Feasibility and safety of laparoscopic radical cystectomy for male octogenarians with muscle-invasive bladder cancer.

This study was designed to evaluate the safety and feasibility of laparoscopic radical cystectomy (LRC) for male octogenarian patients with muscle-invasive bladder cancer (MIBC). Briefly, a total of 57 male octogenarian patients (A group) with bladder carcinoma were enrolled and underwent LRC and intracorporeal pelvic lymph node dissection with bilateral cutaneous ureterostomy from May 2016 to December 2022. Besides, 63 male patients (age < 80 years old) with bladder carcinoma undergoing LRC and 17 octogenarian male patients with bladder carcinoma undergoing open radical cystectomy (ORC) were enrolled in B and C groups as control. All perioperative clinical materials and outcomes of long-term follow-up, and complication were collected. The specific results were shown as follows. Compared with C group, the operation time and resected lymph node in A group was increased, and the estimated blood loss, the number of transfusion needed, duration of pelvic drainage and hospital stay after surgery was decreased. The death rate and ileus complication rate were higher in A group (12 cases) than in C group (15 cases). The cases of ureteral stricture in A group (13 cases) was decreased compared with that in C group. Overall, LRC and bilateral cutaneous ureterostomy are safe, feasible and better choices for the treatment of male octogenarian patients with MIBC. The octogenarian receiving cutaneous ureterostomy heals slowly and exists certain incomplete intestinal obstruction after surgery.

[Clinical features and therapeutic response of aplastic anemia patients with or without cytogenetic abnormalities].

OBJECTIVE: To compare clinical features and therapeutic response of patients with aplastic anemia with and without cytogenetic abnormalities. METHODS: Clinical features of 133 patients with successful chromosomal analysis were retrospectively studied, and therapeutic response between patients with and without cytogenetic abnormalities was compared. RESULTS: Cytogenetic abnormalities were found in 9 patients, which included trisomy 8 (4 cases), monosomy 7 (2 cases) and Xq- (1 case), 1q- (1 case) and 7q- (1 case). No significant difference was detected between patients with or without cytogenetic abnormalities in terms of age (50 vs. 58, P=0.337), sex ratio (male 55.56% vs. 62.10%, female 44.44% vs. 37.90%, P=0.762), or episode of acute aplastic anemia (44.44% vs. 37.10%, P=0.728). Patients with cytogenetic abnormalities had a tendency towards poorer rate of therapeutic response, which was however not significantly different from those without (55.56% vs. 79.03%, P=0.116). All of the 4 patients with +8 responded to treatment, whilst none of those with -7 or 7q- did. CONCLUSION: No significant difference was found between aplastic anemia patients with or without cytogenetic abnormalities in terms of clinical features and therapeutic response. Patients with trisomy 8 seem to have a favorable response towards treatment.

[Study of gene differential display of hydatidiform moles].

OBJECTIVE: To screen the specific molecular maker of invasive hydatidiform moles (HM) by differential display analysis. METHODS: For dot hybridization, about 1.0 microg of each cDNA sample of invasive and non-invasive HM were labeled as probes using the Dig DNA labeling and Detection Kit (Boehringer Mannheim). The specific expression fragments of invasive HM recovered from PAGE gel were re-amplified by PCR, and the PCR products were dotted onto nylon membrane and hybridized by two probes of invasive and non-invasive HM cDNA respectively. Some fragments with a strong positive hybridization signal were cloned into the polylinker of lasmid PUC19 and were sequenced. The fragments' sequences were searched for homology in the NCBI data using the BLAST (Database: GenBank Human EST entries; Posted date:Aug 31, 2004; Number of letters in database: 1,697,659,032; Number of sequences in database: 3,677,722). RESULTS: The 20 fragments in 28 bands with specific expression in invasive HM were re-amplified, of which 13 showed positive hybridization signals, and 3 were cloned into the polylinker of lasmid PUC19. A fragment in the 3 was a new expressed sequence tag (EST) and the sequence was submitted to NCBI data (dbEST_Id: 10875704; GenBank_Accn: BM403211). CONCLUSION: There are more differences in gene expression between invasive and non-invasive HMs, and differential display analyses are of a potential significance to early diagnosis of invasive HM.

[Immunohistochemical expression of integrin alphav, beta5 and beta3 in ovarian epithelial carcinoma: correlation with drug resistance of chemotherapy].

OBJECTIVE: To investigate the possible correlation between the expression of integrin alphav, beta5 and beta3 in tumor tissues and the response to chemotherapy and survival of patients with ovarian epithelial carcinoma. METHODS: Seventy-seven patients with ovarian epithelial carcinoma from January 1996 to December 2002 were entered into the study. All subjects were matched up with the inclusion criteria and followed up till December 2003. Each patient received cytoreductive surgery and systematic chemotherapy. Patients were divided into drug resistant group (n = 26) and drug sensitive group (n = 51). The antigens of integrin alphav, beta5 and beta3 in ovarian tumour tissues were tested by immunohistochemistry. Logistic regression was employed to analyze the correlation between drug resistance and factors including patients' age, clinical stage, pathological degree and type of tumors, chemotherapy methods, operative results and the expression of integrin alphav, beta5 and beta3 in tumors. The disease prognosis was analyzed by multivariate COX regression. RESULTS: In the drug resistance group, the expressions of integrin alphav and beta5 were significantly higher than that in the drug sensitive group (P = 0.004 and 0.001). The expression of integrin beta3 was not statistically different in the two groups (P = 0.668). According to multivariate analysis, the expression of integrin alphav and beta5 and clinical stage were three independent factors correlated with drug resistance and disease prognosis for the patients with ovarian epithelial carcinoma (P = 0.014, 0.030, 0.042 for drug resistance; and P = 0.045, 0.031, 0.001 for prognosis respectively). CONCLUSION: The high expressions of integrin alphav and beta5 in ovarian epithelial carcinoma are risk factors for drug resistance and poor disease prognosis.