[Carcinoma recurrence rates after laparoscopic nephroureterectomy in patients undergoing transurethral incision of the ureteral orifice and open excision of bladder cuff].

OBJECTIVE: To compare the oncologic efficacy of transurethral incision of the ureteral orifice and open excision of bladder cuff in retroperitoneal laparoscopic nephroureterectomy (LNU) for patients with upper tract urothelium carcinoma. METHODS: The hospital records of 86 patients with upper tract urothelium carcinoma who underwent laparoscopic nephroureterectomy were reviewed retrospectively. 53 of the 86 patients, 22 males and 31 females, aged (68.6+/-14.1), underwent transurethral incision of the ureteral orifice (TUIUO), and 33, 14 males and 19 females, aged (72.4+/-15.2), underwent open excision of bladder cuff. Electric cauterization of the ureteral orifice was performed prior to resection. Follow-up was conducted for 28 (3-47) months. RESULTS: In all the specimens in the TUIUO group scar at the ureter orifice caused by electric excision could be seen. Test to check the pressure of distal ureter in 25 specimens proved that the ureters were all sealed. The distal ureter end began to leak at the water pressure of 135 cm in 1 case, at the water pressure of 167 cm in 1 case, and at 175 cm in 2 cases, but no leaking was seen even at 197 cm H2O in the other cases. Recurrence of bladder tumor was seen in 13 of the 53 patients of the TUIUO group and in 8 of the 33 patients of the open excision of bladder cuff group. Local recurrence developed in one case with the tumor at stage pT4N0M0 8 months after operation. CONCLUSION: Electric cauterization of the ureteral orifice prior to resection effectively ensures the leakproofness of the distal ureter end during LNU. As compared with open excision of bladder cuff, TUIUO does not increase the rate of neoplasm recurrence.

[Relationship between genetic polymorphism of NAT2 and susceptibility to urinary bladder cancer].

OBJECTIVE: To study the relationship between genetic polymorphism of NAT2 and susceptibility to bladder cancer. METHODS: NAT2 genotypes were determined by PCR-RFLP method in 69 patients with bladder transitional cell carcinoma and 88 healthy controls. RESULTS: The frequency of NAT2 slow genotypes was 26.1% (18/69) in patients compared with 14.8% (13/88) in controls (P < 0.05). Bladder cancer risk in patients with NAT2 slow genotypes was 2 fold as high as that in patients with NAT2 rapid genotypes. When NAT2 rapid genotypes/non-smoker were used as reference, bladder cancer risk increased to 5.8-fold (P < 0.05). Among the smokers with PY higher than 10, the patients showed a higher frequency of NAT2 slow genotype than controls (P < 0.05). It was also shown that the patients with slow NAT2 genotypes were more likely to have high grade tumor (P < 0.05) and advanced stage tumor (P < 0.01). CONCLUSION: The results suggest that NAT2 genetic polymorphism is associated with bladder cancer susceptibility. People with NAT2 slow genotype have higher bladder cancer risk.

[Expression of androgen receptor isoforms in normal human prostate].

OBJECTIVE: To investigate the expression of androgen receptor (AR) isoforms in normal human prostate. METHODS: Fourteen normal prostatic specimens from donors, aged 25 on average (21-28 yr), were analyzed by high resolution isoelectric focusing (IEF). The expression of AR isoforms was demonstrated in all 14 normal human prostatic tissues. RESULTS: Four types of AR isoforms were detected with isoelectric point value at 6.5, 6.0, 5.8 and 5.3 in 14 prostatic specimens. Binding of 3H-dihydrotestosterone (DHT) to these four AR isoforms was inhibited by the addition of 100-fold excess of DHT and testosterone. No effect of progesterone, estradiol and diethylstilbestrol on tritiated hormone binding was observed. CONCLUSIONS: There are four AR isoforms in normal human prostate. The expression of AR isoforms is different from one another.