Adenocarcinoma ; diagnosis ; surgery ; Aged ; Humans ; Male ; Treatment Outcome ; Ureteral Neoplasms ; diagnosis ; surgery

Disagreement exists about the accuracy of excretory urography in the staging of bladder cancer. During a 2O year period 1O8 of 537 patients with transitional cell carcinoma of the bladder had ureteral obstruction on excretory urography at the time of initial diagnosis. 93 patients (86%) had muscle invasion at staging transurethral resection or open resection. Of those patients 37 had total cystectomy, 4 had partial cystectomy, 5 had curative radiation therapy and the remainder had no further treatment. Ureteral obstruction at the time of initial diagnosis of bladder cancer usually indicates muscle invasion and/or metastases. We believe that our data support the usefulness of excretory urography as a staging tool in carcinoma of the bladder.
Carcinoma, Transitional Cell ; Cystectomy ; Diagnosis ; Humans ; Neoplasm Metastasis ; Ureteral Obstruction ; Urinary Bladder Neoplasms* ; Urinary Bladder* ; Urography*

PURPOSE: To evaluate CT features of metastatic ureteral tumors. MATERIALS AND METHODS: CT findings in 16 patients with ureteral metastases were evaluated retrospectively ;there were eight cases of bilateral ureteral involvement. Primary tumors metastatic to the ureter were advanced gastric cancer (n=13), breast cancer (n=l), colon cancer (n=l), or adenocarcinoma of unknown primary (n=l). We analysed CT findings with regard to the site of ureteral obstruction, configuration of obstructed sites of ureter, presence or absence of periureteral soft tissue density, and status in other organs. RESULTS: Among 24 ureters involved, ureteral wail thickening was noted in 15, periureteral soft tissue density in 13. Small nodular enhancing lesions less than lcm, within the retroperitoneal space around the involved ureters were noted in seven patients, and four of them were multiple lesions. CONCLUSION: Among various primary tumors, gastric cancer was the most common cause of ureteral metastasis. The common CT findings of ureteral metastases were thickening of ureteral wall, periureteral soft tissue density, and small periureteral enhancing nodular lesions. The constellation of these CT findings may be helpful in making the diagnosis of ureteral metastases.
Adenocarcinoma ; Breast Neoplasms ; Colonic Neoplasms ; Diagnosis ; Humans ; Neoplasm Metastasis* ; Retroperitoneal Space ; Retrospective Studies ; Stomach Neoplasms ; Ureter* ; Ureteral Obstruction

OBJECTIVE: To evaluate the clinical value of inflammation-related markers in predicting the prognosis of patients with ureteral urothelial carcinoma. METHODS: 200 patients with ureteral urothelial carcinoma were randomly divided into two groups by split sample validation: modeling group and validation group. Paraffin embedded pathological specimens of the patients were reviewed. Immunohistochemical method was used to detect tumor-infiltrating neutrophil (TIN) (CD66b⁺), tumor-associated macrophage (TAM) (CD163⁺), lymphocyte (CD⁺, CD4⁺, CD8⁺) counts, peripheral blood neutrophil / lymphocyte ratio (NLR) and tumor tissue neutrophil/monocyte ratio (NMR). According to the results of pathological staging, the patients were divided into non-muscle-invasive and muscle-invasive ureteral urothelial carcinoma group. The resolution of the models was evaluated, and the prognostic nomogram models including only peripheral blood parameters and all parameters were established to compare the accuracy of the two models in predicting the prognosis of patients with urothelial carcinoma of the ureter. RESULTS: The median follow-up time was 36 months, the progression-free survival was 40 months, and 42 cases (21.0%) showed tumor progression within 3 years. Tumor size, pathological stage and pathological grade were all single-factor variables predicting the first recurrence of ureteral urothelial carcinoma three years after operation. Tumor size, pathological stage, pathological grade, TIN, TAM, NLR and NMR were multi-factor variables predicting the first recurrence three years after operation. Among 104 cases of non-muscle-invasive ureteral urothelial carcinoma, 10 cases (9.6%) recurred for the first time 3 years after operation, 96 cases (33.3%) of muscle invasive ureteral urothelial carcinoma, and the diffe-rence between the two groups was statistically significant (χ²=15.53, P < 0.05). The predictive nomogram model of progression free survival was established. The concordance index of progression free survi-val was 0.722 (95%CI: 0.70-0.78) in non-muscle-invasion group, and 0.725 (95%CI: 0.71-0.79) in muscle-invasion group, which was in good agreement with the observed 3-year survival rate. The results of discrimination test showed that the concordance index of the whole parameter prediction model of ureteral urothelial carcinoma was 0.726, which was higher than that of peripheral blood parameters (consistency index 0.672). The immune microenvironment of ureteral urothelial carcinoma improved the prediction accuracy of the model. CONCLUSION The prognosis prediction model based on immune inflammation-related markers was established as a perfection and supplement for the existing pathological grading and staging system, providing a basis for accurate individualized treatment of patients with urete-ral urothelial carcinoma. The prognosis prediction model based on the relevant indicators of peripheral blood samples is established, which is easy to obtain specimens, and the detection method is simple and economical, which is more conducive to clinical application.
Biomarkers ; Carcinoma, Transitional Cell/diagnosis* ; Humans ; Neoplasm Recurrence, Local ; Prognosis ; Retrospective Studies ; Tumor Microenvironment ; Ureteral Neoplasms/diagnosis*

To evaluate the diagnostic findings of salivary gland tumors, we reexamined aspiration cytology smears of 7 cases of pleomorphic adenoma, 3 cases of adenoid cystic carcinoma, and 3 cases of mucoepidermoid carcinoma, performed during April 1986 to March 1990, which were com?med by surgical excision and histologic diagnosis. The results obtained are summarized as follows ; 1. All cases of pleomorphic adenoma showed branching cellular clusters of epithelial and myoepithelial cells. Acellular elements including myxomatous and chondroid components were observed. There were no cellular pleomorphism and nucleoli. Keratinizing squamous epithelial cells and keratin pearls were noted. 2. The smears of adenoid cystic carcinoma showed cell balls or cell cords containing a central hyaline core. Nuclear atypism and the nucleoli were frequently observed. There were no keratinizing squamous epithelial cells. 3. The smears of mucoepidermoid carcinoma showed mainly sheets or clusters of intermediate cells and some mucin-producing cells. Some nuclear pleomorphism was observed. Mucinous material and many inflammatory cells were present in the background.
Adenoma, Pleomorphic ; Breast Neoplasms ; Carcinoma, Adenoid Cystic ; Carcinoma, Mucoepidermoid ; Diagnosis ; Epithelial Cells ; Hyalin ; Mucins ; Salivary Glands ; Vesico-Ureteral Reflux*

Metastasis from primary malignancies anywhere in the body can spread to the retroperitoneum and lead to ureteral obstruction. Seventeen patients who had ureteral obstructions caused by advanced gastrointestinal malignancies have been retrospectively analyzed. The results are as follows: 1) Of the 17 patients, 9 were male and 8 were female, and the mean age was 56.9: with a range from 33 to 75. 2) In the 16 patients whose pathologic diagnose were confirmed by primary surgery, the pathologic stages of stomach cancer were stage III in 1 patient and IV in 6 patients, and those of colorectal cancer were stage B in 2 patients, C in 6 patients and D in 1 patient. 3) Urologic symptoms and signs were micro- or macroscopic hematuria (58.8%), elevated BUN (52.9%), and flank pain (29.4%). Sixteen out of 17 patients had one of these findings. 4) The time interval between the original diagnosis of a gastrointestinal malignancy and the subsequent ureteral obstruction in 11 patients (64.7%) was within 2 years. The time interval for a11 17 patients was 33.9 months with a range from 2 months to 10 years. 5) Ureteral involvement was bilateral in 10 patients (58.8%) and unilateral in 7 (41.2%). The levels of ureteral obstruction in stomach cancer were upper (5) and midureter (3), and those in colorectal cancer were upper (1), mid (1) and lower ureter (7). 6) Twenty out of 27 kidneys were managed by a double-J stent (5 kidneys) or a percutaneous nephrostomy (15 kidneys). In conclusion, we believe that the possibility of ureteral obstruction by direct invasion or lymph node metastasis should be taken into account in patients who have advanced gastrointestinal malignancies. If such patients show hematuria, elevated BUN, or flank pain, a secondary ureteral obstruction should be suspected. Also malignant ureteral obstructions should be detected and managed early to preserve the renal function.
Colorectal Neoplasms ; Diagnosis ; Female ; Flank Pain ; Gastrointestinal Neoplasms ; Hematuria ; Humans ; Kidney ; Lymph Nodes ; Male ; Neoplasm Metastasis ; Nephrostomy, Percutaneous ; Retrospective Studies ; Stents ; Stomach Neoplasms ; Ureter* ; Ureteral Obstruction*

Metastasis from primary malignancies anywhere in the body can spread to the retroperitoneum and lead to ureteral obstruction. Seventeen patients who had ureteral obstructions caused by advanced gastrointestinal malignancies have been retrospectively analyzed. The results are as follows: 1) Of the 17 patients, 9 were male and 8 were female, and the mean age was 56.9: with a range from 33 to 75. 2) In the 16 patients whose pathologic diagnose were confirmed by primary surgery, the pathologic stages of stomach cancer were stage III in 1 patient and IV in 6 patients, and those of colorectal cancer were stage B in 2 patients, C in 6 patients and D in 1 patient. 3) Urologic symptoms and signs were micro- or macroscopic hematuria (58.8%), elevated BUN (52.9%), and flank pain (29.4%). Sixteen out of 17 patients had one of these findings. 4) The time interval between the original diagnosis of a gastrointestinal malignancy and the subsequent ureteral obstruction in 11 patients (64.7%) was within 2 years. The time interval for a11 17 patients was 33.9 months with a range from 2 months to 10 years. 5) Ureteral involvement was bilateral in 10 patients (58.8%) and unilateral in 7 (41.2%). The levels of ureteral obstruction in stomach cancer were upper (5) and midureter (3), and those in colorectal cancer were upper (1), mid (1) and lower ureter (7). 6) Twenty out of 27 kidneys were managed by a double-J stent (5 kidneys) or a percutaneous nephrostomy (15 kidneys). In conclusion, we believe that the possibility of ureteral obstruction by direct invasion or lymph node metastasis should be taken into account in patients who have advanced gastrointestinal malignancies. If such patients show hematuria, elevated BUN, or flank pain, a secondary ureteral obstruction should be suspected. Also malignant ureteral obstructions should be detected and managed early to preserve the renal function.
Colorectal Neoplasms ; Diagnosis ; Female ; Flank Pain ; Gastrointestinal Neoplasms ; Hematuria ; Humans ; Kidney ; Lymph Nodes ; Male ; Neoplasm Metastasis ; Nephrostomy, Percutaneous ; Retrospective Studies ; Stents ; Stomach Neoplasms ; Ureter* ; Ureteral Obstruction*

Objective: To explore the diagnostic values of HK2 testing and single-cell sequencing in the urothelial carcinoma (UC). Methods: The qualified urine specimens of 265 suspected UC patients or postoperative patients from the Cancer Hospital of Chinese Academy of Medical Sciences, Beijing, China were collected. Both exfoliative cytology and HK2 testing were performed on clinically suspected UC or postoperative patients. The performance of diagnostic cytology and HK2, including consistency, sensitivity, specificity, positive predictive value and negative predictive value, was evaluated based on histopathological, clinical and imaging diagnosis. Isolated HK2 metabolically abnormal cells were subject to single-cell sequencing to verify the reliability of HK2 detection performance and to explore the molecular characteristics of UC. Results: The concordance rate of HK2 testing and cytology for detecting UC was 90.3% (102/113, Kappa=0.604). Compared with cytology, the sensitivity of HK2 was significantly higher (85.2% versus 75.6%, P=0.024). The detection sensitivity of combined HK2 testing and cytology was increased to 91.1%. HK2 testing was significantly more sensitive than cytology for diagnosing UC in the upper urinary tract (81.8% versus 65.5%, P=0.022). It was also more sensitive than cytology for diagnosing early-stage UC (82.6% versus 69.5%, P=0.375) and low-grade UC (69.6% versus 47.8%, P=0.125). Single-cell sequencing of the ten patients, whose samples were positive for HK2, demonstrated highly concordant copy number variations (CNVs) in tumor cells from the same UC patient, with heterogeneity in CNV profiles among different patients. Deletion of chromosome 8p was found in 3 of the 4 urine samples of renal pelvis UC. The 2 patients with benign lesions had no CNVs in all sequenced cells. Conclusions: The test for abnormal urinary glycolytic HK2 metabolism can assist urine cytology to improve the sensitivity of UC diagnosis, and it provides a novel and reliable approach for early detection of upper urinary tract UC and lower grade UC. Meanwhile, this study has preliminarily revealed the feasibility of single-cell sequencing in urinary samples, which is expected to improve the diagnostic specificity of HK2 testing.
Humans ; Urinary Bladder Neoplasms/diagnosis* ; Carcinoma, Transitional Cell/pathology* ; Reproducibility of Results ; DNA Copy Number Variations ; Kidney Neoplasms ; Ureteral Neoplasms ; Sensitivity and Specificity

Adenocarcinoma ; diagnosis ; secondary ; surgery ; Aged ; Biopsy ; Cystoscopy ; Diagnosis, Differential ; Follow-Up Studies ; Humans ; Laparoscopy ; Male ; Prostatic Neoplasms ; diagnostic imaging ; pathology ; surgery ; Radiography ; Transurethral Resection of Prostate ; methods ; Ureteral Neoplasms ; diagnosis ; secondary ; surgery ; Ureteroscopy ; Urethral Neoplasms ; diagnosis ; secondary ; surgery ; Urothelium ; pathology

A 70-yr-old man presented with painless gross hematuria. He underwent right nephrectomy for benign disease 9 yr ago. Computed tomography and cystoscopy showed a mass in the distal region of the right ureteral stump. He underwent right ureterectomy and bladder cuff resection. Pathological examination showed T1 and WHO grade 2 transitional cell carcinoma. At 6 months postoperatively, the patient is alive without any evidence of recurrence.
Aged ; Carcinoma, Transitional Cell/*diagnosis/pathology/surgery ; Cystoscopy ; Hematuria/urine ; Humans ; Kidney Diseases/*surgery ; Male ; Nephrectomy ; Tomography, X-Ray Computed ; Ureteral Neoplasms/*diagnosis/pathology/surgery