ABSTRACT
BACKGROUND: Previous studies have revealed the importance of microRNAs' (miRNAs) function as biomarkers in diagnosing human bladder cancer (BC). However, the results are discordant. Consequently, the possibility of miRNAs to be BC biomarkers was summarized in this meta-analysis. METHODS: In this study, the relevant articles were systematically searched from CBM, PubMed, EMBASE, and Chinese National Knowledge Infrastructure (CNKI). The bivariate model was used to calculate the pooled diagnostic parameters and summary receiver operator characteristic (SROC) curve in this meta-analysis, thereby estimating the whole predictive performance. STATA software was used during the whole analysis. RESULTS: Thirty-one studies from 10 articles, including 1556 cases and 1347 controls, were explored in this meta-analysis. In short, the pooled sensitivity, area under the SROC curve, specificity, positive likelihood ratio, diagnostic odds ratio, and negative likelihood ratio were 0.72 (95%CI 0.66-0.76), 0.80 (0.77-0.84), 0.76 (0.71-0.81), 3.0 (2.4-3.8), 8 (5.0-12.0), and 0.37 (0.30-0.46) respectively. Additionally, sub-group and meta-regression analyses revealed that there were significant differences between ethnicity, miRNA profiling, and specimen sub-groups. These results suggested that Asian population-based studies, multiple-miRNA profiling, and blood-based assays might yield a higher diagnostic accuracy than their counterparts. CONCLUSIONS: This meta-analysis demonstrated that miRNAs, particularly multiple miRNAs in the blood, might be novel, useful biomarkers with relatively high sensitivity and specificity and can be used for the diagnosis of BC. However, further prospective studies with more samples should be performed for further validation.
Subject(s)
Biomarkers, Tumor/blood , MicroRNAs/blood , Urinary Bladder Neoplasms/blood , Urinary Bladder Neoplasms/genetics , Asian People/genetics , Biomarkers, Tumor/urine , Cystoscopy/adverse effects , Humans , Neoplasm Staging , Nuclear Proteins/urine , Odds Ratio , ROC Curve , Regression Analysis , Sensitivity and Specificity , Urinalysis/methods , Urinary Bladder Neoplasms/diagnosis , Urinary Bladder Neoplasms/urineABSTRACT
Collecting duct carcinoma (CDC) is a rare and aggressive renal cell carcinoma (RCC) with extremely poor prognosis, which has been shown to have a poor response to several kinds of systemic therapy. Targeted agents have greatly changed the therapeutic landscape in advanced RCC. Nonetheless, patients with CDC are always excluded from the prospective trials with targeted therapies due to its rarity. We present a case of metastatic CDC that responded favorably to the multiple tyrosine kinase inhibitor, sorafenib, achieving a partial response in both lungs and retroperitoneal lymph nodes metastases. We also reviewed the limited number of reports of metastatic CDC treated with targeted agents and found that 33.33 % (4/12) of patients had favorable clinical activity. These suggest that targeted therapy should be considered for the treatment of metastatic CDC and its prospective evaluation is encouraged.
Subject(s)
Carcinoma, Renal Cell/drug therapy , Drug Delivery Systems/methods , Kidney Neoplasms/drug therapy , Kidney Neoplasms/pathology , Kidney Tubules, Collecting/pathology , Niacinamide/analogs & derivatives , Phenylurea Compounds/administration & dosage , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Biopsy, Needle , Carcinoma, Renal Cell/diagnostic imaging , Carcinoma, Renal Cell/secondary , Carcinoma, Renal Cell/surgery , Disease Progression , Fatal Outcome , Humans , Immunohistochemistry , Kidney Neoplasms/diagnostic imaging , Kidney Neoplasms/surgery , Lung Neoplasms/pathology , Lung Neoplasms/secondary , Lung Neoplasms/therapy , Male , Middle Aged , Neoplasm Invasiveness/pathology , Neoplasm Staging , Nephrectomy/methods , Niacinamide/administration & dosage , Rare Diseases , Risk Assessment , Sorafenib , Tomography, X-Ray Computed/methodsABSTRACT
INTRODUCTION AND HYPOTHESIS: This study investigated the value of transvaginal contrast-enhanced sonourethrography for the diagnosis of female urethral diverticulum (UD) by comparing results of contrast-enhanced ultrasound images and surgical findings. METHODS: A total of 14 female UD patients underwent preoperative transvaginal contrast-enhanced sonourethrography between July 2010 and June 2012. History and physical examination were initially assessed by the same urologist. Transvaginal contrast-enhanced ultrasound imaging was performed and interpreted by the same ultrasonographer. Definite diagnosis was made by tracking the flow of the microbubbles into the cyst. Additionally, sagittal, cross-sectional, and dynamic images were obtained, and color Doppler ultrasound was applied in all cases. Data on the size, location, configuration, and opening of the UD was documented, and then compared with the surgical findings. RESULTS: The most common symptoms presenting in the UD patients included urinary incontinence (71.5 %), recurrent urinary tract infection (57.1 %), frequency (50 %), urgency (35.7 %), dysuria (35.7 %), and dyspareunia (21.4 %). On physical examination, 8 out of 14 patients (57.1 %) had a palpable anterior vaginal wall mass, while 6 out of 14 patients (42.9 %) had no palpable mass. Transvaginal contrast-enhanced sonourethrography revealed 17 diverticula orifices in total and correlated well with surgical findings regarding the size, location, configuration, and the opening of the UD. CONCLUSIONS: In patients with chronic irritative bladder symptoms, but with no response to conventional treatment a high index of suspicion for UD should be maintained. Our study demonstrates that transvaginal contrast-enhanced sonourethrography is a useful tool for defining the size, location, configuration, and opening of the UD before surgery.
