[目的]评价细胞免疫治疗肾脏透明细胞癌的应用价值.[方法]收集2006年1月至2016年1月期间行细胞免疫治疗的肾癌患者临床资料及细胞免疫治疗资料,分析其相关性.[结果](1)细胞免疫治疗相关不良反应发生率低,未发生危及生命急性、慢性不良反应.(2)肾透明细胞癌患者5年存活率90％,T1～2期患者5年存活率可达94％,T3～4期患者3年存活率超过80％.(3)存在出血、坏死、被膜浸润等病理改变的病例,存活期与无相应病变患者没有差异.表明病理存在出血、坏死以及被膜浸润的患者,更能从细胞免疫治疗获益.[结论](1)细胞免疫治疗在肾透明细胞癌的治疗中是安全的.(2)细胞免疫治疗对肾透明细胞癌有积极治疗作用,可延长存活期,减少转移、复发发生率.(3)有出血、坏死、被膜浸润等病理改变的患者宜尽早进行本治疗,以提高肾癌的治疗效果.

The aim of the present study was to explore use of the acridine orange fluorescence (AO-F) staining method for screening of circulating tumor cells (CTCs) in renal cell carcinoma (RCC) patients. The AO-F positive staining rate of live and dead tumor cells was calculated. The positive staining rate in the live group was 93.4±3.0%, while the dead group failed to emit specific fluorescence. A known number of tumor cells were added to peripheral blood, and the detection sensitivity of the four groups (50, 100, 200 and 500 cells/tube) was 10.2±3.8, 9.2±2.3, 10.8±2.6 and 10.5±1.9%, respectively. The average detection sensitivity of the four groups was 10.16±2.73%. There was a positive correlation between the number of cells that was positively stained with AO-F and the total number cells in the system (χ2=0.959; P<0.001). Subsequently, the AO-F staining method was used to detect positive staining cells in 8 healthy volunteers (control group), and 112 non-metastatic and 27 metastatic RCC patients. The positive staining rate was 13.67% (19/139) in RCC patients, while none of the control group was positive. The AO-F positive staining rate was not significantly different between the metastatic and non-metastatic patients according to age, gender, the pathological pattern, T2/3 (according to the Tumor-Node-Metastasis classification) or Fuhrman grade, while there was a significant difference according to T1. The positive staining rate was 8.93% (10/112) for non-metastatic patients and 33.33% (9/27) for metastatic patients, which showed a significant difference (P<0.05). In 112 non-metastatic and 27 metastatic patients, the positive staining rate was not significantly associated with gender, age, tumor size, the pathological pattern, T classification, Fuhrman grade, the presence of a lesion or metastasis to the lungs. The present study demonstrated that the method of CTC staining with AO-F, which has high reproducibility and specificity, was feasible for identifying CTCs and warrants further study.

Renal inflammatory myofibroblastic tumor (IMT) rarely presents clinically with a picture of nephrapostasis especially in an elderly female patient. A 69-year old woman presented with a 2-month history of left flank pain. Abdominal computed tomography (CT) demonstrated a huge cystic tumor on the left kidney concerning for infection. Under the impression of renal abscess, a laparoscopic renal cyst decortication was performed. Intraoperative frozen sections showed simple renal cyst. However, the postoperative histologic examination showed myofibroblastic spindle cells accompanied by an inflammatory infiltration of plasma cells and lymphocytes, arguing against the diagnosis of a cyst of kidney. Immunohistochemical staining was positive for Vimentin, SMA, CD68, lambda chain and. chain, negative for Desmin, P53, ALK, CK and CD117, confirming the diagnosis of IMT. And the culture of cystic fluid revealed the presence of escherichia coli. Over the course of long-term follow-up after surgery, the patient recovered and did not have recurrence or metastasis.

目的:探讨非肌层浸润性膀胱癌(non-muscle-invasive bladder cancer,NMIBC)合并糖尿病患者的预后及意义.方法:回顾性分析我院2012年1月～2013年12月经病理检查回报为NMIBC的200例患者临床资料,将患者分为糖尿病组(41例)和非糖尿病组(159例).所有患者均为首发尿路上皮癌.运用Kaplan-Meier 法单因素分析各临床病理特点对患者无复发生存期(recurrence-free survival,RFS)和无进展生存期(progression-free survival,PFS)的影响,并用Log-rank检验比较生存曲线,运用Cox回归模型多因素分析糖尿病与NMIBC之间的关系,并评估影响其RFS和PFS的预后因素.结果:200例NMIBC患者平均随访14.2(4～40)个月,糖尿病组和非糖尿病组肿瘤复发率分别为34.1％(14/41)和28.3％(45/159),中位无复发生存时间分别为12.0个月(4～38个月)和14.7个月(5～40个月),肿瘤进展率分别为9.8％(4/41)和6.9％(11/159),糖尿病组较非糖尿病组肿瘤复发率高(x2=4.875,P=0.027),无复发生存时间短(P＜0.001),而进展率的差异无统计学意义(P=0.770).Cox多因素生存分析显示糖尿病(P＜0.001,HR=2.731)、肿瘤大小(P=0.012,HR=2.344)和NMIBC更高的复发风险相关,而灌注药物(P＜0.001,HR=0.110)会显著降低NMIBC的复发风险.结论:糖尿病是NMIBC患者RFS的独立危险因素,患有糖尿病的NMBIC患者术后复发率更高.

目的:探讨非肌层浸润性膀胱癌(non-muscle-invasive bladder cancer,NMIBC)伴术前脓尿患者的临床特点及脓尿对其预后方面的临床意义.方法:回顾性分析2009年11月～2011年3月我院278例首发非肌层浸润性膀胱癌患者的临床病理资料.定义脓尿为每高倍视野下尿白细胞数量≥5个,根据术前尿白细胞值,将患者分为脓尿-组(尿白细胞＜5)和脓尿+组(尿白细胞≥5),运用卡方检验分析脓尿和各临床病理特点之间的关系,运用Kaplan-Meier法比较两组之间无复发生存期(recurrence-free survival,RFS)和无进展生存期(progression-free survival,PFS)的区别,并用Log-rank检验评估其统计学意义.结果:278例NMIBC患者中,有98例(35.3％)出现术前脓尿,平均随访48.6(3～72)个月.在随访期间内,脓尿的出现与大体积、多发、高TNM分期、高级别肿瘤以及高复发率和高进展率显著相关,且经Kaplan-Meier法分析发现,脓尿+组患者无复发生存率明显低于脓尿-组患者(58.2％ vs.71.7％,P=0.016);同样,脓尿+组患者无进展生存率也明显低于脓尿-组患者(74.5％ vs.85.6％,P=0.018).结论:非肌层浸润性膀胱癌伴术前脓尿患者肿瘤多发且体积大,组织学分级和临床分期高,预后较差,应积极手术治疗并术后密切随访.

The aim of the current study was to investigate the biological effect on T24 cells and human umbilical vein endothelial cells (HUVECs) of transfection with brain-specific angiogenesis inhibitor-1 (BAI-1). The recombinant plasmid pReceiver-M61-BAI-1 was transfected into human superficial bladder tumor cells (T24) and HUVECs, in parallel with the vector control. mRNA and protein expression levels of BAI-1 were then detected by quantitative polymerase chain reaction (qPCR) and western blotting, respectively. Cell apoptosis of T24 cells and HUVECs prior and subsequent to transfection with BAI-1 was analyzed by flow cytometric analysis. Proliferation of T24 cells and HUVECs prior and subsequent to transfection of BAI-1 was assessed by the MTT method. T24 cells and HUVECs transfected with pReceiver-M61-BA1-1 were classed as the experimental group; T24 cells and HUVECs transfected with p-Receiver-M61 were the control group. qPCR and western blotting methods confirmed that there was positive expression of BAI-1 in T24 cells and HUVECs transfected with pReceiver-M61-BAI-1, however BAI-1 was not expressed in T24 cells and HUVECs transfected with pReceiver-M61. The results of the MTT assay demonstrated that absorbance was markedly reduced in HUVECs at 12, 48 and 72 h subsequent to transfection with pReceiver-M61-BAI-1 when compared with that of the control group and in T24 cells transfected with p-Receiver-M61-BAI-1. Furthermore, flow cytometry results also indicated that the apoptotic rate of HUVECs transfected with p-Receiver-M61-BAI-1 was significantly increased compared with that of the control group and T24 cells transfected with p-Receiver-M61-BAI-1. BAI-1 was observed to markedly inhibit the proliferation of vascular endothelial cells in vitro, however, no direct inhibition by BAI-1 was observed in T24 cells. In conclusion, BAI-1 is suggested to be a potential novel therapautic target for the inhibition of tumor neovascularization.

目的:探讨肾上腺神经鞘瘤的诊治特点.方法:回顾性分析5例肾上腺神经鞘瘤患者的临床资料,结合文献分析其临床、影像学及病理特点,探讨其治疗及预后.结果:本组5例患者均为体检发现,其中3例曾感患侧腰部不适.入院体检均无特殊发现,与肾上腺有关的血生化检查均为正常.所有患者手术切除肾上腺肿物,术后病理检查证实为肾上腺神经鞘瘤,随访3个月～9年,未见复发或恶变.结论:肾上腺神经鞘瘤来源于肾上腺髓质,为良性肿瘤,较为少见,临床表现缺乏特异性,确诊依赖病理学及免疫组织化学检查.手术切除是主要治疗方法.

The aim of the present study was to investigate the expression levels of brain‑specific angiogenesis inhibitor‑1 (BAI‑1) in bladder transitional cell carcinoma (BTCC) at different stages and the mechanism by which it inhibits tumor endothelial cell proliferation. Normal bladder mucosa biopsy specimens were obtained as the control group, and human BTCC biopsy specimens were used as the study group. Immunohistochemical assays were used to detect the expression levels of BAI‑1, vascular endothelial growth factor (VEGF) and mutant p53, in addition to microvessel density (MVD) in the tissues. Western blotting was used to analyze the differential expression of BAI‑1 in the two samples. Statistical analysis was performed, which indicated that BAI‑1 expression levels in the normal bladder mucosa group were significantly higher than those in the BTCC group and were associated with clinical staging. BAI‑1 levels in the T1 stage BTCC tissues were higher than those in the T2‑4 stage BTCC tissues (P<0.05). BAI‑1 expression levels were negatively correlated with those of VEGF (r=‑0.661, P<0.001), mutant p53 (r=‑0.406, P=0.002) and with the MVD (r=‑0.675, P<0.001). BAI‑1 may be involved in the negative regulation of BTCC microvascular proliferation, and its expression may be associated with a reduction in p53 mutations.

Numerous studies have investigated association between the germline HOXB13 p.Gly84Glu mutation and cancer risk. However, the results were inconsistent. Herein, we performed this meta-analysis to get a precise conclusion of the associations. A comprehensive literature search was conducted through Medline (mainly Pubmed), Embase, Cochrane Library databases. Crude odds ratios (ORs) and their 95% confidence intervals (CIs) were calculated by STATA 12.1 software to evaluate the association of HOXB13 p. Gly84Glu mutation and cancer susceptibility. Then, 25 studies including 51,390 cases and 93,867 controls were included, and there was significant association between HOXB13 p. Gly84Glu mutation and overall cancer risk (OR = 2.872, 95% CI = 2.121-3.888, P < 0.001), particularly in prostate cancer (OR = 3.248, 95% CI = 2.313-4.560, P < 0.001), while no association was found in breast (OR = 1.424, 95% CI = 0.776-2.613, P = 0.253) and colorectal cancers (OR = 2.070, 95% CI = 0.485-8.841, P = 0.326). When we stratified analysis by ethnicity, significant association was found in Caucasians (OR = 2.673, 95% CI = 1.920-3.720, P < 0.001). Further well-designed with large samples and other various cancers should be performed to validate our results.

Epidemiological studies have explored the diagnostic effect of urine BLCA-4 in bladder cancer. However, the results remain controversial. Therefore, we conducted this pooled analyses to determine the overall accuracy of urine BLCA-4 in bladder cancer. A comprehensive electronic and hand search was conducted for related literatures though several databases. QUADAS-2 was used to assess the quality of each included studies. Diagnostic parameters were calculated using Meta-Disc (version 1.4) and Stata (version 12.0) software. Nine published articles with 1,119 subjects were included. The summary estimates were: sensitivity 0.93 (95% confidence interval [CI] = 0.90-0.95), specificity 0.97 (95% CI, 0.95-0.98), positive likelihood ratio 48.16 (95% CI, 11.77-197.01), negative likelihood ratio 0.08 (95% CI, 0.06-0.11), diagnostic odds ratio 534.03 (95% CI, 150.15-1899.31), and the AUC was 0.9607. In conclusion, urine BLCA-4 is a promising marker in diagnosing bladder cancer.

目的：比较保留肾单位手术（NSS）与根治性肾切除术（RN）治疗T1b期肾癌的临床疗效。方法选择T1b期肾癌患者75例，其中36例行NSS（ NSS组），39例行RN（ RN组），比较两组的临床疗效。结果 NSS组和RN组手术时间、术中出血量、术后住院时间比较，P均＞0．05。 NSS组术前、术后24 h、术后1 a血清肌酐分别为（79．6±14．2）、（90．9±29．3）、（82．5±25．4）μmol/L，RN组分别为（83．0±16．8）、（101．7±42．6）、（132．1±38．4）μmol/L；NSS组术后24 h、1 a与术前比较，P均＞0．05；RN组术后24 h、1 a与术前比较，P均＜0．05。 NSS组发生并发症1例、复发率0、生存率100％，RN组分别为0例、0、100％，P均＞0．05。结论 NSS与RN治疗T1b期肾癌均安全、有效，具有相近的肿瘤控制效果；NSS较RN能更好地保留肾功能，并提高肾癌患者的生活质量。

Transforming growth factor-β1 (TGFβ1) plays a significant role in regulating cellular proliferation and apoptosis. A large number of studies related to the association between TGFβ1 Leu10Pro polymorphism and prostate cancer (PC) risk, but get conflicting results. We performed a meta-analysis based on six studies, assessing the strength of the association using odds ratios (OR) with 95 % confidence intervals (CI). Overall, our evidence has indicated that TGFβ1 Leu10Pro polymorphism had significantly increased PC risk in the allele comparison model (OR = 1.081, 95 % CI = 1.003–1.165, P heterogeneity = 0.141, P = 0.041). In the stratified analysis by ethnicity, the same results were found among Caucasians (for heterozygote model, OR = 1.741, 95 % CI = 1.004–3.020, P heterogeneity = 0.000, P = 0.049; recessive model, OR = 1.339, 95 % CI = 1.045–1.717, P heterogeneity = 0.020, P = 0.021; allele comparison model, OR = 1.091, 95 % CI = 1.005–1.184, P heterogeneity = 0.048, P = 0.037). In conclusion, this meta-analysis suggested that TGFβ1 Leu10Pro polymorphism contributed to the development of PC. A well-designed and larger study is still required to evaluate this polymorphism and PC risk.

阴茎疣状癌临床上很少见,属于低度恶性、高分化的鳞状细胞癌,易误诊.2005年9月-2012年9月我院共收治5例,报告如下. 1 资料与方法 1.1 临床资料 本组5例,年龄51～77岁,平均65岁.患者有阴茎肿物病史1～48(平均24.3)月,3例患者病变初期在外院曾误诊为尖锐湿疣进行不恰当治疗,另2例患者入院前未做任何治疗.4例患者既往有包皮过长病史,其中2例为包皮环切术后,5例患者均否认冶游史.

BACKGROUND:To explore the necessity of maintenance, efficacy of low-dose and superiority of various combination therapies of Bacillus Calmette-Guérin (BCG) in treatment of superficial bladder cancer (BCa).METHODS:Comprehensive searches of electronic databases (PubMed, Embase, and the Cochrane Library) were performed, then a systematic review and cumulative meta-analysis of 21 randomized controlled trials (RCTs) and 9 retrospective comparative studies were carried out according to predefined inclusion criteria.RESULTS:Significantly better recurrence-free survivals (RFS) were observed respectively in patients who received BCG maintenance, standard-dose and BCG plus epirubicin therapy comparing to those received induction, low-dose and BCG alone. BCG maintenance therapy was also associated with significantly better progression-free survival (PFS), but there were more incidences of adverse events. Pooled results showed no remarkable advantage of BCG combined with Mitomycin C or with interferon α-2b in improving oncologic outcomes. Sensitivity-analyses stratified by study-design and tumor stage led to very similar overall results and often to a decrease of the between-study heterogeneity. Our data confirmed that non-RCT only affected strength rather than direction of the overall results.CONCLUSIONS:All patients with superficial BCa should be encouraged to accept BCG maintenance therapy with standard-dose if well tolerated. Patients can benefit from BCG combined with epirubicin but not from BCG combined with Mitomycin C or interferon α-2b.

Objective:This study aims to compare the difference in the expression and localization of brain-specific angiogenesis inhibitor 1 (bai-1) between human normal and clear cell carcinoma of kidney tissues at different clinical stages. this study also aims to explore the mechanism of bai-1-mediated inhibition of tumor endothelial cell proliferation. Methods:A total of 133 human normal and cancerous kidney tissues were obtained. the tissue localized more than 4 cm away from the cancerous kidney tissue was identified as the normal control kidney tissue. immunohistochemical staining was conducted to detect the expression of bai-1, vegf, mvd, and p53. the expression was detected with the respective antibodies for quantitative statistical analysis. fresh renal cell carcinoma tissue samples were obtained from 27 patients, and 15 tissue samples were obtained 4 cm away from the cancer. the expression of bai-1 in the renal cell carcinoma tissue was examined through western blot analysis. Results:The bai-1 expression level in the normal kidney tissues is much higher compared with that in the kidney cancer tissues, which ranged from low and moderate to high differentiated stages. statisti-cal analysis results revealed a correlation between the expression of bai-1 and vegf, mvd, and p53 proteins. Conclusion:The expression level of bai-1 in kidney cancer tissues is very low, even difficult to detect, compared with the increased expression of vegf and cd34. this finding suggests that bai-1 can inhibit tumor angiogenesis. the level of p53 is positively correlated with the expression of bai-1 ac-cording to the data derived with the spearman software, suggesting the existence of crosstalk between these two molecules.

Objective: To examine the association between XPD and hOGG1 polymorphisms and prostate cancer (PCa) susceptibility. Methods: A comprehensive search was conducted to identify all case-control studies on the relationship between XPD and hOGG1 polymorphisms and PCa risk. Odds ratios (ORs) were used to investigate the strength of the associations. Results: A total of 15 case-control studies including 5,765 cases and 6,270 controls were eligible for the meta-analyses. For XPD Asp312Asn, no evidence indicated that individuals carrying 312Asn had an increased risk of PCa. In subgroup analyses, Asp312Asn polymorphism was associated with PCa risk in Asian populations [OR = 2.09 and 95% CI = 1.39–3.14 for Asn/Asn vs. Asp/Asp; OR = 1.49 and 95% CI = 1.12–1.98 for (Asn/Asn+Asn/Asp) vs. Asp/Asp]. For XPD Lys751Gln, the individuals with 751Gln did not have increased PCa risk compared with those with 751Arg, and no association was found in the subgroup analyses. For hOGG1 Ser326Cys, no significant association between the polymorphism and PCa risk was observed in the overall analysis. However, Ser326Cys was significantly associated with PCa risk under homologous contrast in Caucasians and Asians. Conclusions: XPD Asp312Asn polymorphism is associated with PCa risk in Asians and hOGG1 Ser326Cys polymorphism is associated with PCa risk in Caucasians and Asians.

OBJECTIVE Insulin resistance plays a part in diabetic nephropathy (DN). The association between the peroxisome proliferator–activated receptor γ Pro to Ala alteration at codon 12 (Pro12Ala) polymorphism and the risk of insulin resistance has been confirmed. The association between the polymorphism and DN risk has also been widely studied recently, but no consensus was available up to now. RESEARCH DESIGN AND METHODS A systematic search of electronic databases (MEDLINE, Embase, and China National Knowledge Infrastructure) and reference lists of relevant articles was carried out, and then 18 case-control studies involving 3,361 DN cases and 5,825 control subjects were identified. RESULTS In the overall analysis, the Ala12 variant was observed to be significantly associated with decreased DN risk (odds ratio 0.76 [95% CI 0.61–0.93]). Some evidence of heterogeneity among the included studies was detected, which could be explained by the difference of ethnicity and stage of DN. Subgroup analyses stratified by ethnicity and stage of DN were performed, and results indicated the Pro12Ala polymorphism was associated with the risk of DN in Caucasians but no similar association was observed in Asians. Additionally, we observed that Ala12 was associated with decreased risk of albuminuria. With only a few of subjects were available, we failed to detect statistically significant association between the polymorphism and end-stage renal disease (ESRD). CONCLUSIONS Our results indicated that the Ala12 variant is a significantly protective factor for DN. Future research should focus on the effect of Pro12Ala polymorphism on ESRD and gathering data of Africans.

Vasohibin-1(VASH1) has recently been isolated as a novel negative feedback inhibitor of angiogenesis. Several studies have demonstrated that VASH1 plays important roles in tumor angiogenesis but the role of this angiogenic inhibitor in renal cell carcinoma (RCC) has not been elucidated until now. In this study, we investigated the expression pattern of VASH1 and the association with clinicopathological features in RCC. Expression of VASH1, hypoxia-inducible factor-1α (HIF-1α), and microvessel density (MVD, labeled by CD34) was assessed by immunohistochemistry in 46 RCC specimens and 20 adjacent nontumorous renal tissues (ANRTs). Correlation between vasohibin-1 and HIF-1α, MVD, and clinicopathological features was then investigated. In RCC, VASH1 was expressed mainly in the cytoplasm and membrane of tumor cells and partly in vascular endothelial cells. In ANRT, it was mainly expressed in the cytoplasm and membrane of renal tubular epithelial cells and partly in vascular endothelial cells and glomerular mesangial cells. The expression level of VASH1 in RCC tissue was significantly lower than that in ANRT and was significantly reduced with the increased degree of malignancy in RCC tissues. In addition, a significantly negative correlation was noted between VASH1 expression and HIF-1α expression and a significantly negative correlation was noted between VASH1 expression and MVD in RCC. Therefore, VASH1 expression is reduced and it associates with clinicopathological features in RCC. Based on our findings and the knowledge of other angiogenesis inhibitors, we postulate that VASH1 would potentially be a biomarker and a candidate for molecular targeted therapy for patients with RCC in the future.

Objective:To improve the diagnosis,differential diagnosis and treatment of calyceal diverticulum. Methods:A total of 17 patients underwent exeresis of caliceal diverticular(13 cases open surgical approach and 4 cases retroperitoneal laparoscopic) from 1998 to 2008.Retrospects it to improve the diagnosis and treatment of it. Results:16 cases were diagnosed to be calyceal diverticulum preoperative,while 1 cases were diagnosed finally by locating the neck of the diverticulum introperative.All patients recovered after operation,however.6 cases received urinomas.We made a new classification base on location,size and symptom of the diverticulum which would be incised. Conclusion:As to the patient who underwent exeresis of caliceal diverticular,postoperative urinoma is relative to the size of diverticular.Open surgery and laparoscopic techniques are used in our hospital,and both can give us satisfactory consequence.