ABSTRACT
BACKGROUND: In search of novel prognostic biomarkers for clear cell renal carcinoma (ccRCC), we analysed the expression of several proteins related to angiogenesis and hypoxia. METHODS: A monocentric study on 30 consecutive surgical samples from surgically-treated ccRCC patients with a 10-year follow up was performed. The following proteins were analysed by immunohistochemistry: Vascular Endothelial Growth Factor- A (VEGF-A), Platelet-Derived Growth Factor ß Receptor (PDGFRß), VEGF-receptor 1 (Flt1), VEGF-receptor 2 (KDR), Glucose Transporter 1 (GLUT1), Carbonic anhydrase IX (CA-IX) and the hERG1 potassium channel. Data were analysed in conjunction with the clinico-pathological characteristics of the patients and follow up. RESULTS: All the proteins were expressed in the samples, with statistically significant associations of VEGF-A with PDGFRß and Flt1 and hERG1 with CA IX. Notably, hERG1 and CAIX co-immunoprecipitated in primary ccRCC samples and survival analysis showed that the positivity for hERG1 and CA IX had a negative impact on Recurrence Free Survival (RFS) at the univariate analysis. At the multivariate analysis only hERG1 maintained its statistically significant negative impact. CONCLUSIONS: hERG1 expression can be exploited to predict recurrence in surgically-treated ccRCC patients. hERG1 channels form a multiprotein complex with the pH regulator CA IX in primary ccRCC samples their potential use as therapeutic target might be suggested.
Subject(s)
Biomarkers, Tumor/metabolism , Carbonic Anhydrase IX/metabolism , Carcinoma, Renal Cell/surgery , Ether-A-Go-Go Potassium Channels/metabolism , Kidney Neoplasms/surgery , Neoplasm Recurrence, Local/metabolism , Aged , Carcinoma, Renal Cell/metabolism , Carcinoma, Renal Cell/mortality , Carcinoma, Renal Cell/pathology , Female , Humans , Italy , Kidney Neoplasms/metabolism , Kidney Neoplasms/mortality , Kidney Neoplasms/pathology , Male , Middle Aged , Neoplasm Staging , Nephrectomy/methods , Prognosis , Survival RateABSTRACT
Objective: Iatrogenic stenosis is a relatively common complication and it could happen after urological procedures in the entire course of the ureter. The aim of this study is to report the surgical outcomes of 36 consecutive patients (period April 2013-November 2018) submitted to robot-assisted correction of benign stricture with previous urological surgery in a tertiary referral center.Methods: Elective criteria were to have had a benign ureteral stricture development after at least one urological procedure. Patients were classified as failures in the event of post-operative ultrasound demonstrating persistent hydronephrosis with or without symptoms or persistent symptoms with renal scan evidence of obstruction or redo procedures.Results: Eighteen patients (50%) were treated for calculosis, seven (19.4%) patients were submitted to double J ureteral stenting and previous pyeloplasty was performed in 11 (30.5%) patients. Overall median operative time was 160 min (IQR = 120-180). Five (13.8%) complications with three (8.3%) surgical post-operative complications occurred. Length of stay was 6 (IQR = 5-7) days. At last follow-up, ranging between 7-60 months, the overall success rate was 86.1% (31/36): three of them (8.3%) were submitted to retrograde holmium laser endopyelotomy, while two (5.5%) underwent a redo robot-assisted correction.Conclusions: Robot-assisted correction procedures can be done safely with good perioperative outcomes and a high post-operative success rate in a tertiary referral center. Further randomized clinical trials are mandatory to confirm the safety of this procedure.
Subject(s)
Postoperative Complications/surgery , Robotic Surgical Procedures , Ureteral Obstruction/surgery , Adult , Constriction, Pathologic/surgery , Female , Humans , Iatrogenic Disease , Male , Middle Aged , Retrospective Studies , Tertiary Care Centers , Treatment Outcome , Urologic Surgical Procedures/methodsABSTRACT
OBJECTIVES: This paper measured the extent to which human immunodeficiency virus (HIV) infection has spread among the male working-class population of Santos, Brazil. METHODS: Questionnaires on risk behaviors and blood tests were administered to a random sample (n = 395) of male port workers employed by the Santos Port Authority. RESULTS: Although the rate of HIV infection among these men- the working-class male population of Santos-remains low (1.1%), self-reported behavioral risks for HIV infection are common. CONCLUSIONS: There is still time to prevent a widespread outbreak of HIV infection among the hetero-sexual population of Santos and of the transportation corridors emanating from that city.
