Immunoglobulin G4-related kidney disease involving the renal pelvis and perirenal fat: A case report.

BACKGROUND: Immunoglobulin (Ig) G4-related disease (IgG4-RD) is an autoimmune disease associated with chronic and progressive inflammation and fibrosis. It is difficult to differentiate IgG4-RD involving the kidney from infectious diseases and malignancy on imaging. CASE SUMMARY: We report the case of a 51-year-old Chinese man whose abdominal computed tomography scan showed diffuse bilateral enlargement of the kidneys and perirenal fat, thickening of the renal pelvic walls, and hydronephrosis of the right kidney. Relevant laboratory test results showed a serum creatinine level of 464 µmol/L. The patient was diagnosed with acute renal failure and was started on intermittent hemodialysis. Further tests revealed high serum IgG4 levels (20.8 g/L) and an enlarged right submaxillary lymph node. Biopsy and histopathological examination of the enlarged node led to the diagnosis of IgG4-RD. After corticosteroid therapy, his serum creatinine level quickly decreased to near normal levels. CONCLUSION: IgG4-RD affecting the renal pelvis or perirenal fat is rare, with atypical imaging features. Multidisciplinary consultation is critical for accurate diagnosis and treatment of this disease. Suspected cases should undergo biopsy to avoid misdiagnosis.

Cytotoxic benzopyranone and xanthone derivatives from a coral symbiotic fungus Cladosporium halotolerans GXIMD 02502.

Coral-derived microorganisms have been historically proven to be prolific sources of bioactive secondary metabolites. Twelve benzopyranone and/or xanthone derivatives, including a new benzopyranone with an uncommon carboxyl group at C-8, coniochaetone K (1), were obtained from the Beibu Gulf-derived coral symbiotic fungus Cladosporium halotolerans GXIMD 02502. Their structures were determined by extensive spectroscopic data interpretation and comparison with literature values. The absolute configuration of 1 was accomplished by comparison of specific optical rotation as well as quantum chemical ECD calculations. The in vitro cytotoxicity of compounds 1-12 against two human prostatic cancer cell lines, C4-2B and 22RV1, were evaluated. And compounds 1, 3, 6-8, and 10-11 demonstrated significant cytotoxicity with inhibitions ranging from 55.8% to 82.1% at the concentration of 10 µM.

[Small-cell carcinoma of the prostate: A report of 2 cases and review of the literature].

OBJECTIVE: To investigate the clinicopathological characteristics and improve the clinical treatment of prostatic small-cell carcinoma (PSCC). METHODS: We reported 2 cases of PSCC derived from prostate cancer after treated by androgen blockade and prostate electrotomy and reviewed the relevant literature. RESULTS: Two patients with PSA elevation were diagnosed with prostate cancer by prostatic puncture biopsy and treated by maximum androgen blockade, which reduced their total PSA to the normal level. Later, due to difficult urination, they both underwent prostate electrotomy, followed by chemotherapy or radiotherapy for PSCC confirmed by postoperative pathology. Nevertheless, they died at 8 to 9 months after the discovery of PSCC. CONCLUSIONS: PSCC can derive from prostate cancer after treatment, which may be attributed to the pathological mutation induced by long-term endocrine therapy. PSCC is more malignant than prostate cancer, and its prognosis is poor.

Serum C-peptide concentration and prostate cancer: A meta-analysis of observational studies.

BACKGROUND: The association between serum C-peptide concentration and prostate cancer remains unexplored. Therefore, we conducted a meta-analysis to assess whether C-peptide serum concentrations are associated with increased prostate cancer risk. METHODS: Several databases were searched to identify relevant original research articles published before November 2017. Random-effects models were used to summarize the overall estimate of the multivariable-adjusted odds ratios (ORs) with 95% confidence intervals (CIs). RESULTS: Nine observational studies involving 11,796 participants were identified. The findings of the meta-analysis indicated that the association between serum C-peptide concentration and prostate cancer was not significant (OR: 1.15, 95% CI: 0.85-1.54; for highest versus lowest category C-peptide concentrations, P = .376). The associations were inconsistent, as indicated by subgroup analyses. CONCLUSION: Although our findings provided no support for the hypothesis that serum C-peptide concentration is associated with excess risk of prostate cancer, people must pay attention to this aspect and increase physical activity or modify dietary habits to constrain insulin secretion, which possibly lead to decreased incidence of prostate cancer. Hence, well-designed observational studies involving different ethnic populations are still needed.

[Inhibitory effect of polyphyllin â on the proliferation of prostate cancer PC3 cells via ERK1/2/P65/DNMT1 and its molecular mechanism].

OBJECTIVE: To explore the inhibitory effect of polyphyllin Ⅰ (PPⅠ) on the proliferation of castration-resistant prostate cancer PC3 cells and its molecular mechanism. METHODS: We cultured human prostate cancer PC3 cells in vitro and treated them with PPⅠ at the concentrations of 0 (blank group), 0.4, 0.8, 1.2, 1.6, 2.0, and 2.4 µmol/L for 24, 48, and 72 hours, respectively. Then we detected the proliferation of the cells by MTT assay, measured their apoptosis by flow cytometry, and determined the expressions of p-ERK1/2, ERK1/2, NF-κB/p65 and DNMT1 proteins as well as the level of NF-κB/p65 in the cells additionally treated with the ERK1/2 inhibitor SP600125 by Western blot. RESULTS: Compared with the blank control group, the PPⅠ-treated PC3 cells showed a concentration- and time-dependent reduction of the survival rate (1.00 ± 0.00 vs 0.85 ± 0.05, P < 0.01) at 0.4 µmol/L after 48 hours of intervention, concentration-dependent early apoptosis at 0.8 µmol/L (4.83 ± 0.95 vs 13.83 ± 2.97, P < 0.01), time-dependent increase of the expressions of p-ERK1/2 (1.00 ± 0.00 vs 1.73 ± 0.17, P < 0.01) and ERK1/2 (1.00 ± 0.00 vs 1.36 ± 0.12, P < 0.01) at 2 hours, and concentration-dependent decrease of the expressions of NF-κB/p65 and DNMT1 at 1.2 µmol/L (1.00 ± 0.00 vs 0.78 ± 0.10 and 0.63 ± 0.06, P < 0.01) and 1.6 µmol/L (1.00 ± 0.00 vs 0.67 ± 0.11 and 0.52 ± 0.09, P<0.01). Inhibition of ERK1/2 phosphorylation with PD98059 markedly reversed PPⅠ-induced decrease of the NF-κB/p65 expression as compared with that in the PPⅠ group (0.86 ± 0.18 vs 0.43 ± 0.09, P < 0.05). CONCLUSIONS: PPⅠ induces the early apoptosis and suppresses the proliferation of PC3 cells, probably by activating the ERK1/2 pathway and inhibiting the expressions of the NF-κB/p65 and DNMT1 proteins.

[Staging Based Strategies and Practice for Prostate Cancer].

Authors raised that staging based strategies and practice of integrative medicine (IM) by combining syndrome typing and disease identification, and choosing suitable measures in accordance with different persons and seasonal conditions after more than ten years' clinical practice and researches. Radical operation as prior (as evil eliminating) and strengthening vital qi in perioerative period are best strategy for promoting rapid rehabilitation of early stage prostate cancer patients. Strengthening body resistance to eliminate evil was used in treating advanced prostate cancer patients. For example, a comprehensive treatment program for hormone-dependent patients was combined with endocrinotherapy and Chinese herbs for synergisic efficacy-enhancing actions. In this way, these patients' quality of life (QOL) were improved and time to castration resistant prostate cancer (CRPC) was delayed, even some patients were clinically cured. There are lack of effective medicines and methods for CRPC patients. Greatly tonifying original qi is mainly used for improving their clinical symptoms and prolonging survivals. Practice has proved staging based strategies and practice of IM has favorable advantages in treating prostate cancer, especially showing prospect in prolonging survival and postponing progression of advanced prostate cancer patients. Besides, it also could provide beneficial considerations and inspiration for combination of syndrome typing and disease identification.

[Laparoscopic radical prostatectomy for incidental prostate cancer after TURP].

OBJECTIVE: To investigate the management of incidental prostate cancer after TURP by laparoscopic radical prostatectomy (LRP). METHODS: Between April 2005 and December 2011, we treated 4 cases of incidental prostate cancer with p504s (+) by LRP, 1 at 3 mon, while the other 3 at 1.5 mon after TURP. RESULTS: The operations were successfully performed in all the 4 cases, all by extraperitoneal approach. Postoperative pathology showed prostate cancer in 2 of the cases with Gleason scores of 6-7, high-level epithelial neoplasia in 1, and no malignancy in the other. Postoperative observation and 1-79 mon follow-up visit revealed good urinary function but no obvious urinary incontinence, metastasis and erectile dysfunction. CONCLUSION: With practiced laparoscopic skills, laparoscopic radical prostatectomy may achieve satisfactory results in the treatment of incidental prostate cancer after TURP.

[Effects of perioperative treatment by integrated traditional Chinese and Western medicine on postoperative parameters of TURP].

OBJECTIVE: To study the clinical effects of perioperative treatment by integrated traditional Chinese and Western medicine on postoperative parameters of TURP. METHODS: From Jun. 2002 to Oct. 2006, 238 cases of TURP were performed in our hospital, of whom, 179 (Group A) were treated by integrated traditional Chinese and Western medicine, and the other 59 (Group B) by Western medicine. The postoperative parameters of the 2 groups were recorded and compared. RESULTS: Postoperative catheter indwelling, hospital stay, Q(max) 4 w after TURP and incidence of bacteriuria (> 5 d) showed no significant difference (P > 0.05), while the incidence rates of overactive bladder and urgent urinary incontinence, hematuria time, dysuria time, IPSS score and QOL score 4 w after TURP were statistically different between the 2 groups (P < 0.05). CONCLUSION: For TURP patients, perioperative treatment by integrated traditional Chinese and Western medicine can reduce postoperative complications, increase the success rate of surgery and improve QOL score.

[Expression of MUC1 and distribution of tumor-infiltrating dentritic cells in human bladder transitional cell carcinoma].

OBJECTIVE: To study MUC1 expression and distribution of tumor-infiltrating dentritic cells (TIDCs) in human bladder transitional cell carcinoma (BTCC). METHODS: Immunohistochemical staining was employed to detect MUC1 expression and TIDC distribution in 69 surgical specimens of BTCC. MUC1 expression was also detected immunohistochemically in BIU-87, T-24 and drug-resistant BIU87/A cells. Flow cytometry was performed for determining the apoptosis rates of these 3 cells after a 48-hour treatment with adriamycin, vincristine and cisplatin, respectively. RESULTS: MUC1 expression was detected in the BTCC tissues of all stages and the immunohistochemical staining patterns were significantly associated with the pathological grade and clinical stage of the tumors (P<0.001). The number of TIDCs in the tumors was inversely correlated with tumor pathological grades and clinical stages (P<0.005). MUC1 expressed weakly in the cytoplasm and on the membrane of BIU-87 cells and T-24 cells, but strongly in the cytoplasm and membrane of BIU-87/A cells, showing significant differences between the drug-sensitive and -resistant cells (P<0.05). The apoptosis rates of BIU-87 cells and T-24 cells increased obviously after treatment with adriamycin, vincristine and cisplatin, but no significant differences were noted between the two cells or between the 3 drugs. The apoptosis rate of BIU87/A cells, however, exhibited no obvious increase after adriamycin or vincristine treatment, but showed significant increase in response to cisplatin treatment (P<0.05). CONCLUSIONS: The expression pattern of MUC1 and distribution of TIDCs can be useful markers to evaluate the degree of malignancy and prognosis of BTCC. The decrease in the number of TIDCs may have important relation to tumor immune evasion and immune tolerance, and MUC1 over-expression may lead to drug resistance of BTCC, indicating its involvement in tumor infiltration and metastasis.

[Value of quantitative examination of urine MUC1 in bladder transitional cell carcinoma].

OBJECTIVE: To evaluate the value of quantitative examination of MUC 1 in the urine of patients with bladder transitional cell carcinoma (BTCC). METHODS: Urine samples were obtained from 31 patients with BTCC for quantification of MUC 1 content by immunoradiometric analysis. The urine samples were also examined in 10 patients with cystitis glandularis, 10 with benign urine disease and 10 healthy volunteers. The differences in urine MUC1 content were statistically measured between the groups, between cancer patients of different clinical stages and classes, between primary and recurrent cancer patients, and between measurements taken before and after operation. RESULTS: Urine MUC 1 was detected in all the patients. No significant differences were found between the groups, nor between patients with BTCC in all stages (P>0.05), or between primary and recurrent cancer patients (P>0.05). But MUC 1 contents showed significant difference before and after the operation in the cancer patients (P<0.05). CONCLUSIONS: Urine MUC 1 can not serve as the marker to screen and diagnose BTCC, but it can be useful in therapeutic effect and prognostic evaluation. Specific oncogene markers are more significant than oncogene phenotype markers in clinical diagnosis and screen of BTCC.

[Tumor infiltrating dendritic cells and Mucin1 gene expression in benign prostatic hyperplasia and prostate cancer].

OBJECTIVE: To study the expression of Mucin1 gene and tumor infiltrating dendritic cells(TIDC) in the tissues of benign prostatic hyperplasia (BPH) and prostate cancer. METHODS: Mucin1 and TIDC were detected in 20 specimens of BPH and 30 specimens of prostate cancer by immunohistochemistry SP method. RESULTS: MUC1 expressed in both prostate cancer and BPH. The staining patterns were significantly associated with tumor pathological grade (P < 0.001). The number of TIDC was negatively correlated with tumor pathological grade, the higher the grade, the smaller the number of TIDC (P < 0.001). CONCLUSIONS: The expression pattern of MUC1 and the number of TIDC could be considered as useful markers to evaluate the malignant degree and prognosis of prostate cancer. The decrease of TIDC plays an important role in tumor immune evasion and immune tolerance. Highly expressed MUC1 could lead to the failure of hormonal treatment for prostate cancer, and contribute much to tumor infiltration and metastasis.

[NF-kappa B and prostatic adenocarcinoma].

Nuclear factor of kappa B (NF-kappa B) is a multipolar nuclear transcription factor, and adjusts many gene expressions concerned with immunization, apoptosis, inflammation, neoplasia and metastasis. Recently, NF-kappa B has become a kind of hot spot in the studies of neoplasia, infiltration, metastasis and drug resistance. NF-kappa B can serve as an ideal target molecular approach to the promising gene therapy. This article reviews recent advances in studies on the structure and function of NF-kappa B, and the relationship between NF-kappa B and prostatic adenocarcinoma infiltration, metastasis and tactics of gene therapy.