The prognostic effect of immunohistochemical staining rates in patients with non–muscle-invasive bladder cancer

Context: Despite the follow-up protocols developed in non–muscle-invasive bladder cancer patients, progression and recurrence could not be prevented. Aims: We aimed to investigate whether proteins such as OCT-4, CD47, p53, Ki-67, and Survivin, which increase in bladder cancer cells, can be used as prognostic markers for patients with non–muscle-invasive bladder cancer. Settings and Design: The study included a total of 89 patients with newly diagnosed non–muscle-invasive bladder cancer between January 2015 and December 2020. Materials and Methods: Levels of OCT-4, CD47, p53, K?-67, and Survivin proteins in cancer cells were determined with a semi-quantitative immunohistochemical experiment. Pathological data and survival rates were compared according to the staining rates. Statistical Analysis Used: Data obtained in the study were analyzed statistically with SPSS 22.0 (SPSS, Chicago, IL, USA). Results: The mean age of the patients was 64.25 ± 9.91 years, and the median follow-up period was 55 months. Recurrence rate was determined to be 36% (n = 32), and the rate of progression at 40.4% (n = 36). The staining rates were stronger for each marker in the progression group and advanced-stage tumors (p < 0.001). The findings of the multivariate analysis carried out as part of the study showed that older age and higher tumor stage were independent risk factors for recurrence-free survival (HR = 1.048 and 7.074, respectively; P = 0.02). Also, higher tumor stages, diameters, and grades were associated with reduced progression-free survival (HR = 0.105, 0.395, 0.225, respectively; P < 0.05). Conclusions: Although immunohistochemical staining rates are promising, it is more appropriate to use tumor characteristics when assessing survival rate in patients with non–muscle-invasive bladder cancer.

Immunohistochemical appraisal of epithelial mesenchymal transition type III in gall bladder cancer

Background: Epithelial-mesenchymal transition (EMT) is the heart of invasion. EMT associated with cancer progression and metastasis is known as type III EMT. Beta-catenin, E-cadherin, and MMP9 markers of EMT are routinely employed for diagnostic purposes. Aims: We employed these markers to study EMT by immunohistochemistry (IHC) in gall bladder cancer (GBC) with respect to depth of tumor invasion, clinical outcome, and disease-free survival. Settings and Design: This was a prospective case-control study. Material and Methods: Seventy gall bladders were included (50 GBC and 20 CC). After detailed histology, immunoexpression was studied in terms of percentage and strength of expression. Statistics Analysis Used: Expression was compared between CC and GBC by Student t test and analysis of variance. Kaplan–Meier was used for survival analysis, and the extent of agreement (“Kappa”) was calculated. Results and Conclusions: The age of incidence of GBC was 49.40 (+11.6) years with female predominance (F:M = 4:1). In 88% (44/50) of GBC, the fundus was involved. Moderately differentiated adenocarcinoma was most frequent [54%; 27/50]. Significant downregulation of E-cadherin (P = 0.022) and beta-catenin (P < 0.001) and upregulation in MMP9 (P < 0.001) were seen in GBC with respect to CC with significant association among them. MMP9 expression was significantly associated with higher tumor stage but with chemotherapeutic response. Our results display that epithelial-mesenchymal transition type III plays a role in GBC invasion. MMP9 overexpression and loss of membranous beta-catenin may be considered a marker for poor clinical outcomes and advanced disease.

La esquistosomiasis como factor de riesgo del cáncer de vejiga. Hospital Central de Nampula, Mozambique

Introducción: la esquistosomiasis es la infección por trematodos más importante a nivel global. El carcinoma de células escamosas constituye el 2 % de todos los tipos histológicos de cáncer vesical; sin embargo, la incidencia de esta variedad en países endémicos de esquistosomiasis es mayor. Objetivo: evaluar la relación entre la esquistosomiasis y el cáncer de vejiga en pacientes del Hospital Central de Nampula. Materiales y métodos: se realizó un estudio observacional, descriptivo y transversal en el período comprendido entre enero de 2014 y diciembre de 2020. Los pacientes se dividieron en grupos etarios, por intervalos de 10 años. Se tomaron muestras de biopsias de tumores de vejiga, clasificándose por tipo histológico, además de los hallazgos relacionados con infestación por esquistosomiasis y formas de presentación del cáncer de vejiga. El universo estuvo constituido por 184 pacientes, y la muestra se conformó por 135 casos. Resultados: se comprobó que el mayor número de pacientes con cáncer de vejiga es del sexo masculino; el tipo histológico más frecuente fue el carcinoma de células escamosas, representando un 84,3 % del total. La cistitis, la presencia de esquistosomas, y sus huevos estuvieron presentes en casi todas las biopsias realizadas. Sus formas de presentación más frecuente fueron la cistitis, la hematúrica y la dolorosa. Conclusiones: el cáncer de vejiga mostró una mayor incidencia en las edades comprendidas entre 30 y 69 años. El carcinoma de células escamosas fue el más frecuente, y su relación con la cistitis y la infección por esquistosomas estuvo presente en más del 90 % de las biopsias.

Introduction: schistosomiasis is the most important trematode infection globally. Squamous cell carcinoma constitutes 2% of all the histological types of bladder cancer; however, the incidence of this variety of cancer in squistosomiasis-endemic countries is higher. Objective: to evaluate the relationship between squistosomiasis and bladder cancer in patients from the Central Hospital of Nampula. Materials and methods: a cross-sectional descriptive observational study was carried in the period between January 2014 and December 2020. Patients were divided into age-groups, by 10-year intervals. Biopsy samples of bladder tumors were taken, classified by histological type, in addition to findings related to squistosomiasis infestations and bladder cancer presentation forms. The universe consisted of 184 patients and the sample of 135 cases. Results: it was found that the largest number of patients with bladder cancer is male; squamous cell carcinoma is the most frequent histological type, representing 84.3% of the total. Cystitis, schistosome and their eggs were present in almost all the biopsies performed. Its most frequent presentation forms were hematuric and painful cystitis. Conclusions: bladder cancer showed higher incidence at the ages between 30 and 69 years. The squamous cell carcinoma was the most frequent, and its relationship with cystitis and schistosome infection was present in more than 90% of biopsies.

Effect of CYFIP2 overexpression on biological function and Wnt/β-catenin signaling pathway of bladder cancer cell line T24 / 国际生物医学工程杂志

Objective:To investigate the effects of cytoplasmic fragile X mental retardation protein 1 binding protein 2 (CYFIP2) overexpression on the biological functions and Wnt/β-catenin signaling pathways of bladder cancer T24 cells.Methods:The control group was T24 cells transfected with the empty pcDNA3 vector, and the overexpression group was T24 cells transfected with the CYFIP2 overexpression vector. The expression of CYFIP2 mRNA and protein was detected by reverse transcriptase, quantitative polymerase chain reaction, and Western Blot. The effect of CYFIP2 overexpression on T24 cell proliferation was detected by CCK-8. The effect of CYFIP2 overexpression on T24 cell migration and invasion was detected by Transwell. The effects of CYFIP2 overexpression on Wnt/β-catenin signaling pathway in T24 cells were detected by Western Blot.Results:Compared with the control group, the expression levels of CYFIP2 mRNA and protein were increased in the overexpression group (all P < 0.001), and the cell proliferation, migration, and invasion abilities were reduced (all P < 0.01). β-catenin, c-Myc, and Cyclin D1 protein expression were down-regulated in CYFIP2 overexpressed T24 cells (all P < 0.05), while the protein levels of p-β-catenin were increased ( P < 0.05). Conclusions:CYFIP2 overexpression can inhibit T24 cell proliferation, migration, and invasion, and its possible molecular mechanism is related to the inhibition of Wnt/β-catenin signaling pathway.

Efficacy and safety of PD-1/PD-L1 inhibitors for neoadjuvant treatment of bladder cancer：meta-analysis of single-group rates / 中国药房

OBJECTIVE To evaluate the efficacy and safety of PD-1/PD-L1 inhibitors for neoadjuvant treatment of bladder cancer， and to provide evidence-based reference for clinical treatment. METHODS Retrieved from PubMed， Cochrane Library， Embase， American Society of Clinical Oncology Meeting Library， CNKI， VIP and Wanfang database， etc.， the randomized controlled trials （RCTs）， non-RCT， case-control studies， cohort studies， etc. about PD-1/PD-L1 inhibitors for neoadjuvant treatment of bladder cancer were collected from the inception to Jan 31st， 2023. After literature screening， data extraction and quality evaluation， RevMan 5.3 software was used to perform meta-analysis of single-group rates； sensitivity analysis and publication bias analysis were conducted using Stata12 software. RESULTS A total of 25 studies were included in this discussion， involving 940 patients. The results of meta-analysis showed that the pathologic complete response （pCR） rate was 32% [OR＝0.32， 95%CI （0.22， 0.45）， P＝0.006]， downstaging rate was 52% [OR＝0.52， 95%CI （0.45， 0.60）， P＝0.55]， and the incidence of ≥grade 3 immune-related adverse events （irAEs） was 16% [OR＝0.16， 95%CI （0.11， 0.22）， P＜0.000 01]. Subgroup analysis showed that the patients receiving PD-1/PD-L1 inhibitors alone had a pCR rate of 25% and a incidence of Grade≥3 irAEs of 9%； the patients receiving combined immunotherapy had a pCR rate of 29% and a incidence of Grade≥3 irAEs of 28%； the patients receiving PD-1/PD-L1 inhibitors combined with chemotherapy had a pCR rate of 43% and a incidence of Grade≥3 irAEs of 12%； PD-L1 positive patients had a pCR rate of 44%， and PD-L1 negative patients had a pCR rate of 25%. The results of the sensitivity analysis showed that the study was robust. The results of the publication bias analysis showed that there was no significant publication bias. CONCLUSIONS PD-1/PD-L1 inhibitors are effective and safe for adjuvant treatment of bladder cancer.

Plumbagin Induces Ferroptosis Through Nrf-2/Keap1 Signaling Pathway in Bladder Cancer Cells / 中国实验方剂学杂志

ObjectiveTo explore the mechanism of plumbagin as a novel ferroptosis inducer in bladder cancer inhibition. MethodBladder cancer T24 cells were used in this study. The effect of different concentrations of plumbagin （0.1， 1， 2， 3， 6， 12， 24， 48 μmol·L-1） on the viability of T24 cells was detected by cell counting kit-8 （CCK-8）. The effect of different concentrations of plumbagin （1.5， 3， 6 μmol·L-1） on the apoptosis of T24 cells was detected by annexin V-fluorescein isothiocyanate （Annexin V FITC）/PI apoptosis kit. Different inhibitors （ferroptosis inhibitor Fer-1， apoptosis inhibitor VAD， and necroptosis inhibitor Nec-1） were used in combination with plumbagin （6 μmol·L-1）. Reactive oxygen species （ROS） fluorescent probe （DCFH-DA）， malonaldehyde （MDA）， and glutathione （GSH） kits were used to detect the effects of different concentrations of plumbagin （1.5， 3， 6 μmol·L-1） on the level of ROS and the content of MDA and GSH in T24 cells， respectively. The effect of different concentrations of plumbagin （1.5， 3， 6 μmol·L-1） on peroxide levels in T24 cells was detected by C11-BODIPY fluorescent probe. Western blot was used to detect the effect of different concentrations of plumbagin （1.5， 3， 6 μmol·L-1） on the protein expression of solute carrier family 7 member 11 （SLC7A11）， glutathione peroxidase 4 （GPX4）， nuclear factor E2-related factor-2 （Nrf-2）， and Kelch-like ECH-associated protein 1 （Keap1）. ResultCompared with the blank group， plumbagin could inhibit the activity of T24 cells （P<0.05） with IC50 of 3.52 μmol·L-1. At the concentrations of 1.5， 3， 6 μmol·L-1， plumbagin significantly promoted the apoptosis of T24 cells （P<0.05） as compared with the blank group. Compared with the plumbagin group at 6 μmol·L-1， the ferroptosis inhibitor and apoptosis inhibitor groups could reverse the inhibitory effect of 6 μmol·L-1 plumbagin on the proliferation of T24 cells （P<0.05）. Compared with the blank group， the plumbagin groups at 1.5， 3， 6 μmol·L-1 showed increased content of ROS， MDA， and lipid peroxides in T24 cells， decreased GSH level， and reduced SLC7A11， GPX4， and Nrf-2/Keap1 （P<0.05）. Conclusionplumbagin can induce ferroptosis， and its mechanism is related to the Nrf-2/Keap1 signaling pathway.

Construction and Validation of A Risk Model for Predicting Prognosis and Immunotherapy Response of Bladder Cancer Based on Cellular Senescence-related Genes / 肿瘤防治研究

Objective To evaluate the prognosis and immunotherapy response of patients with bladder cancer by constructing a risk-score model of cellular senescence-related signature (SRS), as well as to explore the clinical application value of SRS in bladder cancer. Methods Senescence genes were screened from TCGA-BLCA, and cellular SRS genes were screened according to LASSO regression. A bladder cancer risk-score model was constructed based on the SRS genes to analyze the survival difference and model-fit degree of TCGA-BLCA high- and low-risk groups. Univariable and multivariable Cox regression was used to analyze the prognostic risk factors of bladder cancer. Overall survival differences of high- and low-risk groups in GEO-BLCA database were verified, and variations in immunotherapy responses were analyzed in IMvigor210 databases. According to the result of β-gal chromogenic reaction in bladder cancer and normal paracancer tissues, the existence of cell senescence was determined. Results Eight marker genes were screened, and patients were divided into high- and low-risk groups according to the median risk score constructed by the marker genes. The 5-year survival rate of high risk group was lower than that of low risk group (training and validation sets P < 0.05). The area under the ROC curve of TCGA-BLCA in 1-, 3-, and 5-year were 0.657, 0.660, and 0.688, and those for GSE13507 were 0.665, 0.665, and 0.613, respectively. SRS risk score can be used as an independent risk factor for the prognosis of patients with bladder cancer. The SRS risk score in the response group was lower than that in the non-response group during bladder cancer immunotherapy (P < 0.05). The β-gal staining of bladder cancer tissue was positive, but the β-gal staining of adjacent normal tissue was negative. Conclusion Cell senescence occurs in bladder cancer tissues. SRS risk score can predict the clinical prognosis of patients with bladder cancer, and patients with low score can benefit from immunotherapy. SRS is a reliable biomarker for the prognosis and immunotherapy response of bladder cancer.

Application and Development of Artificial Intelligence in A Pathological Study of Urinary System Tumors / 肿瘤防治研究

Global Cancer Statistics for 2020 show that urinary system tumors account for approximately 13% of the total number of cancers. At present, the diagnostic methods of urinary system tumors are imaging, endoscopy, and pathological examination. As the gold standard of tumor diagnosis, pathological examination has problems such as lack of pathologists and long operation time. Artificial intelligence (AI), with a strong ability for pathology image recognition and feature analysis, can be used as an auxiliary diagnosis. It has realized automatic diagnosis, typing, staging, grading, and prognosis prediction in several urinary system tumors. However, AI still has many shortcomings, which limit its clinical application. This article will review the progress of AI and its application in the pathological study of urinary system tumors.

Research Progress of Deep Learning in Bladder Cancer Pathology / 肿瘤防治研究

The incidence of bladder cancer is increasing annually, and the gold standard for its diagnosis relies on histopathological biopsy. Whole-slide digitization technology can produce thousands of high-resolution captured pathological images and has greatly promoted the development of digital pathology. Deep learning, as a new method of artificial intelligence, has achieved remarkable results in the analysis of pathological images for tumor diagnosis, molecular typing, and prediction of prognosis and recurrence of bladder cancer. Traditional pathology relies heavily on the professional level and experience of pathologists; as such, it is highly subjective and has poor reproducibility. Deep learning can automatically extract image features. It can also improve diagnostic efficiency and repeatability and reduce missed and misdiagnosed rates when used to assist pathologists in making decisions. This technology cannot only alleviate the pressure of the current shortage of skilled workforce and uneven medical resources but also promote the development of precision medicine. This article reviews the latest research progress and prospects of deep learning in pathological image analysis of bladder cancer.

Research Progress in Preoperative Evaluation of Lymph Node Metastasis of Bladder Cancer / 中国医学科学院学报

Bladder cancer is a common malignant tumor of the urinary system.The prognosis of patients with positive lymph nodes is worse than that of patients with negative lymph nodes.An accurate assessment of preoperative lymph node statushelps to make treatmentdecisions,such as the extent of pelvic lymphadenectomy and the use of neoadjuvant chemotherapy.Imaging examination and pathological examination are the primary methods used to assess the lymph node status of bladder cancer patients before surgery.However,these methods have low sensitivity and may lead to inaccuate staging of patients.We reviewed the research progress and made an outlook on the application of clinical diagnosis,imaging techniques,radiomics,and genomics in the preoperative evaluation of lymph node metastasis in bladder cancer patients at different stages.

Robot-assisted laparoscopic enucleation in the treatment of leiomyosarcoma of urinary bladder: A case report / 中南大学学报(医学版)

Leiomyosarcoma of urinary bladder (LMS-UB) is a highly malignant mesenchymal tumor, accounting for less than 0.5% of all bladder malignancies, with a predominant clinical presentation of hematuria. Here we report a case of low-grade LMS-UB. A 44-year-old male patient was admitted to the hospital with urodynia for 2 weeks. The patient's pelvis CT showed a mass on the right part of the bladder. For this reason, he was initially diagnosed with bladder cancer. We performed a robot-assisted laparoscopic enucleation of the bladder tumor and low-grade LMS-UB was diagnosed with the histopathological examination. He underwent 5 cycles of adjuvant chemotherapy after surgery. At 19months postoperative follow-up, the patient had no symptoms, recurrence, or distant metastasis. There is no report on the treatment of LMS-UB with minimally invasive enucleation worldwide. This case provides a new comprehensive treatment method of enucleation combined with adjuvant chemotherapy for early low-grade LMS-UB to reduce complications and improve patients' quality of life after surgery.

Construction of prognostic risk model of bladder cancer based on cuproptosis-related long non-coding RNAs / 浙江大学学报·医学版

OBJECTIVES@#To construct a prognosis risk model based on long noncoding RNAs (lncRNAs) related to cuproptosis and to evaluate its application in assessing prognosis risk of bladder cancer patients.@*METHODS@#RNA sequence data and clinical data of bladder cancer patients were downloaded from the Cancer Genome Atlas database. The correlation between lncRNAs related to cuproptosis and bladder cancer prognosis was analyzed with Pearson correlation analysis, univariate Cox regression, Lasso regression, and multivariate Cox regression. Then a cuproptosis-related lncRNA prognostic risk scoring equation was constructed. Patients were divided into high-risk and low-risk groups based on the median risk score, and the immune cell abundance between the two groups were compared. The accuracy of the risk scoring equation was evaluated using Kaplan-Meier survival curves, and the application of the risk scoring equation in predicting 1, 3 and 5-year survival rates was evaluated using receiver operating characteristic (ROC) curves. Univariate and multivariate Cox regression were used to screen for prognostic factors related to bladder cancer patients, and a prognostic risk assessment nomogram was constructed, the accuracy of which was evaluated with calibration curves.@*RESULTS@#A prognostic risk scoring equation for bladder cancer patients was constructed based on nine cuproptosis-related lncRNAs. Immune infiltration analysis showed that the abundances of M0 macrophages, M1 macrophages, M2 macrophages, resting mast cells and neutrophils in the high-risk group were significantly higher than those in the low-risk group, while the abundances of CD8+ T cells, helper T cells, regulatory T cells and plasma cells in the low-risk group were significantly higher than those in the high-risk group (all P<0.05). Kaplan-Meier survival curve analysis showed that the total survival and progression-free survival of the low-risk group were longer than those of the high-risk group (both P<0.01). Univariate and multivariate Cox analysis showed that the risk score, age and tumor stage were independent factors for patient prognosis. The ROC curve analysis showed that the area under the curve (AUC) of the risk score in predicting 1, 3 and 5-year survival was 0.716, 0.697 and 0.717, respectively. When combined with age and tumor stage, the AUC for predicting 1-year prognosis increased to 0.725. The prognostic risk assessment nomogram for bladder cancer patients constructed based on patient age, tumor stage, and risk score had a prediction value that was consistent with the actual value.@*CONCLUSIONS@#A bladder cancer patient prognosis risk assessment model based on cuproptosis-related lncRNA has been successfully constructed in this study. The model can predict the prognosis of bladder cancer patients and their immune infiltration status, which may also provide a reference for tumor immunotherapy.

Research progress on the role of urothelial somatic mutations in the occurrence and recurrence of bladder cancer / 现代泌尿外科杂志

Bladder cancer is characterized by high incidence and high recurrence; however, the mechanism of pathogenesis, especially of recurrence is still unclear. This paper reviews the molecular characteristics of bladder cancer, urothelial somatic mutation, driver genes and mutation characteristics, and prospects the future research directions.

Application of blue laser side light in the vaporization and enucleation of bladder cancer: a report of 16 cases / 现代泌尿外科杂志

【Objective】 To observe the efficacy of blue laser side light in the vaporization and enucleation of non-muscle invasive bladder cancer (NMIBC). 【Methods】 A retrospective analysis was performed on the data of NMIBC patients who received transurethral enucleation of bladder tumor (TURBT) using a 50 W blue laser treatment device. The efficacy and safety of surgery were evaluated by observing the application of blue laser in the treatment of bladder cancer in different locations, operation time, presence of bladder perforation and postoperative urine routine indicators. 【Results】 A total of 16 patients completed the surgery, including 5 cases with multiple bladder tumors, 9 with single bladder tumor, and 2 with lichenoid lesions. The postoperative pathological results showed all of them were NMIBC. The operation time was (10.4±4.7) min, postoperative urinalysis was (689.4±316.7)/μL, and no intraoperative bladder perforation occurred. 【Conclusion】 The lateral infusion mode of 50 W blue laser therapy device can be applied to the surgical treatment of NMIBC. The basal vaporization and enucleation of bladder cancer can be performed under direct vision conditions, and the multi-angle enucleation is suitable for bladder cancer in different positions. The tissue penetration depth of blue laser is shallow, which is conducive to the diagnosis and grading of pathological tissues.

Application of semiconductor blue laser in day surgery for 22 cases of bladder cancer / 现代泌尿外科杂志

【Objective】 To investigate the feasibility and safety of semiconductor blue laser in the treatment of non-muscle invasive bladder cancer (NMIBC) in the day surgery model. 【Methods】 The clinical data of 22 NMIBC patients (average age 55.8 years and tumor size 1.4 cm) who underwent outpatient screening and accepted blue laser ambulatory surgery in our hospital during Jun.2022 and Sep.2022 were retrospectively analyzed. On the day of admission, transurethral resection of cancer was performed using blue laser en bloc enucleation. On the day of surgery or in the morning of next day, bladder irrigation was stopped, the catheter was removed, and patients were discharged. The baseline data, pre-hospital waiting time, operation time, length of hospital stay, hemoglobin decrease, complications and management, follow-up, medical costs, and patients’ satisfaction rate were recorded. 【Results】 The pre-hospital waiting time was 2 to 7 days, average (4.1±1.3)days. The operation time was 29 to 50 minutes, average (40.8±5.5)minutes. The length of hospital stay was 0.6 to 1.2 days, average (0.9±0.2)days. Hemoglobin decrease was 1 g/L to 8 g/L, average (3.8±1.8)g/L. The catheter was indwelt for 0.5 to 1 day, average (0.7±0.1)day. The medical costs were 13 790 to 16 811 Yuan, average (14 941.5±690.2) Yuan. Patients’ satisfaction rate was 100.0%. Mild intraoperative and postoperative complications occurred in 2 cases. One patient developed symptoms of cystitis which disappeared after 2 days of oral antibiotic cefixime, and another patient developed bladder spasm which was relieved after oral solifenacin succinate tablets. No adverse events such as obturator nerve reflex or bladder perforation occurred. After removal of the catheter, no urinary retention was observed. 【Conclusion】 This study was the first to apply blue laser ambulatory surgery in the treatment of bladder cancer, confirming that it is a safe, feasible, economical and efficient model for selected patients, which can be promoted in suitable hospitals.

Efficacy and safety of blue laser en bloc enucleation in the treatment of non-muscle invasive bladder cancer: report of 50 cases from a single center / 现代泌尿外科杂志

【Objective】 To compare the efficacy and safety of blue laser en bloc enucleation and traditional plasmakinetic electrocautery in the treatment of non-muscle invasive bladder cancer (NMIBC). 【Methods】 A total of 50 NMIBC patients treated in our hospital during Oct.2018 and Dec.2019 were enrolled. A randomized, incomplete blinding, parallel control design and non-inferior test method was adopted. The control group (electrocautery group) used plasmakinetic electrocautery for transurethral resection, and the experimental group (blue laser group) used semiconductor blue laser for transurethral en bloc enucleation. The effective resection rate, operation time, postoperative catheter indwelling time, length of hospital stay, perioperative hemoglobin changes and obturator nerve reflex were compared. 【Results】 There were 24 patients in the blue laser group and 26 in the electrocautery group. The effective dissection rate and hemostasis rate in both groups reached 100%. The blue laser group had slightly longer operation time than the electrocautery group (55 min vs.42 min, P=0.009), but lesser hemoglobin decrease (5.7 g/L vs. 10.4 g/L, P=0.007). There were no significant differences in urinary catheter indwelling time, length of hospital stay and reoperation rate between the two groups. The electrocautery group had 3 cases of obturator nerve reflex, while the blue laser group had none. 【Conclusion】 Compared with the traditional electrocautery, blue laser has good vaporization cutting and coagulation hemostatic effects on bladder tumor tissue, and can completely enucleate tumors in a front-firing model with less bleeding and no obturator nerve reflex, which can be used as a new, efficient, safe and easy-to-learn method for NMIBC surgery. However, its effects on postoperative recurrence rate and progression rate still need further studies.

Effects of histone acetyltransferase KAT7 inhibitor WM-3835 on the proliferation and migration of bladder cancer cells / 现代泌尿外科杂志

【Objective】 To investigate the effects of WM-3835, a histone acetyltransferase KAT7 (KAT7) inhibitor, on the proliferation and migration of bladder cancer cells and to explore the possible mechanism. 【Methods】 Human ureteral epithelial immortalized cell line SV-HUC-1, and bladder cancer cell lines UM-UC-3 and T24 were treated with different concentrations of WM-3835 (0, 10, 20, 30, 40 μmol/L). After 48 hours, the effects of WM-3835 on the proliferation, cell cycle distribution and migration of cells were detected with MTT assay, flow cytometry, scratch and Transwell assay, respectively. The expressions of cyclin D1 (cyclin D1), proliferating nuclear antigen (PCNA), matrix metalloproteinase 9 (MMP9) and neurocadherin (N-cadherin) were detected with Western blotting and real-time quantitative PCR. 【Results】 WM-3835 significantly inhibited the proli-feration of bladder cancer cells in a dose-dependent manner. After treatment with WM-3835, the cycle of UM-UC-3 and T24 cells were blocked in the G0/G1 phase, the proliferation was effectively inhibited, and the migration was significantly wea-kened. The expressions of cyclin-D1, PCNA, MMP9 and N-cadherin were down-regulated. 【Conclusion】 WM-3835 can inhibit the proliferation and migration of bladder cancer cells, and has the potential as a chemotherapeutic agent for bladder cancer.

Application of syringe needle guided transabdominal double-J tube placement in total laparoscopic ileal neobladder surgery / 现代泌尿外科杂志

【Objective】 To explore the application of 1.2 mm×35 mm thin walled, long oblique angle syringe needle guided double-J tube insertion through abdominal wall in total laparoscopic ileal neobladder surgery. 【Methods】 Clinical data of 5 patients undergoing total laparoscopic ileal neobladder surgery in our hospital during Dec.2020 and Jan.2022 were retrospectively analyzed. Under laparoscopy and direct vision, 3 cm above pubic symphysis was taken as the puncture point, and an syringe needle was inserted to establish a channel. After that, a double-J tube was inserted under the guidance of the guide wire through the needle. 【Results】 The double-J tube was successfully implanted in all 5 patients. The time needed was 2-4 min, with an average of 3 min. 【Conclusion】 Under the guidance of a 1.2 mm×35 mm syringe needle, the placement of a double-J tube through the abdominal wall in total laparoscopic ileal neobladder surgery is safe, effective, simple and accurate. It can not only preserve the original operation channel without destroying the pneumoperitoneum, but also shorten the operation time. It is a new auxiliary means in total laparoscopic ileal neobladder surgery.

Clinical application of a novel urinary cytology detection system for bladder cancer / 现代泌尿外科杂志

【Objective】 To investigate the diagnostic efficacy of a novel bladder cancer detection system utilizing a urine cell processing kit for urine sample preservation and detection. 【Methods】 Patients with primary persistent gross hematuria and high recurrence risk of bladder cancer after transurethral resection of bladder tumor were prospectively enrolled between Dec.2021 and Mar.2022. Urine specimens were either added to (experimental group) or not added to (control group) the urine cell processing kit and were fixed on Day 0, Day 3 and Day 7. The sensitivity and specificity of the two groups were compared after the cells were fixed, produced, stained and read with body fluid cytology total staining technique. 【Results】 The sensitivity and specificity of the experimental group on Day 0 were 82.50% (33/40) and 87.50% (14/16), respectively; those of the control group were 79.49% (31/39) and 82.35% (14/17), respectively. On Day 3, the sensitivity and specificity of the experimental group were 76.32% (29/38)and 81.25% (13/16), respectively; those of the control group were 52.78% (19/36) and 78.57% (11/14), respectively. On Day 7, the sensitivity and specificity of the experimental group were 71.43% (25/35) and 72.22% (13/18), respectively; those of the control group were 35.71% (10/28) and 60.00% (9/15), respectively. The sensitivity of the experimental group on Day 3 and Day 7 was significantly higher than that of the control group (P<0.05). 【Conclusion】 This bladder cancer urine cytology detection system provides clear diagnostic advantages and can be used as an auxiliary examination before cystoscopy for patients with hematuria and those at high risk of bladder cancer recurrence. It can also be used as a bladder cancer screening tool for pre-screening a large sample of people in order to achieve early diagnosis and treatment of bladder cancer.

Construction of a competing risk model for disease-free survival of patients with non-muscle invasive bladder cancer / 现代泌尿外科杂志

【Objective】 To construct an easy-to-use individual survival prognostic tool based on competing risk analyses to predict the risk of 1-, 2- and 3- year recurrence for patients with non-muscle invasive bladder cancer (NMIBC). 【Methods】 The follow-up data of 419 NMIBC patients were obtained. The patients were randomly divided into training cohort (n=293) and validation cohort (n=126). The variables included age at diagnosis, sex, history of smoking, tumor number, tumor size, histolo-gic grade, pathological stage, and bladder perfusion drug. The cumulative incidence function (CIF) of recurrence was estimated using all variables in the training cohort and potential prognostic variables were determined with Gray’s test. The Fine-Gray subdistribution proportional hazard approach was used as a multivariate competitive risk analysis to identify independent pro-gnostic variables. A competing risk nomogram was developed to predict the recurrence. The performance of the competing risk model was evaluated with the area under the receiver operating characteristic curve (AUC), calibration curve, and Brier score. 【Results】 Five independent prognostic factors including age, number of tumors, tumor size, histologic grade and pathological stage were used to construct the competing risk model. In the validation cohort, the AUC of 1-, 2- and 3- year recurrence were 0.895 (95%CI: 0.831-0.959), 0.861(95%CI: 0.774-0.948) and 0.827(95%CI: 0.721-0.934), respectively, indicating that the model had a high predictive performance. 【Conclusion】 We successfully constructed a competing risk model to predict the risk of 1-, 2- and 3-year recurrence for NMIBC patients. It may help clinicians to improve the postoperative management of patients.