Bacillus Calmette–Guérin (BCG) immunotherapy is the cornerstone of adjuvant management for intermediate- and high-risk non-muscle-invasive bladder cancer (NMIBC). However, 30–40
To study specific endocrine alterations in varicocele by directly comparing hormone profiles between affected internal spermatic vein blood and peripheral vein blood, and to explore potential local testicular functional changes that cannot be detected by conventional peripheral indicators. We prospectively enrolled 76 men aged 18–28 years with clinical grade 2–3 unilateral varicocele, normal peripheral inhibin B and testosterone levels, who underwent microsurgical varicocelectomy. Direct intraoperative sampling of affected internal spermatic vein blood compared with peripheral venous blood. Comparison of hormone levels (Inhibin B, testosterone, estradiol, FSH, LH, progesterone) between affected spermatic vein (aINHB, aT, aE2) and peripheral blood (pINHB, pT, pE2). Correlation between aINHB levels and disease severity parameters (clinical grade, ultrasound grade, venous diameter). We observed a significant “hormone dissociation phenomenon”: aINHB level was significantly lower than pINHB (91.4 ± 71.2 pg/mL vs. 217.8 ± 127.6 pg/mL, p < 0.0001), while aT (450.0 ± 1115.0 nmol/l vs. 26.2 ± 8.0 nmol/l, p < 0.0001) and aE2 (276.0 ± 323.3 ng/L vs. 35.2 ± 15.3 ng/L, p < 0.0001) levels were markedly higher in the affected vein. aINHB level showed significant negative correlations with venous diameter (r = -0.412, p = 0.0052), ultrasound grade (r = -0.317, p = 0.0427), and clinical grade (r = -0.286, p = 0.0483). We report reduced inhibin B levels in the affected spermatic vein of varicocele patients despite normal peripheral levels, a finding consistent with a potential model of selective Sertoli cell dysfunction potentially driven by venous hypertension. This observation highlights a limitation of relying solely on peripheral blood testing and suggests that aINHB warrants further evaluation as a candidate marker.
Three-dimensional measurements from preoperative computed tomography (CT) may describe renal tumor anatomy before partial nephrectomy. We examined whether CT-derived tumor volume and tumor burden ratio were associated with postoperative estimated glomerular filtration rate (eGFR), and whether tumor burden ratio added information beyond radiographic maximum diameter. This retrospective secondary analysis used the public 489-case Kidney Tumor Segmentation Challenge 2023 training set. The main exploratory analysis included partial-nephrectomy patients with preoperative eGFR and a first postoperative eGFR measured 90–365 days after surgery. Tumor burden ratio was tumor volume divided by kidney-plus-tumor volume. The outcome was percentage eGFR decline. Linear regression adjusted for age, sex, body mass index, baseline eGFR, diabetes, and pre-existing chronic kidney disease. We also examined nonlinearity, model fit beyond maximum diameter, cohort selection, dataset composition, and tumor sphericity. Among 275 partial-nephrectomy cases, 74 met the 90-365-day criteria. Each doubling of tumor burden ratio was associated with a 2.83-percentage-point greater eGFR decline (95
Prostate-specific antigen (PSA) has limited specificity in prostate cancer screening, highlighting the need for novel circulating biomarkers to improve diagnostic accuracy. This study aimed to identify candidate biomarkers through preliminary proteomic screening, evaluate the diagnostic potential of plasma growth differentiation factor 15 (GDF15), and develop a diagnostic prediction model for prostate cancer. This observational study enrolled patients hospitalized in the urology department for prostate-related conditions who were scheduled to undergo prostate biopsy. Patients were classified according to biopsy pathology into prostate cancer and non-prostate cancer groups; the latter consisted of biopsy-indicated patients with benign prostatic conditions rather than healthy controls. Preliminary proteomic screening of TiO₂-enriched plasma fractions was used to nominate candidate proteins. The diagnostic performance of these candidates was subsequently evaluated by enzyme-linked immunosorbent assay (ELISA) in unfractionated plasma from the main biopsy-indicated cohort. Receiver operating characteristic (ROC) curves were used to assess diagnostic performance. Multivariate logistic regression was performed to evaluate independent associations with prostate cancer risk, and a nomogram prediction model was subsequently constructed. A total of 312 patients were included, comprising 132 patients with biopsy-confirmed prostate cancer and 180 patients without pathological evidence of prostate cancer. Plasma GDF15 and SLPI levels were significantly higher in the prostate cancer group than in the non-cancer group (P < 0.001). Multivariate analysis demonstrated that GDF15 and SLPI were independently associated with prostate cancer risk. ROC analysis showed that GDF15 achieved an area under the curve (AUC) of 0.805. A nomogram incorporating GDF15, age, body mass index (BMI), and total prostate-specific antigen (tPSA) demonstrated strong predictive performance, with AUCs of 0.887 and 0.874 in the training and validation cohorts, respectively. Plasma GDF15 showed promising diagnostic performance for prostate cancer in this biopsy-indicated cohort. A nomogram integrating GDF15 with clinical variables demonstrated favorable internal diagnostic performance. However, the limited number of patients with tPSA levels of 4–10 ng/mL precluded reliable subgroup analysis in this clinically important range, and further validation in larger cohorts is warranted.
The extent to which short-term changes in chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) symptoms and erectile function align remains uncertain. We retrospectively analyzed 122 men with CP/CPPS who reported sexual activity during both questionnaire reference periods and had complete baseline and week-12 National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) and 5-item International Index of Erectile Function (IIEF-5) assessments during usual care. Improvements were defined as baseline minus week-12 NIH-CPSI and week-12 minus baseline IIEF-5. Their continuous association was evaluated using Spearman correlation with 10,000 bootstrap resamples and baseline-adjusted analysis of covariance. Threshold-based classifications were secondary and exploratory. Mean NIH-CPSI and IIEF-5 improvements were 6.0 points (95
