[Expression of BNIP3 and its correlations to HIF-1alpha and VEGF in clear cell renal cell carcinoma].

OBJECTIVE: To study the expressions of proapoptosis protein BNIP3 and its correlation with HIF-1alpha and VEGF in clear cell renal cell carcinoma (ccRCC). METHODS: The expression levels of BNIP3, HIF-1alpha and VEGF were examined by two-step immunohistochemical staining with tissue chip technique in 104 cases of ccRCC and in 48 cases of normal renal tissues. The correlation of BNIP3 expression with HIF-1alpha and VEGF was analyzed. RESULT: The positive expression rates of BNIP3, HIF-1alpha and VEGF were 36.5%, 61.5%, and 69.2% in ccRCC, while were 12.5%, 8.3%, and 12.5% in paracancerous normal renal tissue, respectively. The expression of both HIF-1alpha and VEGF were not significantly increased in BNIP3 positive tumors in comparison with BNIP3 negative counterpart (P > 0.05), but there was a significant correlation between HIF-1alpha and VEGF (P < 0.05). CONCLUSION: The lower expression level of BNIP3 is not coincident with the high level of HIF-1alpha and VEGF in clear cell renal cell carcinoma.

[Primary leiomyosarcoma of the kidney: a clinicopathological study of 13 cases at a high-volume institution].

OBJECTIVE: To analyze the clinical characteristics, treatment, and survival of adult patients with renal leiomyosarcoma treated at our institution during the past 13 years. METHODS: A retrospective review was performed to collect the demographic distribution, clinical manifestation, treatment, and outcome data about 13 adult patients of renal leiomyosarcoma treated at our institution from January 1996 to January 2008. The clinical parameters were analyzed to determine the effects on survival by logistic regression. RESULTS: Mean age at diagnosis was 45.7 years (range 20 to 71), and 61.5% (8/13) were female. Mean tumor diameter was (11.1 +/- 10.2) cm (range 3 to 34 cm), 53.9% (7/13) had direct invasion of renal capsule, and 23.1% (3/13) had lymphovascular invasion. The follow-up information of 11 cases was available, and duration of follow-up was an average of 39.2 (range 9-81) months. The overall survival (OS) rate at 1, 3, and 5 years was 81.8%, 54.5%, and 16.2% respectively. 8 (72.7%) patients developed metastasis, and 9 (81.8%) patients eventually died. The survival of the patients did not show correlations with age, pathologic grade, extrarenal component, lymphovascular invasion, complete resection or not and chemotherapy or not. CONCLUSION: Primary renal leiomyosarcoma has a poor survival prognosis regardless of the underlying histological and clinical features.

[Comparison of outcomes and complications between antegrade and retrograde approach to open radical prostatectomy].

OBJECTIVE: To compare the operative outcomes and complications between an anterograde versus retrograde approach to open radical retropubic prostatectomy (RRP); METHODS: Retrospectively analyze the clinical data and follow-up results of 76 prostate cancer patients who received radical retropubic prostatectomy from April 2006 to May 2011. According to the resection approach of prostate, the patients were divided into two groups, antegrade RRP group (45 cases) and retrograde RRP group (31 cases). The operative outcomes and complications between two groups were analyzed. RESULTS: There was no peri-operative death and cancer specific death during the follow-up. Eleven cases were found positive surgical margin, 5 (11.1%) in antegrade group, 6 (19.3%) in retrograde group. The estimated blood loss of these 76 operations were 230-1200 mL [mean (367.2 +/- 132.4) mL], (324.0 +/- 70.3) mL in antegrade group and (429.8 +/- 172.3) mL in retrograde group, respectively. The volume of blood loss between the two groups was significantly different. The durations of follow-up for the patients were 2-63 months [(24.22 +/- 13.21) months), 4 cases showed biochemical failure with criterion as prostate specific antigen > 0.2 microg/L, 2 patients had stress incontinence of antegrade RRP group and 1 patient had permanent incontinence of retrograde RRP group, there were no significant difference between the two groups. CONCLUSIONS: Antegrade radical prostatectomy provides a low incidence of complications, reduced blood loss for localized prostatic cancer.

Application of hormonal treatment in hypogonadotropic hypogonadism: more than ten years experience.

OBJECTIVE: To demonstrate the efficacy of hormone treatment on the patients with hypogonadotropic hypogonadism (HH), we summarized our more than 10 years experience. MATERIALS AND METHODS: A total of 242 male patients (age range 15-52 years old) with HH including two Kallmann syndrome treated at the andrology outpatient clinics of university hospital in the past 10 years were reviewed retrospectively. The patients were divided into three groups based on the different treatment strategy. There were 84 patients treated with human chorionic gonadotropin (hCG) (group 1, hCG treatment group), 74 patients treated with hCG plus human menopause gonadotropin (hMG) (group 2, hCG + hMG treatment group), and 84 patients treated with testosterone (group 3, T treatment group). Sex characteristics, testicular volume, and sperm production were determined before and after the treatments. The therapeutic effects in the three groups were analyzed statistically. RESULTS: In total, 42 patients of group 1 (50.0%) and 56 of group 2 (75.7%) had their testicular volumes increased after 6-18 months treatment, from 2.0 ± 1.1 to 6.8 ± 3.2 mL and 2.1 ± 1.1 to 8.8 ± 3.9 mL, respectively. Only six patients of group 3 had their testicular volumes increased but no statistically significant. Among the patients with testes growth, 34 patients of group 1 and 48 patients of group 2 achieved spermatogenesis, and three of them made their wives pregnant naturally. During the follow-up after treatment, there were 36 patients finally defined as delayed puberty, and 204 patients defined as idiopathic hypogonadotropic hypogonadism. CONCLUSIONS: For the hormonal treatment of HH, testosterone therapy could not stimulate testes growth and spermatogenesis, but HCG therapy and hCG/hMG combination therapy both are effective, while hCG/hMG combination therapy could achieve better therapeutic effects.