local/mortality , Neoplasm Recurrence, Local/pathology , Predictive Value of Tests , Prognosis , Proportional Hazards Models , Prospective Studies , Prostatic Neoplasms/pathology , Prostatic Neoplasms/therapy , ROC Curve , Risk Assessment , Survival Analysis , Treatment Outcome
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