Comparing Endovascular and Surgical Treatments for Varicocele: A Systematic Review and Meta-Analysis.

PURPOSE: To conduct a systematic review and meta-analysis to assess the relative efficacy of endovascular and surgical treatments for varicocele. MATERIALS AND METHODS: PubMed and Embase databases were systematically searched to identify studies reporting on the outcomes associated with surgical or endovascular treatments of varicoceles. The studies that assessed the relative efficacy of surgical and endovascular treatments for patients with clinical varicocele were eligible for inclusion. Pooled data analyses were performed. RESULTS: A total of 16 studies incorporating 2,138 patients were included in the present meta-analysis. The pooled risk ratio (RR) values suggested that rates of adverse events were lower among patients who underwent endovascular treatment than those who underwent surgical treatment (RR, 0.63; 95% confidence interval (CI), 0.42-0.93; P = .02). Both treatments were associated with similar rates of recurrence (RR, 1.03; 95% CI, 0.78-1.36; P = .82) and pregnancy (RR, 1.03; 95% CI, 0.85-1.25; P = .82). CONCLUSIONS: These data demonstrate that endovascular treatment for varicocele is associated with similar rates of recurrence and subsequent pregnancy outcomes compared with surgical treatment but with lower rates of adverse events.

Association between multiple sclerosis and cancer risk: An extensive review/meta and Mendelian randomization analyses.

BACKGROUND: Observational investigations examining cancer risk among multiple sclerosis (MS) patients have produced contradictory findings. Herein, we performed an extensive review and meta-analysis to evaluate the correlation and causation between MS and cancer incidence. METHODS: We systematically screened for published articles examining cancer incidences among MS patients within the Cochrane Library, PubMed, and Embase databases. Next, we employed STATA v.16.0 for data analysis. Following meta-analysis, we performed a two-sample Mendelian randomization (MR) analysis to uncover the underlying mechanism behind the MS-mediated regulation of certain cancers. RESULTS: Overall, we selected 18 articles encompassing 14 individual cancers incidences and a total of 368,952 patients for meta-analysis. Based on our analysis, there was reduced pancreatic (ES = 0.68; 95% CI: 0.49-0.93; I 2 = 0%) and ovarian cancer (ES = 0.65; 95% CI: 0.53-0.80; I 2 = 86.7%) co-occurrences among MS patients. Meanwhile, the incidences of breast (ES = 1.10; 95% CI: 1.01-1.21; I 2 = 60.9%) and brain cancers (ES = 1.94; 95% CI: 1.12-3.37; I 2 = 56.1%) were elevated among the same population. However, MR analysis revealed the opposite relation between MS and breast cancer risk (OR = 0.94392; 95% CI: 0.91011-0.97900, P = 0.002). Moreover, it revealed strong incidence of lung cancer (OR = 1.0004; 95% CI: 1.0001-1.0083, P = 0.001) among MS patients, as evidenced by the inverse variance weighting estimator. Lastly, MR found that other forms of cancers were not significantly related to MS. CONCLUSIONS: Using meta-analysis, we demonstrated that MS patients exhibited enhanced pancreatic and ovarian cancer risk, and diminished breast and brain cancer risk. However, using MR analysis, we discovered an inverse relation between MS and breast cancer risk, and additionally saw an uptick in lung cancer co-occurrence among MS patients.

The Diagnostic Accuracy of miR-371a-3p for Testicular Germ Cell Tumors: A Systematic Review and Meta-Analysis.

OBJECTIVE: This study sought to assess the utility of miR-371a-3p levels as a tool for diagnosing testicular germ cell tumors. METHODS: For this systematic review and meta-analysis we reviewed available published studies assessing the accuracy of miR-371a-3p as a tool for diagnosing testicular germ cell tumors. STATA 16.0 was used to calculate pooled sensitivity, specificity, negative likelihood ratio (NLR), positive likelihood ratio (PLR), and area under the curve (AUC) values. RESULTS: In total, six studies incorporating 1835 individuals were included in this analysis. Pooled results suggested that miR-371a-3p was able to differentiate between testicular germ cell tumors and non-testicular germ cell tumors or healthy individuals with a sensitivity of 0.90 [95% confidence interval (CI) 0.88-0.92], a specificity of 0.93 (95% CI 0.87-0.96), a PLR of 12.2 (95% CI 6.90-18.24), an NLR of 0.11 (95% CI 0.09-0.14) a diagnostic odds ratio (DOR) of 121.56 (95% CI 64.84-227.89), and an AUC of 0.94. CONCLUSIONS: MiR-371a-3p represents a viable biomarker associated with testicular germ cell tumors.

Diagnostic accuracy of photodynamic diagnosis for upper urinary tract urothelial carcinoma: A systematic review and meta-analysis.

BACKGROUND: This study aimed to evaluate the effectiveness of photodynamic diagnosis (PDD) for upper urinary tract urothelial carcinoma (UTUC) by performing a meta-analysis. METHOD: Relevant articles were retrieved from the Cochrane Library, PubMed, and Embase databases. Studies evaluating the accuracy of PDD for the diagnosis of upper UTUC were included. The pooled sensitivity, specificity, and area under the curve (AUC) were calculated by STATA 16.0 at the per-lesion level. RESULTS: Six studies with 289 lesions were included in this systematic review and meta-analysis. The pooled results showed that PDD can differentiate upper UTUC from benign lesions with a sensitivity of 0.96 (95 % confidence interval: 0.85-0.99) and a specificity of 0.86 (95 % confidence interval: [0.64-0.95]; AUC, 0.97). Compared with white-light ureterorenoscopy, PDD can significantly improve the additional detection rate of UTUC (RR 0.16, 95 % CI 0.07-0.34 P = 0.000). CONCLUSIONS: PDD is a valid technique that improves the diagnostic accuracy of UTUC compared with standard white-light ureterorenoscopy at the per-lesion level. PDD is a promising endoscopic technique for upper UTUC.

Targeting strategies of adenovirus­mediated gene therapy and virotherapy for prostate cancer (Review).

Prostate cancer (PCa) poses a high risk to older men and it is the second most common type of male malignant tumor in western developed countries. Additionally, there is a lack of effective therapies for PCa at advanced stages. Novel treatment strategies such as adenovirus­mediated gene therapy and virotherapy involve the expression of a specific therapeutic gene to induce death in cancer cells, however, wild­type adenoviruses are also able to infect normal human cells, which leads to undesirable toxicity. Various PCa­targeting strategies in adenovirus­mediated therapy have been developed to improve tumor­targeting effects and human safety. The present review summarizes the relevant knowledge regarding available adenoviruses and PCa­targeting strategies. In addition, future directions in this area are also discussed. In conclusion, although they remain in the early stages of basic research, adenovirus­mediated gene therapy and virotherapy are expected to become important therapies for tumors in the future due to their potential targeting strategies.