Immune-related risk prognostic model for clear cell renal cell carcinoma: Implications for immunotherapy.

Clear cell renal cell carcinoma (ccRCC) is associated with complex immune interactions. We conducted a comprehensive analysis of immune-related differentially expressed genes in patients with ccRCC using data from The Cancer Genome Atlas and ImmPort databases. The immune-related differentially expressed genes underwent functional and pathway enrichment analysis, followed by COX regression combined with LASSO regression to construct an immune-related risk prognostic model. The model comprised 4 IRGs: CLDN4, SEMA3G, CAT, and UCN. Patients were stratified into high-risk and low-risk groups based on the median risk score, and the overall survival rate of the high-risk group was significantly lower than that of the low-risk group, confirming the reliability of the model from various perspectives. Further comparison of immune infiltration, tumor mutation load, and immunophenoscore (IPS) comparison between the 2 groups indicates that the high-risk group could potentially demonstrate a heightened sensitivity towards immunotherapy checkpoints PD-1, CTLA-4, IL-6, and LAG3 in ccRCC patients. The proposed model not only applies to ccRCC but also shows potential in developing into a prognostic model for renal cancer, thus introducing a novel approach for personalized immunotherapy in ccRCC.

Application of a novel computer-assisted surgery system in percutaneous nephrolithotomy: A controlled study.

BACKGROUND: Most complex renal stones are managed primarily with percutaneous nephrolithotomy (PCNL). However, PCNL is still a great challenge for surgeons because of poor comprehension on complex adjacent structures. Novel techniques are required to assist in planning and navigation. AIM: To apply and evaluate the Hisense computer-assisted surgery (CAS) system in PCNL. METHODS: A total of 60 patients with complex renal stones were included. Thirty patients in the CAS group had three-dimensional (3D) virtual models constructed with the CAS system. The model assisted in planning and navigating in the CAS system. Thirty patients in the control group planned and navigated as standard PCNL, without the application of the CAS system. Success rate of one attempt, operation time, initial stone-free rate, decrease in hemoglobin, and complications were collected and analyzed. RESULTS: There were no statistically significant differences in the baseline characteristics or planning characteristics. The success rate of one puncturing attempt (90% vs 67%, P = 0.028) and the initial stone-free rate (87% vs 63%, P = 0.037) were significantly higher in the CAS group. However, there were no statistically significant differences in the operation time (89.20 ± 29.60 min vs 92.33 ± 33.08 min, P = 0.859) or in the decrease in hemoglobin (11.07 ± 8.32 g/L vs 9.03 ± 11.72 g/L, P = 0.300) between the CAS group and the control group. No statistically significant differences in the incidence of complications (Clavien-Dindo grade ≥ 2) were found. CONCLUSION: Compared with standard PCNL, CAS-assisted PCNL had advantages in terms of the puncturing success rate and stone-free rate. The Hisense CAS System was recommended to assist in preoperative planning and intraoperative navigation for an intuitive, precise and convenient PCNL.

Construction of an Immune-Associated Gene-Based Signature in Muscle-Invasive Bladder Cancer.

BACKGROUND: In recent years, immune-associated genes (IAGs) have been documented as having critical roles in the occurrence and progression of muscle-invasive bladder cancer (MIBC). Novel immune-related biomarkers and a robust prognostic signature for MIBC patients are still limited. The study is aimed at developing an IAG-based signature to predict the prognosis of MIBC patients. METHODS: In the present study, we identified differentially expressed IAGs in MIBC by using transcriptomics data from The Cancer Genome Atlas (TCGA) database and proteomics data from our samples. We further constructed an IAG-based signature and evaluated its prognostic and predictive value by survival analysis and nomogram. Tumor Immune Estimation Resource (TIMER) was applied to explore the correlation between the IAG-based signature and immune cell infiltration in the microenvironment of MIBC. RESULTS: A total of 22 differentially expressed IAGs were identified, and 2 IAGs (NR2F6 and AHNAK) were used to establish a prognostic signature. Subsequently, survival analysis showed that high-risk scores were significantly correlated with poor overall survival (OS), progression-free survival (PFS), and disease-free survival (DFS) of MIBC patients. A prognostic nomogram was constructed by integrating clinical factors with the IAG-based signature risk score. In addition, the IAG-based signature risk score was positively associated with the infiltration of macrophages and dendritic cells in MIBC. CONCLUSIONS: We constructed and verified a novel IAG-based signature, which could predict the prognosis of MIBC and might reflect the status of the immune microenvironment of MIBC. Further studies in more independent clinical cohorts and further experimental exploration of the prognostic IAG-based signature are still needed.