OBJECTIVETo determine the expression of bone morphogenetic protein 2 and 4 (BMP-2 and BMP-4) in prostatic carcinoma (PCa) and investigate their relationship with clinical stage and Gleason score of tumor.

METHODSForty-eight PCa cases and 5 normal prostatic tissue were analysed for the expressions of BMP-2 and BMP-4 by Western bolt assay.

RESULTSThe optical densities of BMP-2 expressions in the tumor with Gleason score < or =5, 6-8, and > or = 9 were 7547.1 +/- 1964.12, 9657.4 +/- 2010.54, 12467.7 +/- 2496.75 and of BMP-4 expressions were 5174.4 +/- 1400.54, 5940.3 +/- 1587.42, 6332.1 +/- 1647.83, respectively. The optical densities of BMP-2 expressions in the tumor in T1 - T2 and T3 - T4 stages were 8003.37 +/- 1889.23, 12385.55 +/- 2506.72 and of BMP4 expressions were 5267.41 +/- 1 464.19, 6543.75 +/- 1668.46, respectively. There were significant differences between tissues with Gleason score < or =5 and > or =9 (P <0.01), and tissues in T1 - T2 and T3 - T4 stages, in expressions of BMP-2 protein. The expression of BMP-2 protein was significantly high in the PCa with bone metastasis compared with that without bone metastasis.

CONCLUSIONThe expressions of BMP-2 and BMP-4 increase with the progression of clinical stage and Gleason score compared with normal prostatic tissue. The expression of BMP-2 protein is significantly upregulated in bone metastasis of PCa, which indicates a poor prognosis.

Aged ; Aged, 80 and over ; Blotting, Western ; Bone Morphogenetic Protein 2 ; Bone Morphogenetic Protein 4 ; Bone Morphogenetic Proteins ; biosynthesis ; Humans ; Male ; Middle Aged ; Neoplasm Metastasis ; Neoplasm Staging ; Prostate ; metabolism ; Prostatic Neoplasms ; metabolism ; pathology ; Transforming Growth Factor beta ; biosynthesis

OBJECTIVETo study and summarize the diagnosis and treatment for the corticomedullary mixed tumor of adrenal gland.

METHODSThe clinical data of 25 cases of adrenal corticomedullary mixed tumor from January 2000 to April 2008 were analyzed retrospectively, which including 9 males and 16 females. The ages were from 25 to 60 years old, and the average age was 39 years old. Thirteen cases had paroxysmal hypertension and 11 cases had central obesity, as well as 8 cases with hypokalemia. There were different degree abnormalities in plasma endocrine hormones in laboratory examination. Every case underwent b-ultrasound and CT normal plus extensive scan to make the diagnosis.

RESULTSAdrenalectomy was performed in the 25 cases, which contain 9 cases of open operations and 16 cases of endoscopic adrenalectomies. All of the cases had blood pressure fluctuation during dissection of the adrenal tumors, with the highest blood pressure reached to 230/140 mm Hg (1 mm Hg = 0.133 kPa). Postoperative histopathological study revealed that the pathological changes was corticomedullary mixed tumor of adrenal gland, which was supported by immunohistochemical study.

CONCLUSIONSIn cases with complex phenomenon that can't explain with single cortical or medullary changes, it must beware of the mixed pathological changes in adrenal gland.

Adrenal Gland Neoplasms ; diagnosis ; surgery ; Adrenalectomy ; Adult ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies

Objective To evaluate the clinical features and the strategy for the diagnosis and treat- ment of bilateral testicular tumor.Methods The clinical data (including the signs and symptoms,imaging studies,tumor markers,treatment modalities and histopatbologic diagnoses) of 10 cases of bilateral testicular tumor from January 1980 to December 2004 were reviewed.Their age ranged from 19 to 58 years(mean,34 years).Of the 10 cases,8 with metachronous and 2 with synchronous testicular tumors were identified.The clinical stages at the primary and secondary tumor diagnosis were:5 cases of stageⅠ,3 of stageⅡ;and 6 cases of stageⅠ,1 of stageⅡ,and 1 of stageⅢ,respectively,in 8 metachronous tumor patients.Two syn- chronous tumor patients were both identified as stageⅠdisease.Histological examination showed the primary tumor (seminoma) in 4 cases and the secondary contralateral tumor (seminoma) in 3.Results Two syn- chronous tumor patients underwent bilateral radical orchiectomy simultaneously,and 8 underwent orchiectomy successively.Retroperitoneal lymph node dissection was performed in 3 cases.Postoperatively,hypogonadism occurred in 10 patients,and 7 of them received androgen replacement therapy.Follow-up ranged from 9 month to 23 years with a mean of 10.5 years.Two patients died of the disease;2 had metastasis (1 of them was alive with metastasis);2 had recurrences and underwent local resection.Conclusions Metachronous bilateral testicular cancers are more common than synchronous bilateral testicular cancers.Seminoma was the most common histopathologic type.Testis-sparing surgery can be performed in selected cases.

OBJECTIVETo investigate the expression of TGF-beta1 mRNA in prostate carcinoma tissues and its significance.

METHODSRT-PCR method was used to examine the expression of TGF-beta1 mRNA in normal and carcinomatous prostate tissues.

RESULTSThe relative content of TGF-beta1 mRNA of normal prostate tissues was (0.74 +/- 0.11), while those of carcinomatous prostate tissues at T1-T2 and T3-T4 stages were (0.69 +/- 0.10) and (0.44 +/- 0.08) respectively, with significant difference between T1-T2 and T3-T4 (P < 0.05). And the relative contents of TGF-beta1 mRNA of carcinomatous prostate tissues with Gleason score < or = 5, 6-8 and > or = 9 were (0.70 +/- 0.12), (0.54 +/- 0.11) and (0.42 +/- 0.09) respectively.

CONCLUSIONThe expression of TGF-beta1 mRNA was negatively correlated with the clinical stage and Gleason score of prostate carcinoma.

Aged ; Aged, 80 and over ; Humans ; Male ; Middle Aged ; Neoplasm Staging ; Prostatic Neoplasms ; metabolism ; pathology ; RNA, Messenger ; genetics ; Reverse Transcriptase Polymerase Chain Reaction ; Transforming Growth Factor beta ; biosynthesis ; genetics

OBJECTIVETo study the clinical features, treatment and diagnosis of parapelvic cyst.

METHODSTwenty-three patients of parapelvic cyst of the kidney were reviewed retrospectively. Fourteen cases (61%) complained of lumbar pain or discomfort, and 4 patients (17%) accompany hematuria and hypertension.

RESULTSIn 15 patients receiving surgery, 2 were treated by nephrectomy, one by radical nephrectomy for misdiagnosis. Postoperative diagnosis confirmed a cyst. Eight patients were treated conservatively for cyst being small and without clinical symptoms. Nineteen cases were followed up for 0.5 - 12.0 years.

CONCLUSIONSUltrasonography and CT scan are the main diagnostic methods. Enhanced CT is extremely helpful in differential diagnosis of hydronephrosis. Surgical management is suitable for big cysts, lumbar pain, hematuria, hypertension and other complications.

Adult ; Aged ; Diagnosis, Differential ; Female ; Humans ; Kidney Diseases, Cystic ; diagnosis ; etiology ; surgery ; Kidney Pelvis ; Male ; Middle Aged ; Prognosis ; Tomography, X-Ray Computed

OBJECTIVETo explore the therapeutic methods of adrenal incidentalomas.

METHODSThe data of 156 cases were analyzed retrospectively.

RESULTSThe operation were performed in 151 cases, radiotherapy and chemotherapy in 1 case and follow up in 4 cases. The diameter of the tumors were 1.3-15.0 cm. Pathological results indicated that 34 cases were pheochromocytoma, 83 adrenal cortical adenoma, 5 adrenal cortical carcinoma, 3 metastases carcinoma, and 26 other benign tumors. One hundred and thirty-six cases were followed-up for 1-7 years. 3 cases of metastases carcinoma died in 1.5 years, 2 cases of cortical carcinoma died in 2.0 and 2.5 years for recurrence and metastases. One hundred and thirty-one cases survived healthy, 3 cases of them take orally dexamethasone for 1 year after post-operation.

CONCLUSIONSSurgical operations should be performed in malignant tumors, hypersecretion tumors, deuto-clinical adrenal cortical tumors, pheochromocytoma and those whose diameters of tumors are over 3 cm. But those whose tumors had non-hypersecretion and diameters are less than 3 cm should be followed up closely.

Adolescent ; Adrenal Gland Neoplasms ; pathology ; surgery ; Adrenalectomy ; Adult ; Aged ; Aged, 80 and over ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Retrospective Studies

OBJECTIVETo investigate the clinical methods for reducing bladder cancer recurrence after surgical treatment for renal pelvic carcinoma.

METHODSFrom October 1997 to December 2007, the data of 227 patients undergoing total nephroureterectomy for clinically localized transitional cell carcinoma of the renal pelvis with follow-up results were analyzed retrospectively, including 126 cases of male and 101 cases of female, and the age was 34 to 78 years old. There were 2 kinds of technique used in the dissection of bladder wall circumferentially around the ureteral orifice. Technique A was dissection along the ipsilateral ureter to the bladder wall. Technique B was dissection along the vas deferens to the bladder wall circumferentially around the ipsilateral ureteral orifice and division of the lateral vesical ligament to reach the seminal vesicle. Prophylactic intravesical chemotherapy included 3 method. Method 1 was intraoperative intravesical chemotherapy and then administrated once a week, 10 times in total. Method 2 was intraoperative intravesical chemotherapy and then administrated once a week from the 4(th) week after operation, 10 times in total. Method 3 was intravesical chemotherapy was given once a week from the 4(th) week after operation, 10 times in total. The time of follow-up was 1 to 10 years with regular cystoscopy. Chi-square test and Logistic regression were used to analyzed the recurrence rate of bladder cancer.

RESULTSRecurrence rate of bladder cancer was 27.8% (63/227). The recurrence rates of bladder cancer in patients using technique A and B were 18.0% (7/39) and 12.5% (3/24), respectively (P < 0.05). The postoperative recurrence rates of bladder cancer in patients using 3 kinds of intravesical chemotherapy regimen were 17.9% (11/67), 20.8% (10/48) and 33.3% (17/51), respectively. There was significant difference between the recurrence rates of patients using method 1 and method 3 intravesical chemotherapy (P < 0.05).

CONCLUSIONComplete removal of the bladder mucosa circumferentially around the ureteral orifice, administration of the intraoperative intravesical chemotherapy instillation and instillation once a week may be a useful approach to reduce the recurrence of bladder cancer after operation for renal pelvic carcinoma.

Adult ; Aged ; Carcinoma, Renal Cell ; surgery ; Chemotherapy, Cancer, Regional Perfusion ; Female ; Follow-Up Studies ; Humans ; Kidney Neoplasms ; surgery ; Kidney Pelvis ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; prevention & control ; Postoperative Care ; Retrospective Studies ; Urinary Bladder Neoplasms ; prevention & control ; secondary

OBJECTIVETo investigate the clinical manifestation, biological behavior, diagnosis and treatment of the urothelial inverted papilloma.

METHODSSixty-two cases of urothelial inverted papilloma were analyzed retrospectively from January 1990 to August 2008. Of the 62 patients, 51 were men and 11 were women. The average age at presentation was 56.4 years old. Fifty-six cases were solitary tumors and 6 were multiple. The most common compliant was macroscopic hematuria. The tumor located at the ureter in 5 cases. Of these cases, 4 were treated by local excision, 1 by nephroureterectomy. One case of multiple ureteral inverted papilloma with coexistent bladder inverted papilloma was treated by total cystectomy. The tumor located at the bladder in 52 cases, with 44 treated by transurethral resection of bladder tumor, 6 by partial cystectomy, 2 by total cystectomy. Four cases had the tumor located at the urethra, with 1 treated by transurethral resection of tumor, 3 by tumorectomy.

RESULTSThe postoperative pathological diagnosis of all the 62 cases was inverted papilloma, synchronous urothelial carcinoma in 7. Follow-up data were available in 49 cases. Two cases had a recurrence at 7 months and 79 months, respectively. Three case of subsequent transitional cell carcinoma developed 18 months, 2 years and 6 years later, respectively.

CONCLUSIONSInverted urothelial papilloma is a kind of benign tumor. It should be differentiated from malignant urothelial tumors. Surgical operation is the main treatment choice. Cystoscopic surveillance and followup are necessary after the operation regularly.

Adult ; Aged ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Papilloma, Inverted ; diagnosis ; surgery ; Retrospective Studies ; Urologic Neoplasms ; diagnosis ; surgery

OBJECTIVETo explore the clinical manifestation, management, recurrence factors and prognosis of scrotal Paget's disease.

METHODSWe retrospectively analyzed the clinical and pathological data of 23 cases of scrotal Paget's disease diagnosed and treated in our hospital from 1996 to 2008.

RESULTSThe disease was confined to one side of the scrotum in 15, and involved the whole scrotum and penis in 8 of the cases. Three patients showed enlarged inguinal lymph nodes in the same side, and 2 in both sides. All the cases were confirmed by biopsy and treated by surgery. Post-operative follow-up was conducted for 2-68 months, which revealed 5 cases of local recurrence and 1 case of death for systemic metastasis.

CONCLUSIONBiopsy is proved to be important for the early diagnosis of scrotal Paget's disease, and extended excision of local lesion is a preferred management.

Aged ; Genital Neoplasms, Male ; diagnosis ; pathology ; surgery ; Humans ; Male ; Middle Aged ; Paget Disease, Extramammary ; diagnosis ; pathology ; surgery ; Retrospective Studies ; Scrotum ; pathology

OBJECTIVETo evaluate the significance of the combined assay of chromogranin A (CgA) and prostate specific antigen (PSA) in the diagnosis of prostate cancer.

METHODSSerum CgA and PSA were detected by ELISA technique in 55 cases of prostate cancer (PCa), 25 cases of benign prostate hyperplasia (BPH), and 50 cases of normal subjects (control).

RESULTSThe serum CgA level in the PCa group was significantly higher than those in the control and BPH groups (P < 0.05), and increased with clinical stages. The parallel and serial tests associated with serum PSA and CgA raised the rate of detection of prostate cancer.

CONCLUSIONThe combined assay of serum PSA and CgA is of significant clinical value in raising the rate of diagnosis of prostate cancer, as well as in staging and prognosing the disease.

Aged ; Aged, 80 and over ; Biomarkers, Tumor ; blood ; Case-Control Studies ; Chromogranin A ; blood ; Enzyme-Linked Immunosorbent Assay ; Humans ; Male ; Middle Aged ; Prognosis ; Prostate-Specific Antigen ; blood ; Prostatic Neoplasms ; diagnosis ; Sensitivity and Specificity