Diabetes mellitus and the risk of prostate cancer: an update and cumulative meta-analysis.

INTRODUCTION: To provide further insight into the association between type 2 diabetes mellitus (T2DM) and the pathophysiology of prostate cancer, we conducted an updated, detailed meta-analysis of 56 published case-control and cohort studies. METHODS: MEDLINE and EMBASE were used to identify the literature published in April 2012 related to both diabetes mellitus and prostate cancer. A sensitivity analysis was performed, and potential confounding effects were investigated using a stratified meta-analysis. A cumulative meta-analysis was also carried out to evaluate the cumulative effect estimate over time. RESULTS: A total of 24 case-control and 32 cohort studies with information on a total of ~8,000,000 subjects and ~140,000 individuals with prostatic cancer showed published estimates of the association between diabetes and prostate cancer malignancy. The pooled effect estimate revealed a relative risk (RR) of 0.88 (95% CI, 0.82-0.93). Interestingly, there was an increased trend for Asians (RR = 1.72, n = 7) but not Americans (RR = 0.82, n = 28) and Europeans (RR = 0.86, n = 21) regarding the association between diabetes mellitus and prostate cancer. The sensitivity analysis, excluding any one study, did not significantly change the pooled RR. The range for the pooled RR when one study was omitted was 0.84-0.89. DISCUSSION: The findings of our meta-analysis provide strong evidence of an inverse association between diabetes and prostate cancer. CONCLUSIONS: Further research should focus on limitations in the current literature and re-assess the relationship between diabetes and prostate cancer by analyzing the two different diabetes mellitus types separately.

Correlation of Ureaplasma urealyticum and Chlamydia trachomatis infections with male sterility: a meta-analysis of randomized control trials / 中华男科学杂志

<p><b>OBJECTIVE</b>To evaluate the correlation of Ureaplasma urealyticum (Uu) and Chlamydia trachomatis (Ct) infections with male sterility.</p><p><b>METHODS</b>Data from CBMA and CNKI were searched and studies were made for the correlation of Uu and Ct infections with male sterility by retrieval strategy worked out according to the Collaborative Review Group search strategy. The results were expressed as odds ratio (OR) and 95% confidence intervals (95% CI). The results of 28 clinical controlled trials from 1994 to 2005 were analyzed by software RevMan 4.2. Odds ratio (OR) was applied to the evaluation of the correlation between Uu infection and male sterility.</p><p><b>RESULTS</b>Eighty-eight relative trials were retrieved, of which 28 were included in the Meta-analysis. The combined ORs of Uu and Ct infections to male sterility were OR(Uu): 4.73 (95% CI: 3.77-5.94) and OR(Ct): 4.59 (95% CI: 3.24-6.50).</p><p><b>CONCLUSION</b>Uu and Ct infections are very important risk factors of sterility in Chinese men.</p>

Study on the prognostic factors of patients with invasive bladder cancer after radical surgery / 中华泌尿外科杂志

Objective To investigate the prognostic factors affecting the postoperative survival of patients with invasive bladder cancer,and to predict the survival time of the patients.Methods We retro- spectively analyzed the clinical and follow-up data of 178 patients with invasive bladder cancer treated by radical cystectomy and urinary diversion from 1991 to 2004.A multivariate analysis was performed in these patients by the Cox proportional hazard model.A prognostic index(PI)based on the Cox regression was con- structed.According to the individualized PI,the patients were classified into different hazard groups and the expected survival curve of each patient was calculated.Results Cox regression analysis showed that the factors which influenced the postoperative survival included tumor stage(RR=1.982,P=0.000),grade (RR=1.978,P =0.042),lymph node metastasis(RR=2.142,P=0.048),Tis(RR=6.177,P= 0.000),tumor shape(RR=0.416,P=0.003),number of tumors( RR=1.820,P=0.035),pathological type(RR=2.228,P=0.032),patient age(RR=0.672,P=0.025)and neoadjuvant chemotherapy (RR=0.257,P=0.016).Based on the percentile of PI,patients were classified into 3 prognostic groups; the median survival time of 3 groups were 42.5,22.5 and 7.0 months,respectively.There were significant differences between each 2 among the 3 groups(P＜0.01).Conclusions Neoadjuvant chemotherapy, tumor stage,grade,lymph node metastasis,Tis,shape and number of tumors,pathological type,patient age were important prognostic factors.PI value can be used to predict the prognosis of patients with invasive blad- der cancer.

Significance of p16 gene and p21 gene expression abnormality in the prognosis of bladder carcinoma:a Meta-analysis / 中华泌尿外科杂志

Objective To investigate the correlation of p16 gene and p21 gene expression abnormal- ity with the prognosis of bladder carcinoma.Methods Using the search terms“bladder neoplasm”,“prognosis”,“p16”or“p21”,the literature on the correlation of p16 gene and p21 gene expression abnor- mality with the prognosis of bladder carcinoma were searched from MEDLINE database,PubMed database, CBMdisc and China Academic Periodical database,and were evaluated by Meta-analysis with Dersimonian- Laird model.Results A total of 19 trials involving 1584 patients(positive rate of 40.4%)were identi- fied,including 12 trials of 975 patients(positive rate of 37.4%)on p16 gene expression abnormality and 7 trials of 609 patients(positive rate of 45.4%)on p21 gene expression abnormality.The combined relative hazard(RH)of p16 gene expression abnormality on the prognosis of bladder carcinoma,p21 gene expression abnormality on the prognosis of bladder carcinoma and both p16 gene and p21 gene expression abnormality on the prognosis of bladder carcinoma was 3.70(95% CI,3.42-3.99),3.01(95% CI,2.81-3.21)and 3.18(95% CI,3.01-3.35),respectively.Conclusions Both p16 gene and p21 gene expression abnor- malities are biomarkers for poor prognosis of bladder carcinoma.The detection of these biomarkers may be helpful in making the treatment strategy.

Malignant rhabdoid tumor of the kidney in adults: a clinical and pathologic study / 中华泌尿外科杂志

Objective To study the pathologic and clinical features of malignant rhabdoid tumor of the kidney(MRTK),and to improve the diagnosis and treatment of the disease.Methods The clinical and pathologic data of 5 patients(4 men and 1 woman;mean age,50 years;age range,21-67 years)with MRTK(3 tumors on the left and 2 on the right)were retrospectively analyzed in combination with review of the relevant literature.Of the 5 cases,I was incidentally diagnosed with renal tumor during physical examina- tion;and 3 had gross hematuria,low back pain and discomfort,and abdominal masses.Results Radical nephrectomy was performed in all 5 cases.The tumors averaged 6.5cm in diameter.By NWTS staging,4 ca- ses had stageⅡtumors and 1 case had stageⅢtumor.Pathological features were as follows.Rhabdoid cells were characterized by eccentric nuclei,prominent nucleoli,and abundant cytoplasm containing eosinophilic inclusions that were strongly positive for vimentin and epithelial membrane antigen(EMA).Electron micros- copy showed intermediate filaments and round,irregular fibroid or whorl-like corpuscles in the cytoplasm. Follow-up was available in 4 patients(mean,6.8 months;range,3-24 months).Of them,2 died of metasta- sis or complications 12 months after operation;and 2 were alive without recurrence and metastasis for 6 months.Conclusions MRTK is a rare and morphologically distinctive neoplasm with specific findings of pathological features.The tumor has a poorer prognosis,but comparatively it is better in adults than in adoles- cents.