Astrocyte elevated gene-1 overexpression in histologically favorable Wilms tumor is related to poor prognosis.

OBJECTIVE: Astrocyte elevated gene-1 (AEG-1) is associated with tumorigenesis and progression in various types of human cancers. However, the status of AEG-1 expression and its significance in Wilms tumor are still unclear. In this study, we investigated the expression of AEG-1 and evaluated its clinical and prognostic significance in favorable-histology Wilms tumor (FHWT). MATERIALS AND METHODS: Immunohistochemistry was performed to examine AEG-1 protein expression in paraffin-embedded tissues from 38 FHWT patients. All patients underwent radical nephrectomy from January 2003 to June 2008 with subsequent therapy according to National Wilms Tumor Study Group protocols. Statistical analyses were performed to evaluate the association between AEG-1 expression and clinical parameters. RESULTS: We found high AEG-1 expression in 17 of 38 (44.7%) patients. AEG-1 expression was significantly correlated with clinical stage (p = 0.019) and status of recurrence (p = 0.023). Importantly, patients with high AEG-1 expression had a shorter disease-free survival and overall survival compared with those with low AEG-1 expression (p = 0.011 and p = 0.013). CONCLUSION: AEG-1 expression is associated with FHWT outcome in this study, and AEG-1 may represent a novel and valuable predictor for prognostic evaluation of FHWT patients.

The expression of IL-6 and STAT3 might predict progression and unfavorable prognosis in Wilms' tumor.

PURPOSE: To investigate the expression profiles of IL-6 and STAT3 in Wilms' tumor (WT) and their relationship with disease progression. METHODS: Immunohistochemistry was used to examine IL-6 and STAT3 expression in 58 primary tumors and 18 invasive/metastatic ones. RESULTS: Positive expression rate of IL-6/STAT3 was 39.7% (23/58)/29.3% (17/58) in primary WT tissues, while 61.1% (11/18)/33.3% (6/18) in associated invasive/metastatic tissues. The expression rate of IL-6 and STAT3 was higher in primary WT tumors of invasive/metastatic group than that of non-invasive/metastatic group (P=0.033; P=0.012). There was a positive correlation between IL-6 and STAT3 expression in 76 WT tissues (P<0.001, r=0.444). The expression of IL-6 /STAT3 between primary WT and matched invasive/metastatic tissues was concordance (P=0.727; P=0.99). IL-6 expression status and histopathological type were associated with disease-free survival (DFS) and overall survival (OS) (P<0.05), while STAT3 was only correlated with DFS (P<0.05). CONCLUSIONS: IL-6 and STAT3 expression in WT might be correlated with progression and predict unfavorable prognosis, highlighting a new therapy target for invasive or metastatic WTs.

A new classification of duplex kidney based on kidney morphology and management.

BACKGROUND: The initial classic classification of duplex kidney into complete (two ureters) and incomplete ("Y" shaped ureter) types are based on the ureter status. At the meantime, the features of the upper and lower moieties of duplex kidney were very crucial for appropriate procedure of hemi-nephrectomy, which was most commonly used for addressing the issues caused by a duplex kidney; and recently more applications of laparoscopy were used. In this study, we aimed prudently to propose a new classification based on the features of the upper and lower moieties of duplex kidney. METHODS: Sixty-five children with 83 duplex kidneys were reviewed retrospectively. Based on kidney morphology found in CT urography and surgical findings, duplex kidney was classified into five types. RESULTS: The first was the appendant type (36/83) and its feature was that the mini upper moiety was located on top of the lower one, with a visualized shallow groove between them. The ureter was dilated with an ectopic orifice or ureterocele. The second was the embedded type (13/83), the feature of which was that mini upper moiety located in the interior top of the lower one within the same capsule. The upper ureter was dilated with an ectopic orifice or ureterocele. The third was the hydronephrosis type (12/83). The severe hydronephrotic upper moiety was almost as big as the lower moiety. The upper ureter was severely dilated and circuitous with an ectopic orifice. The forth was the dual-poor type (2/83). The two moieties were all very small with "Y" shaped ureters and ectopic orifices. The last was the dual-well type (20/83). The upper moiety was almost the same size as the lower one, without apparent dilation of "Y" shaped or double ureters. CONCLUSION: Based on kidney morphology, duplex kidney can be mainly classified into five types which can be depicted by CT urography prior to management and can provide an aid in selecting a successful course of surgical correction.

[Medical treatment following successful separation of thoracopagus conjoined twins].

OBJECTIVE: To analyze and summarize the medical treatment experience following separation of thoracopagus conjoined twins. METHOD: The clinical manifestations and the medical therapy of a pair of thoracopagus conjoined twins were analyzed. The conjunction of the female twins was from 5 cm above the nipple to the umbilicus. They also suffered from complex congenital heart diseases. At the 17th day of their lives, they were surgically separated. One girl died after the operation, the other survived but experienced heart failure, sepsis and multiple organ dysfunction (including liver, blood and kidney et al). In order to protect or maintain the main organ function, the vital signs and the objective indexes were monitored continually, such as blood routine test, C reactive protein, hepatorenal function, bacterial culture, and galactomannan test, blood gas analysis and chest radiogram. CONCLUSION: It is important to protect the main organ function and prevent or control infection. The early surgical correction of congenital heart disease may contribute to recovery of the children.

Adenomatoid tumor of the testis in a child.

Adenomatoid tumors are rare benign neoplasms thought to be of mesothelial origin. Although most reported cases arise from the epididymis, rare cases have been reported in the spermatic cord, testicular tunica, ejaculatory ducts, prostate, and suprarenal recess. We describe a 4.5-year-old boy who presented with a relatively asymptomatic right testicular mass that was resected and confirmed to be adenomatoid tumor of the testis by histopathology. Because of its rarity, the clinical and histopathologic aspects are discussed.