RESUMO
BACKGROUND/AIM: Smoking is a risk factor for carcinogenesis and progression of urothelial cancer (UC). Green tea polyphenol inhibits these malignant behaviors and suppresses human antigen R (HuR) expression, which is associated with malignant aggressiveness. This study aimed to clarify the anti-cancer effects of green tea based on the smoking status of UC patients. PATIENTS AND METHODS: Three hundred and sixty (260 with bladder cancer, BC and 100 with upper tract UC) patients were divided into three groups based on consumption of green tea: low (<1 cup/day, n=119), middle (1-4 cup/day, n=160), and high (>5 cup/day, n=81). HuR immunoreactivity was evaluated immunohistochemically in formalin-fixed specimens. RESULTS: In never smokers, multivariate analysis showed that the frequency of green tea consumption was a significant predictor (middle: hazard ratio, HR, 0.36, p=0.002; high: HR, 0.20, p=0.003) of urinary tract recurrence. A high consumption of green tea was associated with low rates of urinary tract recurrence and up-grading in UC patients. In BC, high consumption was associated with a lower risk of up-grading (p=0.011) and up-staging (p=0.041) in recurrent cancer. HuR expression in the high-consumption group was lower (p=0.019) than that in other groups. These significant findings were not detected in ever smokers. CONCLUSION: High consumption of green tea suppressed urinary tract recurrence and the risks of up-grading and up-staging by recurrence in never smokers. Our results suggested that HuR expression played important roles in such mechanisms.
Assuntos
Chá , Neoplasias da Bexiga Urinária/dietoterapia , Neoplasias Urológicas/dietoterapia , Urotélio/patologia , Adulto , Idoso , Feminino , Regulação Neoplásica da Expressão Gênica/efeitos dos fármacos , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/dietoterapia , Recidiva Local de Neoplasia/genética , Recidiva Local de Neoplasia/patologia , Polifenóis/administração & dosagem , Polifenóis/química , Receptores de Antígenos/genética , Fatores de Risco , Fumantes , Chá/química , Neoplasias da Bexiga Urinária/genética , Neoplasias da Bexiga Urinária/patologia , Sistema Urinário/efeitos dos fármacos , Sistema Urinário/patologia , Neoplasias Urológicas/genética , Neoplasias Urológicas/patologia , Urotélio/efeitos dos fármacosRESUMO
When sevelamer hydrochloride is used as a phosphate binder instead of the more common calcium carbonate, the PTH rises. This has been observed in many cases and makes it more difficult for practical use. However, considering the calcium load, the excessive dosing of calcium carbonate must be avoided. With that in mind, we divided the i-PTH in groups of 100 pg/mL and tested the changes in i-PTH value, P value, the adjusted Ca value, and the product of Ca and P before and after a dosage of sevelamer hydrochloride. When the average i-PTH was under 100mg/mL 6 months before dosing, the sevelamer hydrochloride single dosage group showed an early rise in i-PTH after dosing, maintaining a higher level than the calcium carbonate combined dosage group. Therefore, it was concluded that the use of sevelamer hydrochloride alone as a phosphate binder is best. On the other hand, the group with an average i-PTH over 100 pg/mL 6 months before dosing showed a rise of i-PTH that went over the K/DOQI guideline with a single dosing of sevelamer hydrochloride. Therefore, we concluded that using both sevelamer hydrochloride and calcium carbonate for phosphate binder is best.