American journal of clinical and experimental urology最新文献

Cribiform and intraductal carcinoma are patterns of aggressive prostate carcinoma. This study investigated the clinical and pathological features of hereditary prostate cancer. Twenty cases of hereditary prostate cancer from 11 family lines treated at the First Affiliated Hospital of Zhejiang University School of Medicine between 2016-2022 were included to summarize the clinical and pathological features by analyzing clinical information including follow up the survival of the patients and pathological features. Of the 20 hereditary prostate cancer cases, 19 were radical prostate specimens and 1 was a biopsy specimen. The mean age at diagnosis of the patients was 67.55 years and the mean PSA was 15.44 ng/ml, of which 10 cases had PSA ≥ 10 ng/ml and 5 cases had PSA ≥ 20 ng/ml. Of the 19 radical prostate specimens, Gleason cribriform pattern (Gleason grade 4) of PCa is observed in 15 cases (78.95%), and intraductal carcinoma, usually a rare form, is seen in 9 cases (47.3%). Two cases demonstrated pelvic lymph node metastasis, and 7 cases (35%) belonged to high-risk or very high-risk PCa. One case (5.26%) showed partial deletion of expression of RB1, and 13 cases (68.42%) showed deletion of expression of PTEN. Follow-up was 4-90 months, 2 cases had biochemical recurrence and 1 case died from prostate cancer. The mean age at diagnosis of this group of patients with hereditary prostate cancer was 67.55 years, the mean preoperative PSA was 15.44 ng/ml, and their histomorphology was characterized by a high percentage of intraductal carcinoma and cribriform pattern of the prostate.

Upper urinary tract adenocarcinoma is a rare malignancy with a challenging diagnosis and limited treatment options. This paper presents a rare case of primary ureteral adenocarcinoma, an exceptionally uncommon malignancy typically associated with genitourinary or extra-genitourinary tumors. The 53-year-old patient, with a history of gastric adenocarcinoma and prior chemotherapy, developed left flank pain. Imaging revealed a tumor in the distal ureter, leading to a left radical nephroureterectomy. Histopathology confirmed an intestinal-type adenocarcinoma of the upper urinary tract. Unique to this case, the adenocarcinoma originated separately from the stomach. Despite planning adjuvant chemotherapy, the patient's deteriorating condition led to palliative care, and he passed away three months post-diagnosis. The paper underscores the challenges in diagnosing and treating such rare malignancies, emphasizing the need for further research to understand their etiology and optimal management.

Objective: In this study we aimed to determine the impact of human urine derived stem cells (USC) and genetically modified USC that were designed to overexpress myogenic growth factor IGF1 (USC^IGF), on the regenerative capacity of cardiotoxin (CTX)-injured murine skeletal muscle.

Methods: We overexpressed IGF1 in USC and investigated the alterations in myogenic capacity and regenerative function in cardiotoxin-injured muscle tissues.

Results: Compared with USC alone, USC^IGF1 activated the IGF1-Akt-mTOR signaling pathway, significantly improved myogenic differentiation capacity in vitro, and enhanced the secretion of myogenic growth factors and cytokines. In addition, IGF1 overexpression increased the ability of USC to fuse with skeletal myocytes to form myotubes, regulated the pro-regenerative immune response and inflammatory cytokines, and increased myogenesis in an in vivo model of skeletal muscle injury.

Conclusion: Overall, USC genetically modified to overexpress IGF1 significantly enhanced skeletal muscle regeneration by regulating myogenic differentiation, paracrine effects, and cell fusion, as well as by modulating immune responses in injured skeletal muscles in vivo. This study provides a novel perspective for evaluating the myogenic function of USC as a nonmyogenic cell source in skeletal myogenesis. The combination of USC and IGF1 expression has the potential to provide a novel efficient therapy for skeletal muscle injury and associated muscular defects in patients with urinary incontinence.

Chronic prostatitis/chronic pelvic pain syndrome (CP/CPSS) is a debilitating condition characterized by prostate inflammation, pain and urinary symptoms. The immune system's response to self-antigens is a contributing factor to CP/CPSS. In this review, we examine the use of experimental autoimmune prostatitis (EAP) in rodents to model salient features of autoimmune mediated CP/CPSS. By exploring etiological factors, immunological mechanisms, and emerging therapeutic strategies, our aim is to enhance our understanding of CP/CPSS pathogenesis and promote the development of strategies to test innovative interventions using the EAP pre-clinical model.

Sex-determining region Y-box 2 (SOX2) is a transcription factor with a central role in embryologic development. SOX2 is also an oncogene in several cancer types. Prior work by our group has shown SOX2 activity associates with cell cycle dysregulation in early-stage bladder cancer. The present study was thus undertaken to broadly investigate SOX2 in bladder cancer, with emphasis on associations with tumor stage, clinical outcomes, and tumorigenicity. Gene expression was quantified by immunohistochemistry in an established tissue microarray (n=303 cystectomy specimens, all stages) and whole tissue sections of noninvasive papillary urothelial carcinoma (n=25). Gene expression by RNA sequencing was evaluated in non-muscle invasive and muscle-invasive cohorts from publicly available repositories. By immunohistochemistry, SOX2 was expressed in 40% of whole tissue sections of noninvasive papillary carcinoma, which correlated with SOX2 expression by RNA sequencing (r=0.6, P=0.001, Spearman correlation). Expression tended to be focal (median H-score =6). SOX2 was expressed in only 9% of TMA cases, consistent with focal expression. SOX2 expression was substantially higher in muscle-invasive compared with noninvasive papillary urothelial carcinoma by RNA sequencing (P<0.001, Wilcoxon rank sum test). SOX2 expression associated with stage progression in lamina-propria invasive cancers (hazard ratio =2, P=0.05, Cox model, binary, RNA sequencing) but not noninvasive papillary cancers (P=0.5, Cox model, binary, RNA sequencing). SOX2 expression did not associate with overall survival in muscle-invasive carcinoma. Activity of SOX2 in bladder cancer was tested in vivo using murine allografts created with MB49 cells that express human SOX2 (MB49-SOX). MB49-SOX allografts expressed this protein focally by immunohistochemistry, much like human tumors. Compared with controls, MB49 allografts demonstrated larger tumor size (P=0.03, Wilcoxon rank sum test) and higher tumor burden in mesenteric metastases (P=0.009, Wilcoxon rank sum test). Though SOX2 expression is focal within tumors, it may drive tumorigenesis, increase growth rate, and promote aggressive features of bladder cancer, particularly stage progression of early-stage disease.

Purpose: Interstitial cystitis/bladder pain syndrome (IC/BPS) is a condition characterized in part by urinary urgency, frequency, and pain. There is a strong interest in gathering more data to compare and assess the differences in characteristics based on the presence of Hunner's lesions in patients with IC/BPS.

Materials and methods: Using a nationwide crowdsource effort, we collected surveys and urine samples from patients with a history of IC/BPS. Participants completed the Interstitial Cystitis Symptom Index (ICSI) and Problem Index (ICPI), Overactive Bladder questionnaire (OABq SF), and pain scores. In addition, participants reported any co-morbidities and lifestyle modifications. Urinary cytokine levels were measured and compared to symptom severity.

Results: 491 participants enrolled: 119 with history of ulcerative Hunner's lesions (UIC), 372 reported no lesions (NHIC), and 2 unknowns. 96.3% were female, and prevalence of UIC was equal for both genders. Average age was higher for UIC vs. NHIC group (P = 0.011), as was the duration since diagnosis (P < 0.001). Symptom scores were elevated in UIC patients (P < 0.001). Both groups widely implemented lifestyle modifications, with dietary changes being most prevalent (70.1%), followed by prescription medication usage (63.1%). More UIC compared to NHIC participants experienced co-morbidities (P = 0.010). Urine samples were analyzed for GRO, IL-6, IL-8, and MCP-1. MCP-1 levels were significantly higher in UIC patients (P = 0.044). Weak positive correlation was found between cytokines and symptom scores.

Conclusions: Patients with UIC and NHIC from across the United States displayed distinct phenotypic and urine biological characteristics. These findings contribute to increased understanding of IC/BPS and may aid in improving our knowledge of the condition.

Objective: To study the predictive performance of the imaging model based on the texture analysis of CT plain scan in distinguishing between low (grade I and II) and high (grade III and IV) of Fuhrman pathological grade of renal clear cell carcinoma.

Methods: The clinical data of 94 patients with ccRCC who underwent CT scan and were confirmed by biopsy or surgery in TCGA-KIRC public database were retrospectively analyzed. There were 32 cases of low-grade ccRCC and 62 cases of high-grade ccRCC. The patients were randomly divided into training set and verification set according to the proportion of 7:3 by stratified sampling method. The imaging characteristics of ccRCC were calculated in the plain CT images. Lasso regression was used to reduce the dimensionality of the imaging characteristics of the training set, and binary logistic regression was used to construct the prediction model. Bootstrap method was used to verify the training set model and the validation set model, and the area under the receiver operating characteristic (ROC) curve (AUC) was calculated respectively.

Results: Binary logistic regression showed that only imaging features were independent risk factors for predicting the Furhman classification of ccRCC. The predictive model was y = 1/[1 + exp (-z)], z = 1.274 × imaging risk score + 0.072. The results of bootstrap internal validation showed that the AUC of the training group was 0.961 (95% CI: 0.900-0.913). The Hosmer-Lemeshow goodness of fit test showed that the prediction model had a good calibration in the training group (P = 0.416). The AUC of prediction model in validation group was 0.731 (95% CI: 0.500-1.000). The Hosmer-Lemeshow goodness of fit test results showed that the prediction model had a good calibration in the validation group (P = 0.592).

Conclusion: The model based on CT texture analysis has a good predictive effect in differentiating low-grade and high-grade ccRCC and can provide reference for the treatment and prognosis of patients.

Objective: Our objective is to observe the long-term surgical results of urethral reconstruction using either pedicled penile flaps or lingual mucosa grafts. We also assess the histocompatibility of the reconstructed urethra.

Materials and methods: Clinical data of patients with anterior urethral stenosis undergoing urethra reconstruction by applying different materials were collected from 2014 to 2022 in the Second Hospital of Hebei Medical University. We assessed their efficacy and the occurrence of complications. Patients who required reoperation due to complications were selected. Sections of the reconstructed urethra created with various materials were excised during repair procedures. The excised tissues underwent hematoxylin-eosin staining and immunohistochemistry. Comparison with the original histological morphology was conducted to evaluate histocompatibility.

Results: 42 of the 55 patients were cured which showed a surgical success rate of 76.36%. The success rate of urethra reconstruction surgery utilizing lingual mucosa is 71.43% and that of surgeries using pedicled penis flaps is 79.41%. The long-term prognosis of the two groups is similar (P > 0.05). Observations show that the histological morphology of the original epithelium gradually disappeared, leading to adaptive changes to the urinary environment with favorable histocompatibility.

Conclusion: The application of lingual mucosal and pedicled penis flaps for urethral reconstruction both have a high surgical success rate. The long-term follow-up results are positive. Both methods are viable for urethral reconstruction and exhibit favorable histocompatibility.

Introduction: Percutaneous Nephrolithotomy (PCNL) is a widely used surgical intervention for removing large and complex renal calculi. While considered a safe and effective procedure, it can still lead to severe and rare complications, including bleeding, pulmonary complications, and liver dysfunction.

Case presentation: This case report presents a case who underwent PCNL for a kidney stone and subsequently developed a series of rare and severe complications. Following the PCNL procedure, the patient experienced significant bleeding, a known but uncommon complication of PCNL, pulmonary complications, a common complication that may carry a risk of death, and acute liver failure, an exceedingly rare consequence of PCNL.

Conclusion: In summary, while PCNL is a valuable technique for treating kidney stones, it is not without risk. This case underscores the importance of recognizing and managing rare complications following PCNL surgery, highlighting the need for vigilance, multidisciplinary care, and timely interventions to ensure favorable patient outcomes.

High-risk localized prostate cancer (PCa) has the potential of recurrence and progression to a lethal phenotype, and neoadjuvant therapy followed by radical prostatectomy (RP) may be an option for these patients. Docetaxel has been recently shown to be an effective chemotherapeutic agent for high-volume metastatic hormone-sensitive PCa and metastatic castration-resistant PCa, and these increased efficacy create the impetus to assess the potential role of preoperative docetaxel in high-risk localized PCa. In this mini-review, we found that neoadjuvant chemohormonal therapy (NCHT) may be an effective neoadjuvant regimen to improve oncological outcome of high-risk PCa. However, the addition of docetaxel in the neoadjuvant setting would unavoidably increase the rate of adverse events, impose additional economic burdens. Therefore, suitable patient selection is crucial and pathological response might be a surrogate endpoint. Furthermore, we also found that molecular imaging prostate-specific membrane antigen (PSMA) PET/CT was a promising tool to evaluation the effectiveness of NCHT, and the expression status of AR, AR-V7, Ki-67, PTEN and TP53 might be helpful for urologists to identify more suitable candidates for NCHT.