OBJECTIVE: To investigate the impact of preoperative diagnostic ureteroscopy and biopsy (UB) on radical nephroureterectomy (RNU) and the prognosis of upper tract urothelial carcinoma (UTUC). METHODS: The clinical data of UTUC patients receiving RNU between Jan. 2007 and Dec. 2016 were retrospectively collected. The median follow up time was 40 months. The operation time and blood loss of RNU were compared between UB group and non-UB group. Subgroup analyses were conducted according to the time interval between UB and RNU, and surgery methods of lower ureter. The linear regression model was used to adjust for other common factors that impacted operation time. RESULTS: A total of 163 UTUC patients were included in the final analysis. For the lower ureter, open ureterectomies were performed in 91 patients (55.9%), while retroperitoneal laparoscopic ureterectomies were performed in 72 patients (44.1%). A total of 110 (67.5%) patients received preoperative UB. Compared with non-UB group, the average operation time of UB group was significantly longer [(252.5±79.8) min vs. (221.3±79.8) min, P=0.019], but no difference of blood loss was found (median, 50 mL vs. 50 mL, P=0.143). In subgroup analysis, the average operation time of RNU was significantly prolonged when RNU was performed after 1 week of UB (P=0.023). Meanwhile, the median blood loss of RNU increased significantly when it was done after 2 weeks of UB compared with non-UB group (100 mL vs. 50 mL, P=0.012). UB was also significantly prolonged the operation time of RNU in retroperitoneal laparoscopic ureterectomy group (P=0.012). In multivariable analysis, UB (P=0.049), ≥pT3 (P=0.039), pN+ (P=0.018) and ureterectomy method (P=0.005) were independent risk factors of prolonged operation time. The 3-year cancer specific survival (CSS) rate was 87.2% in our cohort. UB had no significant impact on cancer specific survival (P=0.435). CONCLUSION UB was an independent risk factor of prolonged RNU time, but did not significantly influence cancer specific survival of upper tract urothelial carcinoma patients.
Biopsy ; Carcinoma, Transitional Cell/diagnostic imaging* ; Humans ; Nephrectomy ; Nephroureterectomy ; Retrospective Studies ; Ureter ; Ureteral Neoplasms/diagnostic imaging* ; Ureteroscopy

BACKGROUNDTransitional cell carcinoma of the upper urinary tract (UUT-TCC) accounts for 5% to 10% of all renal tumours and 5% to 6% of all urothelial tumours all over the world. In China, the proportion of UUT-TCC to all urothelial tumours may be 26%, which is higher than that in the western world. The early diagnosis of UUT-TCC is difficult and the present study elucidates the diagnostic value of poor or nonvisualization (PNV) in intravenous urography in patients with UUT-TCC and its correlations with pathological findings and clinical characteristics.

METHODSThe data of 172 consecutive patients between January 1997 and January 2005 with UUT-TCC who underwent nephroureterectomy in our departments were selected and analyzed retrospectively.

RESULTSOf our sample, 144 cases presented with gross haematuria (83.7%) and 12 with microscopic haematuria (7.0%). Forty-six cases (26.7%) were detectable by cytology. Filling defect identified 36 positive cases of 172 patients (20.9%), PNV was present in the images of 105 of 172 patients (61.0%). The detection rate by PNV (61.0%) was significantly different from that by cytology (26.7%) or by filling defect (20.9%) (P = 0.031, P = 0.001, respectively). Univariate logistic regression analysis for PNV showed that tumour stage, grade and size were significant predictors (P = 0.028; P = 0.031; P = 0.006, respectively). Tumour stage and size were identified as independent risk factors in the multivariate logistic regression model (P = 0.042; P = 0.014).

CONCLUSIONSExcept for suspected urolithiasis, urinary tuberculosis or congenital abnormalities, UUT-TCC should be considered if PNV exists in intravenous urography especially of old patients. The value of PNV is much more significant than filling defect in intravenous urography in the diagnosis of UUT-TCC. It is supposed that PNV carries more risk of higher stage and larger tumour size in UTT-TCC.

Adult ; Aged ; Aged, 80 and over ; Carcinoma, Transitional Cell ; diagnostic imaging ; Female ; Humans ; Kidney ; diagnostic imaging ; Logistic Models ; Male ; Middle Aged ; Radiography ; Sensitivity and Specificity ; Urologic Neoplasms ; diagnostic imaging

Aged, 80 and over ; Carcinoma, Transitional Cell ; diagnostic imaging ; pathology ; Humans ; Male ; Tomography, X-Ray Computed ; Urinary Bladder Neoplasms ; diagnostic imaging ; pathology

Objective To investigate the clinicopathological features and immunohistochemical phenotypes of brain metastatic carcinoma in Tibetan patients. Methods The clinical and pathological data of all patients with brain metastases from 2014 to 2020 in Tibet Autonomous Region People's Hospital were retrospectively analyzed,including 13 cases of brain metastatic carcinoma.All cases were diagnosed and classified by immunohistochemical staining. Results 13 cases(9 males and 4 females)of brain metastatic carcinoma,aged 26-62 years old,present with headache,dizziness,nausea and vomiting clinically.Four patients had a medical history of tumor,and among the 9 patients with no history of tumor,7 present space occupying lesions in both the brain and other organs.Imaging data could be found in 10 cases,including 4 cases of single lesion and 6 cases of multiple lesions.Primary tumors were identified in 11 cases(8 located in the lung,including 4 cases of adenocarcinoma,3 cases of small cell carcinoma,and 1 case of squamous cell carcinoma;1 case of urothelial carcinoma of the renal pelvis;1 case of thyroid papillary carcinoma;1 case of uterine choriocarcinoma),whereas the primary tumor was unknown for the other 2 cases(1 case of small cell carcinoma and 1 case of adenocarcinoma). Conclusions Brain metastatic carcinoma are more common among middle-aged and elderly people in Tibet.Most of the cases have no history of tumor,with the initial site at the brain metastatic lesions.The most common primary site is the lung,and the primary site of some cases is unknown.Multiple lesions are common in brain metastatic carcinoma,especially in the cerebral hemisphere.For older patients with multiple brain space occupying lesions,the possibility of brain metastatic carcinoma increases.
Adult ; Aged ; Brain ; Brain Neoplasms/diagnostic imaging* ; Carcinoma, Transitional Cell ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Thyroid Neoplasms ; Tibet ; Urinary Bladder Neoplasms

OBJECTIVETo investigate the clinical value of dual-phase (18)F-FDG PET/CT with oral diuretics in preoperative staging of bladder cancer.

METHODSThe imaging data were analyzed of 73 patients with bladder cancer undergoing preoperative dual-phase (18)F-FDG PET/CT with oral diuretic between May, 2003 and May, 2012. All the patients underwent whole-body PET/CT scan 60 min after intravenous injection of 270-350 MBq of (18)F-FDG. Additional delayed pelvic PET/CT images were acquired after forced diuresis using oral furosemide (40 mg). All the patients underwent subsequent radical cystectomy, and (18)F-FDG PET/CT findings were compared with the histopathologic results to evaluate the value of dual-phase (18)F-FDG PET/CT in preoperative staging.

RESULTSThe concordance rate of dual-phase FDG PET/CT-based bladder cancer staging with the histopathologic results was 63.0% in the 73 patients, and was 100% (7/7) for pT4 bladder cancers. With dual-phase FDG PET/CT, the detection rate was 75.0% (6/8) for lymph node metastases, 100% (4/4) for distant metastases, and 100% (4/4) for other concurrent primary malignancies.

CONCLUSIONThough with limited accuracy in T-staging of pTa, pT1, pT2, and pT3 bladder cancer, dual-phase FDG PET/CT has important clinical value in staging of pT4 bladder cancer and in N-staging, M-staging and detection of other concurrent primary malignancies.

Adult ; Aged ; Aged, 80 and over ; Carcinoma, Transitional Cell ; diagnostic imaging ; pathology ; Female ; Fluorodeoxyglucose F18 ; Humans ; Male ; Middle Aged ; Neoplasm Staging ; Positron-Emission Tomography ; Radiopharmaceuticals ; Tomography, X-Ray Computed ; Urinary Bladder Neoplasms ; diagnostic imaging ; pathology

OBJECTIVEIn order to improve the preoperative diagnostic accuracy, the computed tomographic (CT) features of ovarian Brenner tumor were described and analyzed.

METHODSCT image and clinical data of nine patients with pathologically confirmed Brenner tumor were collected and analyzed retrospectively. There were 8 benign lesions and 1 borderline lesion.

RESULTSAll lesions in the nine cases were unilateral, round, lobulated or irregular in shape and well defined, in a mean diameter of 7.8 cm. Among the nine cases, 5 were benign tumors with uniform structure, 3 were benign tumors accompanied with other pathological components, and 1 was borderline tumor. On the CT images, the 5 uniform benign lesions showed to be solid tumor of low density (lower than that of muscle) or with small cyst inside, two of the 5 lesions had calcification, and other 2 lesions showed slightly heterogeneous enhancement after enhanced scanning. The 3 benign Brenner tumors accompanied with other pathological structures were solid-cystic or cystic, with a clear demarcation of solid and cystic components. The density of solid parts was lower than that of muscle, and slight enhancement, and one of them had calcification. The one borderline tumor was a heterogeneous solid one and its density was higher than that of muscle, with a large proportion of low density and large calcification, and moderately enhanced after enhancing. None of the 9 cases had metastasis or effusion.

CONCLUSIONOvarian Brenner tumors are usually unilateral and often accompanied with other type of tumor components. When a tumor is of uniform component, the CT imaging often shows a homogeneous solid tumor with homogeneous or heterogeneous density. When a tumor is accompanied with other tumor components, it may be solid-cystic or cystic and has partial calcification. After enhancing, a benign Brenner tumor is slightly enhanced, while the borderline one is moderately/highly enhanced.

Aged ; Brenner Tumor ; diagnosis ; diagnostic imaging ; Carcinoma, Transitional Cell ; diagnosis ; Cystadenoma, Mucinous ; diagnostic imaging ; Cystadenoma, Serous ; diagnosis ; Diagnosis, Differential ; Female ; Humans ; Middle Aged ; Ovarian Neoplasms ; diagnosis ; diagnostic imaging ; Ovary ; diagnostic imaging ; Sex Cord-Gonadal Stromal Tumors ; diagnosis ; Tomography, Spiral Computed ; methods

OBJECTIVETo label a human bladder cancer cell line and establish a novel human bladder cancer mouse model.

METHODST-24 cells, a human bladder transitional cell carcinoma cell line, were transfected with GFP plasmid to screen stable GFP-expressing clones. The latter were implanted into the wall of the bladder or the subcutaneous tissue of the neck of nude mice. The growth, invasion, and metastasis of the implanted tumor were observed and evaluated with whole-body optical imaging system. The findings were compared with those of HE staining on routine paraffin sections.

RESULTSGFP-labeled tumor cells displayed green fluorescence under fluorescent microscopy and showed stable GFP expression in vitro and in vivo. One week after in situ transplantation of 5 x 10(5) T24 cells, the new bladder cancer was observed and evaluated under whole-body optical imaging system. Two weeks later, the new bladder tumor could be palpated, and 4 weeks later, metastasis to regional drainage lymph nodes in the pelvic and retroperitoneal lymph nodes occurred. The growth and metastasis of the implant bladder tumor were easily observed and accurately evaluated by fluorescent microscope.

CONCLUSIONGFP-labeled tumor cells display green fluorescence under fluorescent microscopy and show stable GFP expression. GFP-labeled T-24 cells and the novel human bladder cancer model described hereby provide a simple and reliable means for studying human bladder cancer in vivo.

Animals ; Carcinoma, Transitional Cell ; metabolism ; pathology ; Diagnostic Imaging ; Disease Models, Animal ; Female ; Green Fluorescent Proteins ; biosynthesis ; genetics ; Humans ; Indicators and Reagents ; Male ; Mice ; Mice, Inbred BALB C ; Mice, Nude ; Microscopy, Fluorescence ; Neoplasm Transplantation ; Urinary Bladder Neoplasms ; metabolism ; pathology