[Clinicopathological features and prognostic analysis of papillary renal cell carcinoma].

OBJECTIVE: To investigate the clinicopathological features and prognostic characteristics of papillary renal cell carcinoma (pRCC). METHODS: The clinical data of 114 patients with pRCC, including 91 males and 23 females, admitted to the Department of Urology, Peking University Third Hospital from May 2012 to May 2021 were retrospectively analyzed. All the cases were operated patients with clear pathological diagnosis and complete follow-up data. The log-rank test was used to analyze the relationship between the patients' clinicopathological characteristics and survival time, the Kaplan-Meier method to draw survival curves, and the Cox regression model for univariate and multifactorial analysis. RESULTS: The mean age of the 114 patients was (57.3±12.6) years. The tumors were located in the left kidney in 49 cases and in the right kidney in 65 cases. In the study, 48 radical nephrectomies and 66 partial nephrectomies were performed, 42 cases were type 1 and 72 cases were type 2, and the mean maximum tumor diameter was (5.5±3.6) cm. pT1a stage 52 cases, pT1b stage 22 cases, pT2 stage 4 cases, pT3 stage 33 cases, and pT4 stage 3 cases were staged. According to the World Health Organization / International Society of Urological Pathology (WHO/ISUP), there were 13 cases of gradeⅠ, 44 cases of grade Ⅱ, 51 cases of grade Ⅲ, and 6 cases of grade Ⅳ. And 34 of the 114 patients had vascular cancer embolism, 30 cases had lymph node metastasis, and 3 cases had adrenal metastasis. The median follow-up time after surgery was 22 months, and the 3-year progression-free survival rate was 95.6%. The patients with type 1 and type 2 pRCC showed statistically significant differences in age (P=0.046), body mass index (P=0.008), surgical approach (P=0.001), maximum tumor diameter (P < 0.001), vascular cancer embolism (P < 0.001), lymph node metastasis (P < 0.001), pT stage (P < 0.001), and nuclear grade (P < 0.001). The 3-year progression-free survival rates for type 1 and type 2 pRCC were 100% and 69.4%, respectively, with type 1 having a significantly better prognosis than with type 2 (P=0.003). Univariate analysis of the patients with type 2 pRCC showed that pT stage (P < 0.001), vascular cancer embolism (P < 0.001) and lymph node metastasis (P < 0.001) were strongly associated with their prognosis. Multifactorial analysis showed that vascular cancer embolism was an independent prognostic factor for progression-free survival in type 2 pRCC (P=0.001). Univariate analysis of the pRCC patients undergoing radical nephrectomy showed that pT stage (P=0.006), vascular cancer embolism (P=0.001), and lymph node metastasis (P=0.008) were significant factors affecting their prognosis, and further multifactorial analysis showed that only vascular cancer embolism was an indepen-dent prognostic factor for their progression-free survival (P=0.006). CONCLUSION: Type 2 pRCC has more morbidity, more lymph node metastases, more advanced pT stage, and higher pathologic grading than type 1 pRCC. The presence of vascular cancer embolism is an independent prognostic factor in patients with type 2 pRCC and pRCC undergoing radical nephrectomy.

[Adiponectin ameliorated pancreatic islet mitochondrial injury induced by chronic intermittent hypoxia].

Objective: To explore the effect of adiponectin (APN) on islet injury induced by chronic intermittent hypoxia (CIH). Methods: Thirty-six SD rats were randomly divided into three groups: Normal control (NC), CIH, and CIH + APN groups. The rats in the CIH and CIH+APN groups received an intermittent hypoxia exposure while the rats in NC group received the room air only. The rats in CIH+APN group received the intravenous injection of APN. The intermittent hypoxia events persisted 8 hours a day and last for 35 days. The fasting blood glucose and fasting insulin were detected at the time of 0, 7, 14, 21, 28, and 35 day. After 35 days, the level of serum adiponectin, and adenosine triphosphate (ATP) level, superoxide dismutase (SOD), malondialdehyde (MDA), the mRNA levels of mitochondrial oxidative phosphorylation function and mitochondrial synthesis gene, and the protein level of mitochondrial and cytoplasmic cytochrome C of pancreatic islet were detected. Results: The glucose and insulin level had no statistically differences among three groups at different time points (all P>0.05). However, compared with NC and CIH+APN groups, CIH reduced the serum adiponectin [(7 265±2 209) ng/ml, (6 536±1 678) ng/ml vs (4 923±1 742) ng/ml, both P<0.05], ATP levels [(30.92±1.12) nmol/mg, (26.55±0.72) nmol/mg vs (20.22±1.47) nmol/mg, both P<0.05], mRNA levels of mitochondria oxidative phosphorylation function and mitochondrial synthesis gene, the activity of SOD, and the rate of mitochondrial/cytoplasmic cytochrome C protein level while increased the MDA level in pancreatic islet. Compared with NC group, the MDA level increased (P<0.05) and the APN level had no statistically difference, while the level of other indicators decreased in CIH+APN group (all P<0.05). Conclusion: APN ameliorates the pancreatic islet injury induced by CIH through inhibition of oxidative stress.

[Clinicopathological analysis of patients with papillary renal cell carcinoma].

OBJECTIVE: To investigate the clinicopathological features,treatment and prognosis of patients with papillary renal cell carcinoma (PRCC) and PRCC-complicated with tumor thrombus. METHODS: Single center retrospective analysis of 75 patients with PRCC treated from January 2012 to October 2017 was performed. There were 55 males and 20 females at an age range of 24-82 years. Sixteen PRCC patients were complicated with tumor thrombus. All the patients were with a surgery and had clear pathological diagnosis and detailed follow-up data. The clinicopathological features, prognosis and influencing factors of the patients with PRCC and PRCC complicated with tumor thrombus were analyzed and summarized. RESULTS: The average age of the 75 patients was(56.05±11.59)years,the average body mass index (BMI) was (26±3) kg/m², and the average tumor maximum diameter was (5.17±3.85) cm. There were significant differences between tumor maximum diameter larger than 7 cm and less than 7 cm (69.6% vs. 94.4%, P<0.001), lymph node metastasis and no lymph node metastasis (<38% vs. 98%, P<0.001), adrenal metastasis and no adrenal metastasis (0% vs. 95.3%, P<0.001), pulmonary metastasis and no pulmonary metastasis (0% vs.90.7%, P<0.001), complicated with and without tumor thrombus (<66.4% vs. 93.5%, P<0.001) on the effect of 3-year survival rate of the PRCC patients. In this study, there were 16 patients with type 2 PRCC complicated with tumor thrombus. There were significant differences in concomitant symptoms (62.5% vs. 22.0%, P=0.005), maximum tumor diameter (68.8% vs.13.3%, P<0.001), adrenal metastasis (18.8% vs. 0.02%, P=0.029), pulmonary metastasis (18.8% vs. 0%, P=0.008), nuclear grade (P<0.001) and pathological type (100% vs. 44.1%, P<0.001) between the PRCC patients with and without tumor thrombus. CONCLUSION: There were significant differences in tumor diameter,lymph node metastasis,adrenal metastasis, pulmonary metastasis,pathological type, nuclear grade and tumor thrombus in the effect of the 3-year survival rate of PRCC patients. PRCC patients with tumor thrombus were more commonly suffered from type 2 PRCC, for whom the tumor diameter was larger,the nuclear grade was higher,and the distance metastasis happened more easily.

A MAb-based ELISA for detecting circulating antigen in CSF of patients with neurocysticercosis.

A monoclonal antibody (MAb)-based enzyme-linked immunosorbent assay (ELISA) was evaluated for detecting circulating antigen (CAg) in the cerebrospinal fluid (CSF) of patients with neurocysticercosis. CAg of Cysticercus Cellulosae was detected in 95 out of 116 patients with neurocysticercosis. Of the 21 neurocysticercosis patients in whom CAg was not detected, 14 had only higher density spots, 3 had one or two lower density spots and 4 had no obvious damage in their brain Computed Tomography (CT) scans. CAg was also not detected in CSF samples of patients with other diseases of the central nervous system. These included cerebral tumor, encephalopyosis, brain trauma, viral meningitis and cerebral hemorrhage. Detecting CAg with MAb-based ELISA is better than any previously available methods for the diagnosis of active neurocysticercosis.

[Effects of low calcium on myocardial necrosis of Keshan disease by food preference].

It was noticed that monotonous diet which imitated the composition of diet for the susceptible population of Keshan disease with a habit of food preference was prominently low in calcium and selenium. The plasma calcium ion content of rats kept on a monotonous diet was significantly lowered to merely half the content of the stock diet group with significant lowering of GSH-px activity. After peritoneal injection of furosemide, the plasma calcium ion contents of the monotonous diet group were further lowered significantly and signs of calcium deficiency, such as muscle tremor, spasm and convulsion might occur. If anoxic factor NaNO2 acted simultaneously, acute and severe myocardial necrosis developed. Morphologically, the myocardial necrosis was similar to that in Keshan disease. When monotonous diet was supplemented with only calcium, the growth state of the rats was significantly improved, and the degree of myocardial necrosis was significantly decreased. Supplement of calcium, selenium as well as vitamin E, seemed more effective. It is suggested that low selenium is the basic factor of endemic pathogenesis of Keshan disease, and low calcium intake by food preference among the susceptible population of Keshan disease plays an important role in the pathogenesis of myocardial necrosis in Keshan disease.

[Detection of CAg in CSF of 231 cerebral cysticercosis patients].

The results of detection of circulating antigen (CAg) in cerebrospinal fluids (CSF) of 231 cerebral cysticercosis patients with McAb (4F8)--based ELISA were reported and compared with the case histories, clinical manifestations and CT scans. No relationship was found between CAg detected in CSF of these cases and history of taeniasis. However, the positive rate of CAg in cerebral cysticercosis patients with subcutaneous nodules was found significantly higher than those in cases with simple cerebral cysticercosis and in cases with subcutaneous nodules disappeared after anti-Cysticercus therapy before CSF collection. The results of CAg detection in CSF were related with the CT findings as well as the stage of the disease. It is thus indicated that McAb (4F8)-based ELISA might be useful not only for diagnosis of neurocysticercosis, but also for the evaluation of efficacy of anti-Cysticercus therapy.