Fournier's Gangrene (FG) is a rare, fulminant, and necrotizing inflammation of the perineal fascia. We present a case of 35-year-old Men who have Sex with Men (MSM) man with severe gangrene (Fournier's Gangrene Severity Index (FGSI) ≥ 17) due to atypical etiology: mechanical damage to the perineum resulting from sexual intercourse and ingestion of a vasoconstrictor substance, with the background of an active, chronic inflammatory process of the intestines. In the described patient, due to severe sepsis and diverse microbiology, four radical urological interventions were initially performed, following one more reconstructive surgery. The defects were reconstructed using split-thickness skin grafts and flaps - sixth surgery. The discussion focuses on the management of the defects without orchidopexy, conventional wound management (without vacuum assisted closure (VAC) or Hyperbaric Oxygen Therapy (HBOT)), and multi-stage complications (urethral fistula and limited erections), which are noticeable on the quality of patient's life (QoL).
Prostate cancer is a heterogeneous disease shaped by evolving cellular states within a spatially organized tumor ecosystem. Advances in single-cell RNA-sequencing, single-nucleus sequencing, and spatial transcriptomics have facilitated high-resolution dissection of epithelial lineage hierarchies, tumor-associated luminal states, and microenvironmental remodeling. These approaches have revealed that progression from androgen receptor-dependent adenocarcinoma to castration-resistant prostate cancer and the development of neuroendocrine phenotypes reflect lineage plasticity and epigenetic reprogramming rather than simple linear genetic progression. Single-cell studies have indicated that immunosuppressive niches, cancer-associated fibroblast heterogeneity, endothelial activation, and metabolic adaptation collectively contribute to therapeutic resistance. The integration of multi-omics data with spatial context has begun to redefine prostate cancer taxonomy based on cellular state composition and ecosystem architecture. In this review, we summarize recent discoveries from single-cell and spatial analyses, discuss their implications for biomarker development and treatment stratification, and outline ongoing technical challenges, including standardization, reproducibility, and clinical scalability. Overall, this review provides valuable insights for the development of a state-informed framework to understand prostate cancer progression and guide precision oncology strategies.
INTRODUCTION:Elevated intrarenal pressure during ureteroscopy has been linked to complications during recovery from stone removal surgery. Intrarenal pressure depends on irrigation flow rate, inflow and outflow resistance, and kidney compliance. These have been examined for porcine models in the literature. In this study, we report on the experimental method and results of characterizing compliance and outflow resistance in human cadaveric kidneys. METHODS:To characterize compliance a catheter is inserted retrograde into the renal collecting system and sealed at the UPJ. Pressurized irrigation fluid is then allowed to flow into the renal pelvis. Pressure and flow are recorded over time, representing a measure of compliance. To characterize outflow resistance a UAS is inserted into the ureter and a ureteroscope placed. Inflow is increased over time and pressure and outflow recorded. RESULTS:The resulting compliance curves show a high variability between specimens. Anatomical differences and initial volume are significant contributing factors. We show that non-dimensionalizing the data with respect to a measure of volume allows us to fit a single non-linear compliance model to the data. Our outflow testing shows that with consistent placement of devices, outflow resistance is primarily a function of device parameters and largely independent of the specimen anatomy. We determined an outflow resistance of 8.1 mmHg/(ml/min) (σ = 1.6) for UAS size 10/12 F, 0.73 mmHg/(ml/min) (σ = 0.05) for size 11/13 F and 0.18 mmHg/(ml/min) (σ = 0.04) for size 12/14 F. CONCLUSION:The compliance results for human kidneys add a critical data set that enables more accurate modelling of the mechanics of processes involved in stone removal. The outflow data similarly provides critical parameters for modelling the mechanics of ureteroscopic procedures and confirms that this characteristic is primarily driven by surgical device parameters.
Radical prostatectomy (RP) is a highly effective treatment for localized prostate cancer; unfortunately, post-prostatectomy urinary incontinence (UI) remains a prevalent and distressing complication, significantly diminishing patients' quality of life. Current therapeutic options often provide incomplete continence restoration and may lead to substantial morbidity. This review examines the rapidly advancingfield of regenerative medicine, specifically focusing on stem cell and exosome-based therapies as innovative approaches to address post-RP UI. We go deeper into the unique pathophysiology of male post-prostatectomy UI, distinguishing it from other forms of UI, and present the compelling biological rationale for these regenerative interventions. Highlighting advancements from 2014 to 2025, we explore recent preclinical and clinical progress in this domain. Furthermore, we critically assess the persistent challenges crucial for widespread clinical application, including optimizing cell dose and source, ensuring long-term efficacy and safety, and interpreting complex regulatory environments. By bridging the understanding of sex-related differences between females and males in UI and tackling the specific challenges of male post-RP incontinence, this review emphasizes that while promising, the journey from laboratory bench to bedside for these innovative therapies demands rigorous scientific inquiry and collaborative efforts.
Background: This study aimed to develop a non-invasive, simple, and rapid predictive model for identifying non-diabetic kidney disease (NDKD) in patients with type 2 diabetes mellitus (T2DM). Methods: We performed a retrospective analysis of clinical data from 117 T2DM patients who underwent renal biopsy at a single medical institution between 2017 and 2022; candidate variables were first prioritized based on clinical relevance, followed by the construction of a predictive framework using logistic regression. Dubbed the RICH model, the final framework integrated four key parameters: red blood cell (RBC) count, immunoglobulin A (IgA) level, cystatin C-derived estimated glomerular filtration rate (eGFR_2), and glycated hemoglobin A1c (HbA1c). Results: External validation was conducted across three independent centers involving 299 T2DM patients (2018-2024), achieving area under the receiver operating characteristic curve (AUC-ROC) values of 0.755, 0.764, and 0.755, which complemented the internal validation AUC-ROC of 0.847; at an optimal threshold probability of 0.559, approximately 20% of patients obtained clinical net benefit from the model, and notably, applying the RICH model for early NDKD screening has the potential to reduce the renal biopsy rate by 42.05%. Conclusions: The RICH model exhibits robust performance in predicting NDKD among T2DM patients with renal impairment, providing a practical tool for clinical decision-making.
Objective: Millions of aging men are diagnosed with lower urinary tract dysfunction (LUTD) each year. Alpha adrenergic receptor blockers relax prostatic, urethral, and bladder smooth muscle to relieve LUTD symptoms and are often, but not always, effective. Serotonin is proposed to cause contractions in the female urethra, as well as in the lungs and bowel. This study tests that serotonin synthesized in the periphery, outside of the central nervous system, contributes to the development of LUTD induced in mice by subcutaneous implants of testosterone (T) and estradiol (E2), mimicking the hormone milieu of aging men. Methods: Immunofluorescent staining of male human and mouse urethra was used to confirm the presence of neuroendocrine cells and interstitial cells of Cajal, which contribute to serotonin-induced contractions in the female mouse urethra. Wild type and tryptophan hydroxylase 1 null (Tph1(-/-)) mice, which are deficient in the rate-limiting enzyme in peripheral serotonin synthesis, were given sham surgery or T+E2 implants. Voiding behavior was measured with the void spot assay one day before surgery and two weeks post-surgery. Four weeks after surgery, bladders were exteriorized and measured to calculate volume, and anesthetized cystometry was performed to assess bladder activity. Results: Serotonin-positive neuroendocrine cells and serotonin receptor positive interstitial cells of Cajal were detected in the prostatic urethra of humans and mice. Two weeks after T+E2 implantation surgery, a baseline level of urinary retention occurred in both wild type and Tph1(-/-) mice. However, wild type mice treated with T+E2 had increased frequent small voids (P<0.01) and decreased bladder activity (P<0.005) when compared to wild type mice with sham treatment and Tph1(-/-) mice with T+E2 treatment. Conclusions: Wild type mice developed a more severe voiding dysfunction phenotype than Tph1(-/-) mice when treated with T+E2, indicating that peripheral serotonin plays a role in T+E2-mediated LUTD. Because the urinary dysfunction observed in mice mimics that of human men, future studies to understand and exploit the role of serotonin may provide a treatment option for a subset of LUTD.
OBJECTIVE:Metabolites of volatile organic compounds (mVOCs) have attracted considerable attention in contemporary research. The urine flow rate (UFR) serves as an objective metric for a full evaluation of bladder function. This research aimed to investigate the correlation between mVOCs and UFR. METHODS:We examined mVOCs and UFR data from the National Health and Nutrition Examination Survey (NHANES) between 2011 and 2020. The mVOCs measurements were subjected to log transformation to achieve normal distribution. We used weighted multivariate linear regression models to evaluate the association between mVOCs andUFR. The relationship between mVOCs mixture and UFR was assessed using three different analytical models: Bayesian kernel machine regression (BKMR), weighted quantile sum (WQS), and quantile g-computation (Qgcomp). An analysis stratified by gender was also conducted. RESULTS:The research had 3,370 participants, of whom 1,703 (51%) were male. Multivariate linear regression revealed a negative correlation between increased mVOCs and UFR across all research cohorts (all P < 0.001). The BKMR model displayed a notable negative correlation, identifying N-Acetyl-S-(3,4-dihydroxybutyl)-L-cysteine (DHBMA) and Phenylglyoxylic acid (PGA) as possibly important chemicals. The WQS model exhibited a negative connection with UFR across the total cohort and its male and female subgroups, with all P values being less than 0.05. The findings of the Qgcomp model aligned with those of the WQS model. CONCLUSIONS:Our data indicate a substantial negative connection between exposure to urinary mVOCs and UFR among US adults, with no notable gender differences seen.
Lower urinary tract dysfunction (LUTD) is prevalent in aging men. It is characterized by urinary symptoms such as weak stream and more frequent urination, and is linked to a variety of prostate and urethral pathologies. While the leading medical therapies for male LUTD aim to reduce the tone and volume of the prostate and urethra, no current therapies target two prominent emerging mechanisms of male LUTD: prostate inflammation and fibrosis. LUTD arises and progresses over decades of a man's life, making it difficult to pinpoint disease mechanisms. Non-human research models, including mice, have been useful for investigating slow-progressing diseases of aging. Research involving mouse models of lower urinary tract dysfunction is surging due to a growing suite of genetic, pharmacological and immune-based tools for manipulating mouse prostate histopathology, cell signaling and phenotyping mouse urinary voiding. Current research is focused on understanding how macrophages, fibrocytes, mast cells and other cells are recruited to the prostate and how these cells are activated to drive prostate inflammation and fibrosis. This review highlights recent mouse studies to investigate the cellular and molecular underpinnings of prostate inflammation and fibrosis, and the molecular mechanisms that have emerged from these studies as potential therapeutic targets.
Renal aging contributes to declining kidney function and heightened susceptibility to chronic kidney disease (CKD). A key factor in this process is the diminished number and functionality of renal stem/progenitor cells, though the underlying mechanisms remain incompletely understood. Human urine-derived stem/progenitor cells (USCs) represent a promising, non-invasive source with notable regenerative potential. In this study, we examined cellular proliferation, reactive oxygen species (ROS) production, and senescence-associated protein expression as indicators of age-related degeneration in renal progenitor cells. USCs obtained from older healthy and diabetic individuals were compared to those from young, healthy donors. Our results demonstrate that USCs from aged and diabetic donors exhibit significantly reduced proliferation, elevated ROS levels, and increased β-galactosidase expression. Moreover, these cells showed impaired capacity to form 3D renal spheroids with tubular-like structures over a two-week culture period, relative to young controls. Together, these findings suggest that USCs from older or diabetic individuals - when cultured in both 2D and 3D systems - serve as a valuable model for studying renal aging and progenitor cell dysfunction. This model may facilitate the identification of biomarkers for renal aging and CKD risk and inform future regenerative and therapeutic strategies.
Recently, accumulating studies demonstrate that some long non-coding RNAs (lncRNAs) contain open read frames and have protein/peptide-coding potential. NCYM is a 109-amino acid product encoded by lncRNA MYCNOS variant 2 that is an antisense transcript of MYCN oncogene. NCYM is amplified in human neuroblastomas and associated with poor prognosis. However, its functional role in Wilms tumor (WT) remains unclear. In this study, we identified lncRNA MYCNOS as a promising prognostic factor in Wilms tumor through bioinformatics analysis. The expression of NCYM and downstream genes was determined by western blotting. Cell proliferation, migration, and invasion were measured by CCK-8, wound healing and Transwell assays, respectively. Cell apoptosis was evaluated by flow cytometry assay. The subcutaneous xenograft and lung metastasis mouse model were established by the armpit injection or tail intravenous injection of WT cells, respectively. Our results showed that NCYM was validated to be abundantly expressed in Wilms tumor cell lines and tissues. The exogenous overexpression of NCYM promoted WT cell proliferation, migration, and invasion. The silencing of SIX1 expression abolished the pro-growth effect of NCYM and downregulated β-catenin in WT. Additionally, NCYM facilitated tumor growth and formation of lung metastasis in vivo. In summary, the exogenous overexpression of NCYM could play a critical role in WT progression by mediating SIX1 and β-catenin as an oncopromoting factor.
Artificial Intelligence (AI) is revolutionizing prostate cancer (PCa) care, addressing the major clinical challenges of subjectivity and overtreatment. Our traditional tools - like PSA, DRE, mpMRI, and Gleason scoring - often lack the precision needed to distinguish truly aggressive tumors from indolent disease, leading to unnecessary morbidity in up to 50% of low-risk men. This review explains how AI, specifically machine learning (ML) and deep learning (DL), is poised to solve this. We cover AI's role from initial diagnosis, where radiomics and digital pathology boost grading accuracy and reduce inter-reader variability, to treatment selection and surgical precision through predictive models and Augmented Reality (AR) guidance. We also detail its utility in predicting biochemical recurrence (BCR) and managing long-term side effects. Finally, we address the critical barriers to adoption, including the need for large, diverse datasets (to combat algorithmic bias), the "black box" problem (solved by Explainable AI, XAI), and navigating FDA regulation. The future of PCa care hinges on this precise, data-driven approach.
Clear Cell Urothelial Carcinoma (CCUC) is a rarely reported urothelial carcinoma variant first described in 1995. Due to CCUC's clinical rarity, reporting additional cases may aid future clinicians on surgical and oncological management. We present a case of an 89-year-old male with primary CCUC and highlight the aberrant histopathological findings with a literature review. This study aims to add to current descriptions of CCUC and inform surgical and oncological management in future patients. An 89-year-old male with a history of smoking presented to clinic with painless hematuria of six months duration. Imaging showed right-sided hydroureteronephrosis down to a bladder mass. This was confirmed to be a bladder tumor on office cystourethroscopy. Following TURBT procedure, the pathology report came back suggesting 3.6 cm superficial low-grade Ta CCUC. Five months later, the patient presented with hematuria, acute kidney injury, and anemia. He was found to have T3a muscle-invasive urothelial carcinoma. This was confirmed on additional analysis which showed an FGFR3 mutation and abundant glycogen-filled clear cells. Histologically, CCUC is characterized by a glycogen-rich clear cytoplasm, severe atypia and a "nested" growth pattern. CCUC may be differentiated from non-CCUC by as few as a 30% clear cell change morphology of all cells. CCUC must be differentiated from Renal Cell Carcinoma and Clear Cell Adenocarcinoma. Treatment for CCUC has varied by case, with some surgeons electing to treat with radical cystectomy while others opting for local resection. Our case helps combat the paucity of literature by further characterizing and contributing to the management of CCUC.
OBJECTIVES:To compare prostate cancer rates in magnetic resonance imaging (MRI)-detected lesions for patients who are chronically taking beta-blockers, nonsteroidal anti-inflammatory drugs (NSAIDs), or immunosuppressors. METHODS:This cohort consisted of 897 Prostate Imaging Reporting & Data System (PI-RADS)v2 3-5 lesions from 590 MRI-targeted fusion prostate biopsies (UroNav). Baseline characteristics and clinicopathological data were collected. A matching cohort was analyzed, and multivariate analysis was completed for each medication group. Matching analysis accounted for age, prostate-specific antigen (PSA), and PI-RADS score. Multivariate analysis additionally considered lesion size. RESULTS:Of the 897 lesions, 261/897 (29%) of lesions were identified as PI-RADS 3, 373/897 (42%) were PI-RADS 4, and 263/897 (29%) were PI-RADS 5. In the patient cohort, 16% were taking a beta-blocker, 3.9% were taking an NSAID, and 5.4% were taking an immunosuppressant. An equal number of lesions in controls were matched to 148 lesions in males taking beta-blockers, 37 lesions in males taking NSAIDs, and 46 lesions in males taking immunosuppressants. Matching was based on age, PSA, and PI-RADS score. In the matched cohort, neither beta-blockers, NSAIDs, nor immunosuppressants altered clinically significant prostate cancer (csPCa) identification on MRI (OR 1.11, CI 95% 0.6, 1.9; OR 0.70, CI 95% 0.32, 1.66; OR 1.73, CI 95% 0.59, 5.35, respectively). CONCLUSION:This pilot study shows no difference in csPCa detection rates in patients using anti-inflammatories or drugs that alter prostate blood flow.
Time from cancer diagnosis to treatment initiation (TTI) can influence clinical outcomes and is a measure of care quality. This study aimed to evaluate the associations between clinical, sociodemographic, and facility-level factors with treatment delays among patients with prostate cancer during the COVID-19 pandemic. We conducted a retrospective analysis of the National Cancer Database (NCDB) for prostate cancer cases diagnosed in 2020 and 2021. We assessed the associations between clinical factors, sociodemographic variables (age, race, ethnicity, sex, income, education, insurance), facility-related factors (facility type, geographic region), and TTI. Multivariable logistic regression was used to identify factors associated with prolonged TTI, defined as the top decile of days to treatment. We identified 160,863 patients, with a median TTI of 71 days (IQR: 43-107). The 90th percentile for TTI was 154 days. Compared to White race, Black (OR 1.39, 95% CI 1.33-1.45), Asian (OR 1.28, 95% CI 1.08-1.52), and Hispanic (OR 1.31, 95% CI 1.21-1.41) patients had significantly longer TTI. Treatment at academic (OR 1.84, 95% CI 1.70-2.00), network (OR 1.37, 95% CI 1.25-1.49), and comprehensive facilities (OR 1.16, 95% CI 1.07-1.26) was associated with longer TTI compared to community facilities. Lastly, private insurance was associated with shorter delays compared to uninsured individuals (OR 0.75, 95% CI 0.71-0.81). Sociodemographic disparities, including race, insurance status, and treatment facility, were associated with longer TTI among prostate cancer patients during the COVID-19 pandemic. These findings can guide efforts to improve timeliness of cancer care.
OBJECTIVE:To evaluate the efficacy and safety of retrograde intrarenal surgery (RIRS) combined with a flexible vacuum-assisted ureteral access sheath (FV-UAS) in patients with 1-2 cm lower calyceal renal stones. PATIENTS AND METHODS:In total, 203 patients with calyceal stones were prospectively randomized into two groups (Clinical trial registration number: ChiCTR2200056402). Of them, 101 patients were assigned to the FV-UAS group and 102 to the traditional UAS group (control). The primary outcome was the stone-free rate (SFR) on postoperative day 1 and in the 4th week. Secondary outcomes included operative time, length of postoperative hospital stay, hospitalization costs, and procedure-related complications. RESULTS:No significant differences were noted in baseline demographics and preoperative clinical characteristics between the two groups (all P > 0.05). Postoperative data indicated that the SFRs on both postoperative day 1 and week 4 were significantly higher in the FV-UAS group than in the traditional UAS group (86.1% vs. 70.6%, P = 0.007; 92.1% vs. 82.4%, P = 0.038, respectively). Hospitalization costs were also lower in the FV-UAS group than in the traditional UAS group ($2524.1 vs. $2635.4, P < 0.001). Furthermore, the incidence rates of postoperative fever, perirenal hematoma, and urosepsis were significantly lower in the FV-UAS group than in the traditional UAS group (fever: 2.0% vs. 8.8%, P = 0.031; hematoma: 0.0% vs. 4.9%, P = 0.024; urosepsis: 1.0% vs. 7.8%, P = 0.018). CONCLUSIONS:Our findings suggest that the combination of FV-UAS and RIRS offers a promising treatment approach for 1-2 cm lower calyceal renal stones. This method results in higher SFRs, lower complication rates, and reduced hospitalization costs, making it a valuable technique for clinical adoption.
BACKGROUND:Tuberculosis spondylitis, also known as Pott's disease, is a form of osteomyelitis that primarily affects the vertebral bodies and can lead to severe complications such as paravertebral abscesses, kyphosis, and degenerative spinal changes. Although it typically involves the skeletal system, contiguous spread to adjacent organs, such as the genitourinary tract, is rare. METHODS:We report the case of a 64-year-old male with chronic back pain who underwent a renal protocol abdominopelvic CT scan following ultrasound findings of right kidney stasis. RESULTS:The CT revealed obstructive uropathy with a dilated and tortuous ureter, a 27×30 mm intraluminal lesion, intraluminal gas, and periureteric fibrosis. Fusion of the L3-L5 vertebrae with gibbous deformity and degenerative changes suggested tuberculous spondylodiscitis with extension to the ureter. Urinalysis was positive for acid-fast bacilli, confirming genitourinary tuberculosis. The patient underwent right ureteronephrectomy due to pyonephrosis and extensive adhesions precluding ureteral reconstruction. CONCLUSION:This case highlights a rare but serious complication of spinal tuberculosis involving direct spread to the ureter. Timely diagnosis using imaging and microbiological testing, followed by appropriate surgical intervention, is critical to prevent long-term morbidity.
OBJECTIVES:Clear cell and papillary renal cell carcinomas (RCC) are the two most common RCC subtypes, accounting for approximately 70% and 15% of kidney cancers, respectively. Clear cell RCC is commonly associated with VHL alterations, while papillary RCC typically exhibits chromosomal abnormalities such as +7, +17, and -Y. Furthermore, clear cell RCCs are less likely to exhibit PBRM1 and SETD2 alterations. This study aims to improve the accuracy of RCC diagnosis by investigating molecular alterations in RCC cases with clear cells, papillary structures, and other atypical histological features. METHODS:Nine RCC cases were retrospectively selected and analyzed using histologic slides and immunohistochemical staining for CAIX, RCC, CD10, CK7, P504S, Vimentin, and EMA. Next-generation sequencing was performed on all cases to identify genetic mutations, and cytogenetic analysis was conducted on one case. RESULTS:The cohort consisted of nine male patients aged 49 to 68 years (mean 61.4). Surgical specimens included six radical and three partial nephrectomies; seven tumors were located in the left kidney and two in the right. Tumor sizes ranged from 0.8 to 15.2 cm. Immunohistochemical analysis revealed positive staining for RCC (6/9), CAIX (3/4), CD10 (6/6), and CK7 (5/9). In six clear cell RCCs, next-generation sequencing identified VHL mutations in four tumors, PBRM1 alterations in three, and SETD2 mutations in one. Five tumors with papillary fronds, sarcomatous components, or unclassified features harboring VHL, PBRM1, and/or SETD2 mutations were reclassified as clear cell RCC. One clear cell RCC with leiomyomatous stroma showed mTOR mutations. A case of clear cell papillary renal cell neoplasm showed no reportable gene mutations. The role of a FANCA mutation in one papillary RCC remains uncertain. Cytogenetic analysis of one case (Case #5) revealed 50, X, -Y, +3, +7, +16, +17, +20, consistent with papillary RCC. CONCLUSIONS:Next-generation sequencing is a useful method for categorizing RCCs with clear cells, papillary features, and unusual histology. Additionally, VHL mutations could be a promising target for personalized treatment in clear cell RCCs and their histologic variants.
PURPOSE:Temsirolimus and pazopanib serve as first-line therapies for renal cell carcinoma (RCC). This meta-analysis was performed to assess and compare their efficacy, optimal treatment targets, and associated toxicities. METHODS:We searched the PubMed, CNKI, Wanfang, and VIP databases for relevant literature published from 2003 to 2023. Studies were selected based on specific exclusion criteria, and eligible articles were subjected to data extraction for subsequent subgroup analysis. RESULTS:Fourteen studies of moderate to high quality were included. In the low-risk group, the mortality rate was significantly lower in the temsirolimus group at 0.23 (95% Cl, 0.15-0.31) compared to 0.44 (95% Cl, 0.40-0.47) in the pazopanib group. In the high-risk group, the mortality rate was 0.73 (95% Cl, 0.69-0.76) for temsirolimus and 0.67 (95% Cl, 0.64-0.71) for pazopanib. CONCLUSION:Temsirolimus demonstrated greater efficacy in the low-risk group, while pazopanib was superior in the high-risk group for the treatment of RCC. Consideration of both efficacy and toxicity is crucial to guide drug selection for patients. TRN: CRD42024578497 (Registration date: 2024/08/21).
OBJECTIVES:This study evaluated the cancer detection profile of magnetic resonance imaging/transrectal ultrasound fusion-guided biopsies (fusion biopsy) using the BiopSee® system in patients assessed with the Prostate Imaging Reporting and Data System (PI-RADS) version 2.1, focusing on clinically significant prostate cancer (csPCa) detection in regions of interest (ROI) and non-ROI areas. METHODS:We retrospectively analyzed 59 patients who underwent fusion biopsy between February and November 2024. Detection rates of csPCa (grade group ≥ 2) were compared between the ROI and non-ROI regions, and clinical and biopsy characteristics were compared between patients with and without csPCa. Univariate logistic regression analysis was performed to identify predictors of csPCa. RESULTS:The median patient age was 74 years, with a median prostate-specific antigen (PSA) level of 8.93 ng/mL. The csPCa detection rate was significantly higher in the ROI than in the non-ROI regions (61% vs. 44%, P = 0.012). Across the cohort, PI-RADS 4 and 5 lesions were more common than PI-RADS 3 lesions. A higher PI-RADS score (4 or 5) was identified as a significant predictor of csPCa detection (odds ratio 5.14, P = 0.034), whereas age, PSA, number of ROIs, and biopsy core numbers were not significant predictors. CONCLUSIONS:Fusion biopsy using the BiopSee® system achieved a high csPCa detection rate in targeted ROIs, especially for PI-RADS 4 and 5 lesions, while also highlighting the importance of combining systematic biopsy with targeted approaches because of the substantial proportion of csPCa detected in non-ROI regions.
2'-Hydroxyflavanone (2HF) has been recognized for its antitumor potential in recent years. In the past decade, the role of miRNAs in tumors has been gradually explored. Since natural compounds may regulate miRNA networks, our objective is to investigate the potential effects and mechanisms of 2HF in the treatment of bladder cancer (BCa) by targeting miRNAs. Cell viability, tube formation, Transwell, western blotting and colony formation assays were used to evaluate the effects of 2HF on the viability and angiogenesis of BCa cells. The expression of miR-99a-5p and mTOR was detected via RT-qPCR and western blotting. A subcutaneous xenograft animal experiment was used to evaluate the tumor inhibition of 2HF in vivo. The binding of miR-99a-5p to mTOR was demonstrated via dual-luciferase reporting and RNA pull-down assays. 2HF inhibited the cell viability, angiogenesis, protein expression of VEGFa and Ki67 in T24 and 253J cells and protein expression of CD31 in HUVEC cells. Also, 2HF induced the upregulation of miR-99a-5p but the downregulation of mTOR expression. Additionally, the inhibitory effect of 2HF on tumor cells can be effectively rescued by silencing miR-99a-5p or overexpressing mTOR in vitro. Moreover, 2HF inhibited tumor growth in nude mice, in which it upregulated miR-99a-5p but suppressed mTOR expression in xenograft tissues. Mechanistically, miR-99a-5p can directly target the mRNA of mTOR by binding to its 3' untranslated region (3'-UTR) and then inhibiting the expression of mTOR. 2HF inhibited BCa cell proliferation and angiogenesis by regulating the miR-99a-5p/mTOR/VEGFa axis, which may provide a novel treatment strategy and molecular mechanism for BCa treatment.
