Objective To explore the expressions and significance of IL-1 β,tumor necrosis factor-α (TNF-α),IL-8,IL-2,IL-12,interferon-γ (IFN-γ),IL-10,and IL-4 in immune microenvironment of cervical persistent HPV infection.Methods Twenty transient HPV infection patients and 63 patients with persistent HPV infection [22 patients with chronic cervicitis and 19 patients with low-grade squamous intraepithelial lesion (LSIL),and 22 patients with high-grade squamous intraepithelial lesion (HSIL)] were detected by proteinchip technique.The expressions of IL-2,IL-12,IL-1 β,IL-8,IL-10,IL-4,TNF-α,and IFN-γ in vaginal lavage fluid were detected.Results The expressions of TNF-α and IL-1 β in HPV transient infection group were statistically significantly lower than those in persistent HPV infection group (P＜0.001,P=0.035);the expressions of TNF-α in chronic cervicitis group,LSIL group,and HSIL group were statistically significantly higher than those in HPV transient infection group (P＜0.05);the expression of IL-10 in HPV transient infection group was statistically significantly higher than those in chronic cervicitis group and LSIL group (P=0.007,P=0.013),but the expression of IL-10 in LSIL group was statistically significantly lower than that in HSIL group (P =0.027);the expression of IL-8 in LSIL group was statistically significantly lower than that in HSIL group (P =0.039);there was no statistically significant difference in the expressions of IL-2,IL-12,and IFN-γ among different groups.Conclusion Proinflammatory cytokines (IL-lβ,TNF-α) and chemokine (IL-8)expressions in HPV persistent infection and cervical lesion increased,which provides a favorable immune microenvironment for HPV persistent infection and the occurrence and development of cervical lesions;IL-4 can regulate the balance of cervical pro-inflammation and antiinflammation;IL-10 may play different roles in different stages of HPV infection and cervical lesions.

Objective To investigate the histopathologic characteristics of bladder tumor and provide theoretical basis for the reasonable selection of treatment modality.Methods This retrospective study collected the pathological data of 4 200 bladder tumor from May 2001 to October 2014.There were 3 443 male and 757 female, and the average diameter of these tumors was (1.8 ± 0.6) cm (ranged 0.2 to 6.5 cm).Among all cases, 3 214 (76.5％) cases were solitary tumor while 986 (23.5％) were multiple tumors.The histologic subtype, pathological grade and stage, the existence of vascular and lymphovascular invasion, tumor in situ, abnormal variants and rare subtypes were recorded and analyzed.Results 162 cases (3.9％)were benign tumors and 4 038 cases (96.1％)were malignant tumors including 4 008 cases of urothelial cancer (UC), 18 cases of primary adenocarcinoma and 12 cases of primary bladder squamous carcinoma.Furthermore, 2 460 (61.4％)cases were high grade UC while 1 548(38.6％)cases were low grade.320 cases were found intravascular tumor embolus or lymphovascular tumor thrombus and 391 (9.3％)cases were found metaplasia of squamous epithelium.Moreover, there were 230 cases of squamous differentiation, 120 cases of glandular differentiation, 110 cases of both squamous and glandular differentiation, and 39 cases (0.9％)of other rare subtypes or variations.On pathological stage, 112 (2.8 ％) cases were carcinoma in situ, 548 (13.7％)cases were Ta, 2 599(65.1％)cases were T1, 480(12％)cases were T2, 92 cases(2.3％)were T3 and 23 cases(0.6％)were T4 stage, with the rest cases being unable to be accurate staging.Multiple Logistic regression analysis revealed that lymphovascular invasion was related to tumor grade , pathological stage and abnormal differentiation (P ＜ 0.02).Moreover, UC with squamous and glandular differentiation were related with tumor recurrence and progression (P =0.02).Conclusions Most bladder tumors were high grade and low stage urothelial cancer with various forms of differentiation.Squamous and glandular differentiation were most common variation which should be avoided to diagnosed as hybrid carcinoma.Lymphovascular tumor thrombus and abnormal differentiation were correlated with tumor stage and grade.

Objective To investigate the pathological characters of clinical T1b (4 ＜ diameter ≤7 cm) renal cell carcinoma and provide reference basis for the nephron sparing surgery (NSS).Methods From January 2002 to December 2014, the pathological features of clinical T1b renal cell carcinoma were studied in 710 cases, including 505 male cases and 205 female cases.The mean age was 58 years old, ranged from 26 to 88 years old.The location of tumor included 377 in left side and 383 in right side.In the recorded 372 cases, the accurate site of tumor included 137 in upper portion, 96 in middle portion and 139 in lower portion.The initial symptom included hematuria in 103 cases, back pain in 62 cases, hematuria accompanied with back pain in 34 cases and asymptom in 511 cases.The diameter of tumor ranged from 4.0 to 7.0 cma, mean 5.4 cm.We analyzed pathological features, Fuhrman grades, histologic subtype, tumor metastasis, perirenal fat invasion and vein tumor thrombosis in all patients.Results The proportions of the clear cell, papillary, chromophobe, unclassified and mixed cell histologic subtype were 75.8％ (538/710), 5.1％ (36/710), 4.6％ (33/710), 1.1％ (8/710) and 13.4％ (95/710), respectively.The proportions of hemorrhage, necrosis, cystic degeneration and fibrosis were 51.0％ (362/710), 30.1％ (214/710), 35.4％ (251/710) and 7.8％ (55/710), respectively.The rates of perirenal fat invasion and vein tumor thrombosis were 4.1％ (29/710) and 3.1％ (22/710).Among the 710 clinical T1b renal cell carcinoma, 144 (20.3％) were Fuhrman grade Ⅰ , 513 (72.3％) were grade Ⅱ, 43 (6.1％) were grade Ⅲ, 10 (1.4％) were grade Ⅳ.In 657 cases with low Fuhrman grade (Ⅰ/Ⅱ), 17 cases were noticed perirenal fat invasion.In 53 cases with high Fuhrman grade (Ⅲ/Ⅳ), 10 cases were noticed perirenal fat invasion.The analysis showed that high Fuhrman grading was concerned with the perirenal fat invasion.Conclusions Clinical T1b renal cell carcinoma has obvious heterogeneity in its biological behavior.Most of them has characters of high differentiation, low malignant tendency and good biological behavior.Rare carcinoma exhibits the aggressive character or early distant metastasis.During the nephron sparing surgery, perirenal fat should be removed and perform pathological examination.Vein tumor thrombosis should be bolt out and radical nephrectomy is recommended at the same time.

前列腺癌是欧美国家发病率最高的男性恶性肿瘤之一，其病死率仅次于肺癌，居第2位。近年来，我国随着人口老龄化和饮食结构等因素的变化，前列腺癌的发病率和病死率呈逐年上升的趋势。检测外周血液中循环肿瘤细胞（ circulating tumor cells，CTCs）是一种具有巨大发展潜力的无创诊断和实时疗效监测手段，对于前列腺癌患者早期转移和复发的筛查、诊断有重要意义。 CTCs是指自发或因诊疗操作由实体瘤或转移灶释放进入外周血循环的肿瘤细胞，由于CTCs具有与肿瘤原发灶相似的基因型和表型，通过观察CTCs的数量变化及其分子特性，分析CTCs的分子表观遗传学特征，进行基因检测有助于判断病情以及决定肿瘤治疗方案，对于前列腺癌个体化治疗具有重要的临床意义［1］。

Lymphovascular invasion (LVI) is the primary and essential step in the systemic dissemination of cancer cells. The aim of our study was to assess the independent prognostic role of LVI for pT1 urothelial carcinoma with squamous differentiation in bladder cancer. We retrospectively analyzed the clinical and pathological information of 206 patients diagnosed pT1 urothelial carcinoma with squamous differentiation. Of the 206 patients, LVI was detected in 57 (27.6%) patients. The 5 year cancer specific survival (CSS) rates were 87.2% in LVI (−) and 52.4% in LVI (+) (p < 0.001). According to univariate analysis, tumor multiplicity, tumor size, recurrence and LVI were the prognostic factors associated with CSS. Additionally, tumor size and LVI significantly influenced the CSS in multivariate analysis. TURBT had shorter median CSS than RC in recurred patients with LVI (+). Our study suggested that LVI is an important predictor for survival of pT1 urothelial carcinoma with squamous differentiation. LVI positive status and tumor size ≥3 cm led to a higher risk of death. RC should be routinely performed in recurred LVI (+) bladder cancer patients of pT1 urothelial carcinoma with squamous differentiation.

Objective To study the clinical and histopathologic features of small renal carcinoma (diameter≤4 cm)and provide theoretical basis for evaluating the safety,efficacy and prognosis of nephron sparing surgery.Methods This retrospective study collected the pathological data of 490 patients with small renal cell carcinoma,who were treated in our hospital,from May 2000 to October 2014.We recorded and analyzed the tumor size,histological subtype,Fuhrman grading,pathological stage,the existence of mulifocality,vascular invasion,tumor psuedocapsule,hemorrhage or necrosis and distant metastasis.Results The median diameter of tumor was (3.2 ± 0.6) cm,ranged 0.6 to 4.0 cm.Of all the subjects,422 (86.1％) were clear cell carcinoma,32 (6.5％) were chromophobe cell carcinoma,23 (4.7％) were papillary carcinoma and 13 (2.7％) were other rare types.Among the 422 clear cell carcinoma cases,27 were Fuhrman grade Ⅰ,157 were Ⅰ-Ⅱ grade,210 were grade Ⅱ,21 were Ⅱ-Ⅲ grade,7 were grade Ⅲ and no one was grade Ⅳ.Multifocal tumors were found in 18 cases (3.7％) and tumor embolus of renal vein was found in 6 cases (1.2％).Intact psuedocapsule were found in 326 (66.5％) tumors with the thickness ranged from 0.2 to 1.0 mm.Tumor infiltration without the psuedocapsule penetration were found in 82 cases (16.7％),penetrated into the psuedocapsule were found in 11 cases (2.2％),infringement of perirenal fat were found in 9 cases (1.8％).Hemorrhage and necrosis were found in 240 cases (48.9％),synchronous lung metastases occurred in 3 patients (0.6％).Logistic regression analysis revealed that tumor invasion and pseudocapsule penetration were related to Fuhrman Ⅱ-Ⅲ,Ⅲ and tumor diameter (P =0.04).Moreover,tumor size was related with histological grade and renal capsule invasion (P =0.02).Nevertheless,there was no relationship among tumor size,renal vein embolus or mulifocality (P =0.35).Conclusions Although most small renal tumors are high differentiation and low grade,but rare cases are aggressive with infringement of perirenal fat or early distant metastasis,suggesting heterogeneity in its biological behavior.Most small renal tumors have obvious psuedocapsule.When the tumor size is greater than 3.0 cm and its Fuhrman classification was high,the psuedocapsule and perirenal fat are more likely to be infiltrated.Nephron sparing surgery should remove the tumor and its surface adipose tissue entirely.

Objective To investigate the clinical characteristics and prognosis of bladder urothelial carcinoma with glandular differentiation.Methods From January 2009 to April 2014,the clinical data of 53 cases of bladder urothelial carcinoma with glandular differentiation were analyzed and compared,retrospectively.This group included 45 men and 8 women,which the median age was 67 years old (range 39 -81 years old).The initial symptoms included gross hematuria in 44 cases (83.0％),urinary irritation in 5 cases(9.4％),dysuria in 2 cases (3.8％) and found through physical examination in 2 cases (3.8％) TURBT was performed in 37 cases (69.8％).Partial and radical cystectomy were undergone in 6 (11.3％) and 10 (18.9％) cases,respectively.53 cases of bladder urothelial carcinoma without glandular differentiation were collected as control group,including 42 men and 11 women with a median age of 65 years (range 41-82 years).45 cases (84.9％) presented gross hematuria.Urinary irritation and dysuria was complained in each one case (1.9 ％).6 cases(11.3％) were found through physical examination.TURBT was performed in 38 cases (71.7％).Partial and radical cystectomy were undergone in 6 (11.3％) and 9 (17.0％) cases,respectively.Results According to the 2004 WHO classification criteria,there were 28 (52.8％)cases with pT1,18 (34.0％)cases with pT2,5 (9.4％)cases with pT3,2(3.8％)cases with pT4 in the glandular group.In the control group,the stage classification included 2 (3.8％)cases with pTa,32 (60.4％) cases with pT1,16 (30.2％) cases with pT2,2 (3.8％) cases with pT3,1 (1.9％) cases with pT4.There were 51 cases with high grade carcinoma and 2 cases with low grade carcinoma in the glandular group.In the control group,40 cases showed high grade carcinoma and 13 cases exhibited low grade carcinoma.Significant difference was found in those groups (P ＜ 0.05).The mean duration of follow-up was 23 and 24 months in glandular and control group,respectively.In glandular group,14 recurrence were recorded with a mean 16 months follow up and 2 cases were dead.In control group,6 recurrence were recorded with a mean 2 5 months follow up and no patients dead (P ＜ 0.05).Conclusions Bladder urothelial carcinoma with glandular differentiation tends to have high level of malignant and higher recurrent incidence.Patients should be treated immediately after being diagnosed and intimate following up.

Objective To investigate the clinical and pathological features of urothelial carcinoma with clear cell variant.Methods The pathological and clinical data of 7 cases pathological diagnosed urothelial carcinoma with clear cell variant between March 2005 and May 2014 were retrospectively reviewed.There were 6 males and 1 female,aged 46-75 years (mean,61 years).Clinical manifestations included gross hematuria in 5 cases,hematuria and backache in another 2 cases.The mean tumor size was 3.5 cm (ranged 2.0-6.0 cm).One case was multiple tumor and 6 cases were single tumor.Five cases were positive in urine cytology.All the 7 cases accepted surgical treatment,including radical nephroureterectomy in 2 cases,transurethral resection of bladder tumor plus pharmorubicin regular intravesicalinstillationin 1 case,and radical cystectomy in 4 patients.Results Pathological findings revealed that all the tumors were high-grade urothelial carcinoma with clear cell variant in different proportion.Among them,clear cell tumor was predominant in 1 case and focal in other 6 cases.Meanwhile,tumorsaccompanied by glandular differentiation were found in 2 cases,squamous differentiation was found in 1 case,and micropapillary variant was found in 1 case.Vascular tumor embolus was found in 4 cases.Pathological stage was pT2a (n =1),pT2b (n =3),and pT3a (n =3).Immunohistochemicalstaining revealed cytokeratin 7 (+),cytokeratin 20 (+),epithelial membrane antigen (+)and prostate specific antigen (-).Six cases were followed up.The bladder preservation case was followed up for 8 months without recurrence.In 3 radical cystectomy cases,1 died of cancer 25 months after surgery and another 2 case were followed up for 10 and 12 months after surgery without recurrence and metastasis.In 2 nephroureterectomy cases,1 died of tumor metastasis 18 months after surgery and the other case was followed up for 6 months without recurrence or metastasis.Conclusions Urothelialcarcinoma with clear cell variant is a malignancy often with advanced stage and poor prognosis.Radical surgery is recommended for the treatment.

阴茎癌是一种起源于阴茎头、冠状沟和包皮内板黏膜以及阴茎皮肤的恶性肿瘤。由于国家、民族、宗教信仰以及卫生习惯的不同，阴茎癌的发病率有明显的差异。在欧洲其发病率为0．1～0．9／10万；在美国为0．7～0．9／10万；但是在亚洲、非洲和南美洲的部分经济欠发达地区，发病率则高达19／10万［1］。随着纳米技术和基因分析及腹腔镜技术的应用，阴茎癌诊断和治疗水平不断提高，保留阴茎手术和腹腔镜腹股沟淋巴结清扫在临床上的应用更加广泛。此外，新辅助治疗和靶向治疗的出现也为阴茎癌的治疗提供了更多的手段。