1.Predictive value of serum MMP-2,T-AOC,and CRP for postoperative total extraperitoneal repair recurrence in patients with inguinal hernia
Limin WEI ; Yunge WANG ; Guanghui WANG ; Haige LEI
International Journal of Laboratory Medicine 2025;46(2):201-204,209
Objective To investigate the relationship between serum metalloproteinase-2(MMP-2),total antioxi-dant capacity(T-AOC),C-reactive protein(CRP),and recurrence in inguinal hernia(IH)patients with postoperative laparoscopic total extraperitoneal repair(TEP),as well as their predictive value.Methods A total of 122 IH pa-tients undergoing TEP in the First Affiliated Hospital of Xi'an Jiaotong University from January 2019 to De-cember 2022 were selected as the observation group,and 122 healthy subjects during the same period were se-lected as the control group.The patients were followed up for 10 months,and were divided into relapse group(n=37)and recovery group(n=85)according to their recurrence situation.Serum MMP-2 levels were detec-ted by automatic biochemical analyzer,T-AOC levels were determined by chemical colorimetric method,and CRP levels were assessed by enzyme-linked immunosorbent assay.The influencing factors of TEP recurrence in IH patients were analyzed by Logistic regression.The predictive value of serum MMP-2,T-AOC and CRP for postoperative TEP recurrence in IH patients was analyzed by receiver operating characteristic(ROC)curve.Results Serum MMP-2 and CRP levels in observation group were significantly higher than those in control group(P<0.05),and T-AOC levels were significantly lower than those in control group(P<0.05).MMP-2 and CRP in relapse group were significantly higher than those in recovery group(P<0.05),and T-AOC level was lower than that in recovery group(P<0.05).The area under the curve(AUC)of serum MMP2,T-AOC and CRP in pre-dicting TEP recurrence in IH patients were 0.775,0.804 and 0.731,respectively,and the AUC of the combined pre-diction of the three was 0.887,which was better than that of each indicator alone(Z=2.597,1.983,3.275,P=0.009,0.047,0.001).Conclusion Serum levels of MMP-2,T-AOC and CRP in IH patients with postoperative TEP recurrence significantly increase,which can be used as effective indicators to predict the postoperative TEP recurrence in IH patients,and the combined prediction efficiency of the three is higher.
2.Value of ultra high-frequency ultrasound measurement of artery intima thickness combined with monocyte to high-density lipoprotein cholesterol ratio in predicting the severity of coronary artery stenosis in premature coronary artery disease
Chenjing XU ; Jianjun YUAN ; Lixia WANG ; Yingjie CHU ; Xijun ZHANG ; Ming WU ; Yanyan GUO ; Haige YU ; Haohui ZHU
Chinese Journal of Ultrasonography 2025;34(2):114-121
Objective:To investigate the value of carotid,radial and podalic artery intima thickness(CIT,RIT,PIT)combined with monocyte to high-density lipoprotein ratio(MHR)in predicting the severity of coronary artery stenosis in patients with premature coronary artery disease(PCAD).Methods:A total of 80 patients with PCAD who received treatment in Henan Provincial People's Hospital from October 2023 to May 2024 were prospectively recruited,and they were divided into high group(≥41 score,40 cases)and low group(<41 score,40 cases)according to the median dichotomy of Gensini score. Thirty-four gender,age and body mass index(BMI)-matched healthy volunteers were selected as the control group. The CIT,RIT,PIT,media and intima media thickness of carotid,radial artery and podalic artery(CMT,RMT,PMT,CIMT,RIMT,PIMT)were measured using 24 MHz ultra-high frequency ultrasound probe,and the ratio of intima to media thickness(CIT/CMT,RIT/RMT,PIT/PMT)was calculated. The differences of general clinical data,laboratory indexes and ultrasonic parameters among the three groups were compared. Risk factors affecting the severity of coronary stenosis in PCAD patients were explored by binary logistic regression. Subject working characteristic curves were plotted,area under the curve(AUC)was calculated,and the values of each ultrasound parameter and MHR in the independent and combined diagnosis of the severity of coronary artery stenosis in PCAD patients were evaluated.Results:①There were no statistically significant differences in age,gender,BMI,total cholesterol,CMT,RMT and PMT among the three groups(all P>0.05). There were no statistically significant differences in the comparison of smoking,hypertension,diabetes mellitus,systolic blood pressure,diastolic blood pressure,low-density lipoprotein cholesterol,total cholesterol,and triglycerides between the two subgroups of the PCAD(all P>0.05). ②CIT,CIMT,CIT/CMT,RIT,RIMT,RIT/RMT,PIT,PIMT,PIT/PMT were thickened in the high group compared with the low group,and MHR was higher than in the low group(all P<0.05),the differences in the above parameters remained statistically significant when comparing the PCAD group with the control group(all P<0.05). ③The AUC values for MHR,CIT,RIT and PIT alone to predict the severity of coronary stenosis in patients with PCAD were 0.781,0.767,0.780 and 0.722,respectively. The combined diagnostic efficiency of the four parameters was better than the independent diagnostic efficiency(AUC = 0.885). Conclusions:CIT,RIT and PIT are thicker in PCAD patients with high Gensini score and the combination of artery intima thickness and MHR has good efficacy in predicting the severity of coronary artery stenosis in PCAD patients.
3.Impact of gamified behavior intervention based on mobile health on patients with coronary heart disease after percutaneous coronary intervention
Jie WANG ; Qingjuan GONG ; Haige ZHANG ; Mingming ZHANG
Chinese Journal of Practical Nursing 2025;41(19):1441-1448
Objective:To explore the effects of gamified behavior intervention based on mobile health on compliance, psychological status, and physical activity behavior of patients with coronary heart disease after percutaneous coronary intervention (PCI), providing a guidance for effectively improving the intervention effect of patients after PCI for coronary heart disease.Methods:The research plan was designed using a randomized, prospective, single blind, single center clinical research method. The patients with coronary heart disease who received treatment after PCI in the Second Affiliated Hospital of Air Force Medical University from January 2021 to November 2023 were selected as the study subjects by convenience sampling method and divided into the control group and the intervention group by the random number table method. The control group received routine intervention, while the intervention group received gamified behavior intervention based on mobile health on the basis of the control group. Both groups were intervened for 3 months and followed up for 3 months. The compliance, psychological status, physical activity behavior, and quality of life before intervention and after 3 months of follow-up, as well as the occurrence of adverse cardiovascular events during intervention and follow-up between two groups were compared.Results:A total of 88 patients with coronary heart disease after PCI were included, with 44 cases in both the control group and the intervention group. There were 23 males and 21 females in the control group with an age of (64.54 ± 4.32) years old. There were 24 males and 20 females in the intervention group with an age of (65.01 ± 4.36) years old. The scores of exercise, medication, diet, lifestyle compliance scores, physical activity behavior levels, the scores of social function, emotional function, physical function, role function, cognitive function after a 3-month follow-up in the intervention group were (95.32 ± 1.54) points, (95.07 ± 1.60) points, (93.43 ± 1.76) points, (95.03 ± 1.43) points, (1511.32 ± 113.54) metabolic equivalent/week, (94.03 ± 1.02) points, (93.42 ± 1.09) points, (92.21 ± 1.32) points, (93.42 ± 1.15) points, (88.54 ± 3.03) points, respectively, which were higher than the control group (77.43 ± 2.54) points, (78.31 ± 1.71) points, (74.32 ± 2.43) points, (75.14 ± 1.98) points, (1 432.65 ± 107.65) metabolic equivalent/week, (87.22 ± 1.21) points, (86.74 ± 1.30) points, (85.65 ± 3.43) points, (88.76 ± 1.09) points, (73.76 ± 3.43) points, the differences were statistical significant( t values were 3.34-54.02, all P<0.05). The scores of the Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) after a 3-month follow-up in the intervention group were (32.54 ± 1.85), (31.54 ± 0.87) points, respectively, which were lower than the control group (43.65 ± 2.03), (41.54 ± 1.23) points in the control group, the differences were statistical significant ( t=26.83, 44.03, both P<0.05). The incidence of adverse cardiovascular events during the intervention and follow-up period was 4.55% (2/44), which was lower than the control group 18.18% (8/44), the differences was statistical significant ( χ2=4.06, P<0.05). Conclusions:The nursing effect of gamified behavior intervention based on mobile health on patients with coronary heart disease after PCI was good, which could effectively improve compliance, promote the improvement of patients′ psychological state and physical activity behavior, reduce the occurrence of adverse cardiovascular events, further improve their quality of life.
4.Value of ultra high-frequency ultrasound measurement of artery intima thickness combined with monocyte to high-density lipoprotein cholesterol ratio in predicting the severity of coronary artery stenosis in premature coronary artery disease
Chenjing XU ; Jianjun YUAN ; Lixia WANG ; Yingjie CHU ; Xijun ZHANG ; Ming WU ; Yanyan GUO ; Haige YU ; Haohui ZHU
Chinese Journal of Ultrasonography 2025;34(2):114-121
Objective:To investigate the value of carotid,radial and podalic artery intima thickness(CIT,RIT,PIT)combined with monocyte to high-density lipoprotein ratio(MHR)in predicting the severity of coronary artery stenosis in patients with premature coronary artery disease(PCAD).Methods:A total of 80 patients with PCAD who received treatment in Henan Provincial People's Hospital from October 2023 to May 2024 were prospectively recruited,and they were divided into high group(≥41 score,40 cases)and low group(<41 score,40 cases)according to the median dichotomy of Gensini score. Thirty-four gender,age and body mass index(BMI)-matched healthy volunteers were selected as the control group. The CIT,RIT,PIT,media and intima media thickness of carotid,radial artery and podalic artery(CMT,RMT,PMT,CIMT,RIMT,PIMT)were measured using 24 MHz ultra-high frequency ultrasound probe,and the ratio of intima to media thickness(CIT/CMT,RIT/RMT,PIT/PMT)was calculated. The differences of general clinical data,laboratory indexes and ultrasonic parameters among the three groups were compared. Risk factors affecting the severity of coronary stenosis in PCAD patients were explored by binary logistic regression. Subject working characteristic curves were plotted,area under the curve(AUC)was calculated,and the values of each ultrasound parameter and MHR in the independent and combined diagnosis of the severity of coronary artery stenosis in PCAD patients were evaluated.Results:①There were no statistically significant differences in age,gender,BMI,total cholesterol,CMT,RMT and PMT among the three groups(all P>0.05). There were no statistically significant differences in the comparison of smoking,hypertension,diabetes mellitus,systolic blood pressure,diastolic blood pressure,low-density lipoprotein cholesterol,total cholesterol,and triglycerides between the two subgroups of the PCAD(all P>0.05). ②CIT,CIMT,CIT/CMT,RIT,RIMT,RIT/RMT,PIT,PIMT,PIT/PMT were thickened in the high group compared with the low group,and MHR was higher than in the low group(all P<0.05),the differences in the above parameters remained statistically significant when comparing the PCAD group with the control group(all P<0.05). ③The AUC values for MHR,CIT,RIT and PIT alone to predict the severity of coronary stenosis in patients with PCAD were 0.781,0.767,0.780 and 0.722,respectively. The combined diagnostic efficiency of the four parameters was better than the independent diagnostic efficiency(AUC = 0.885). Conclusions:CIT,RIT and PIT are thicker in PCAD patients with high Gensini score and the combination of artery intima thickness and MHR has good efficacy in predicting the severity of coronary artery stenosis in PCAD patients.
5.Impact of gamified behavior intervention based on mobile health on patients with coronary heart disease after percutaneous coronary intervention
Jie WANG ; Qingjuan GONG ; Haige ZHANG ; Mingming ZHANG
Chinese Journal of Practical Nursing 2025;41(19):1441-1448
Objective:To explore the effects of gamified behavior intervention based on mobile health on compliance, psychological status, and physical activity behavior of patients with coronary heart disease after percutaneous coronary intervention (PCI), providing a guidance for effectively improving the intervention effect of patients after PCI for coronary heart disease.Methods:The research plan was designed using a randomized, prospective, single blind, single center clinical research method. The patients with coronary heart disease who received treatment after PCI in the Second Affiliated Hospital of Air Force Medical University from January 2021 to November 2023 were selected as the study subjects by convenience sampling method and divided into the control group and the intervention group by the random number table method. The control group received routine intervention, while the intervention group received gamified behavior intervention based on mobile health on the basis of the control group. Both groups were intervened for 3 months and followed up for 3 months. The compliance, psychological status, physical activity behavior, and quality of life before intervention and after 3 months of follow-up, as well as the occurrence of adverse cardiovascular events during intervention and follow-up between two groups were compared.Results:A total of 88 patients with coronary heart disease after PCI were included, with 44 cases in both the control group and the intervention group. There were 23 males and 21 females in the control group with an age of (64.54 ± 4.32) years old. There were 24 males and 20 females in the intervention group with an age of (65.01 ± 4.36) years old. The scores of exercise, medication, diet, lifestyle compliance scores, physical activity behavior levels, the scores of social function, emotional function, physical function, role function, cognitive function after a 3-month follow-up in the intervention group were (95.32 ± 1.54) points, (95.07 ± 1.60) points, (93.43 ± 1.76) points, (95.03 ± 1.43) points, (1511.32 ± 113.54) metabolic equivalent/week, (94.03 ± 1.02) points, (93.42 ± 1.09) points, (92.21 ± 1.32) points, (93.42 ± 1.15) points, (88.54 ± 3.03) points, respectively, which were higher than the control group (77.43 ± 2.54) points, (78.31 ± 1.71) points, (74.32 ± 2.43) points, (75.14 ± 1.98) points, (1 432.65 ± 107.65) metabolic equivalent/week, (87.22 ± 1.21) points, (86.74 ± 1.30) points, (85.65 ± 3.43) points, (88.76 ± 1.09) points, (73.76 ± 3.43) points, the differences were statistical significant( t values were 3.34-54.02, all P<0.05). The scores of the Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) after a 3-month follow-up in the intervention group were (32.54 ± 1.85), (31.54 ± 0.87) points, respectively, which were lower than the control group (43.65 ± 2.03), (41.54 ± 1.23) points in the control group, the differences were statistical significant ( t=26.83, 44.03, both P<0.05). The incidence of adverse cardiovascular events during the intervention and follow-up period was 4.55% (2/44), which was lower than the control group 18.18% (8/44), the differences was statistical significant ( χ2=4.06, P<0.05). Conclusions:The nursing effect of gamified behavior intervention based on mobile health on patients with coronary heart disease after PCI was good, which could effectively improve compliance, promote the improvement of patients′ psychological state and physical activity behavior, reduce the occurrence of adverse cardiovascular events, further improve their quality of life.
6.Risk factors analysis and early prediction model construction for necrosis in interstitial oedematous pancreatitis
Bo CAO ; Jianguo ZHU ; Wenwen GUO ; Fan YANG ; Sheng SU ; Zhiyue WANG ; Haodong GUO ; Qiong WANG ; Haige LI
Journal of Practical Radiology 2024;40(11):1818-1822
Objective To investigate the risk factors associated with necrosis in interstitial oedematous pancreatitis(IOP)and to develop a nomogram model for the early prediction of necrosis in IOP.Methods A retrospective analysis was conducted on 306 patients diagnosed with IOP.Patients were stratified into necrosis and edema groups based on the presence or absence of pancreatic necrosis through follow-up CT-enhanced examinations.Logistic regression analysis was employed to identify independent predictive factors for necrosis in IOP.Subsequently,a nomogram model was developed,and its discriminative ability,accuracy,and practicality were assessed through receiver operating characteristic(ROC)curve,calibration curve,and decision curve analysis(DCA).Results Balthazar computed tomography severity index(CTSI),gender,lactate dehydrogenase(LDH),and triglyceride(TG)were finally identified as four independent predictors for constructing the nomogram model.The area under the curve(AUC)of the nomogram model was 0.800[95%confidence interval(CI)0.731-0.869].The calibration curve indicated good consistency between the predicted probabil-ity and the actual probability of necrosis in IOP(P=0.737).DCA suggested high practicality of the nomogram model within the threshold probability range of 3%to 66%and 75%to 96%.Conclusion The nomogram model based on Balthazar CTSI,gender,LDH,and TG demonstrates good efficacy in early prediction of necrosis in IOP.
7.Effect of long non-coding RNA00963 on lipopolysaccharide-induced apoptosis of rat renal tubular epithelial cells via microRNA-150-5p/interleukin-1 receptor-associated kinase 1 axis
Wenxuan CUI ; Yan WANG ; Yang YU ; Juan JIA ; Haige ZHAO
Chinese Journal of Diabetes 2024;32(12):941-950
Objective To investigate the effect of long-chain non-coding RNA00963 (LINC00963) on lipopolysaccharide (LPS) induced apoptosis in rat renal tubular epithelial cells via microRNA-150-5p (miR-150-5p)/interleukin-1 receptor-associated kinase 1 (IRAK1) axis. Methods Rat renal tubular epithelial cells NRK-52E were cultured in vitro. NRK-52E cells were divided into control group (Con),LPS group,LPS+si-NC group,LPS+si-LINC00963 group,LPS+si-LINC00963+inhibitor NC group,LPS+si-LINC00963+miR-150-5p inhibitor group,LPS+si-LINC00963+oe-NC group,and LPS+si-LINC00963+oe-IRAK1 group. MTT and EdU methods were used to detect cell proliferation. Flow cytometry was used to detect cell apoptosis rate. ELISA kits were used to detect TNF-α,IL-6,and IL-10 levels,and commercial reagent kits were used to analyze malondialdehyde (MDA),superoxide dismutase (SOD),glutathione peroxide dismutase (GSH-Px) levels. The qRT-PCR was used to detect the expression levels of LINC00963,miR-150-5p,and IRAK1 genes in each group. Western blot was used to detect the expression of cysteine aspartic acid specific protease-3(Caspase-3),Bax,Bcl-2,and IRAK1 proteins in cells. Dual luciferase reporter gene and RNA pull down experiment were used to verify the relationship between miR-150-5p and LINC00963 and IRAK1. Results Compare with the Con group,the expression of LINC00963 and IRAK1 mRNA,the levels of TNF-α,IL-6,the content of MDA,apoptosis rate,the expression of Caspase-3,Bax,and IRAK1 proteins in NRK-52E cells were obviously increased (P<0.05),the expression of miR-150-5p,A490 (24 hours,48 hours) values,proliferation rate,the level of IL-10,the activities of SOD and GSH-Px,and the expression of Bcl-2 protein were obviously reduced (P<0.05) in the LPS group and LPS+si-NC group. Compare with the LPS+si-NC group,the expression of LINC00963 and IRAK1 mRNA,the levels of TNF-α,IL-6,the content of MDA,apoptosis rate,the expression of Caspase-3,Bax,and IRAK1 proteins in NRK-52E cells were obviously reduced (P<0.05),the expression of miR-150-5p,A490 (24 hours,48 hours) values,proliferation rate,the level of IL-10,the activities of SOD and GSH-Px,and the expression of Bcl-2 protein were obviously increased (P<0.05) in the LPS+si-LINC00963 group. Down-regulation of miR-150-5p expression or overexpression of IRAK1 could reduce the improvement effect of interference LINC00963 on LPS induced NRK-52E cell damage (P<0.05). Conclusions Interference with LINC00963 can regulate the miR-150-5p/IRAK1 axis to alleviate LPS-induced oxidative stress,inflammatory response,and apoptosis in NRK-52E cells.
8.Effect of long non-coding RNA00963 on lipopolysaccharide-induced apoptosis of rat renal tubular epithelial cells via microRNA-150-5p/interleukin-1 receptor-associated kinase 1 axis
Wenxuan CUI ; Yan WANG ; Yang YU ; Juan JIA ; Haige ZHAO
Chinese Journal of Diabetes 2024;32(12):941-950
Objective To investigate the effect of long-chain non-coding RNA00963 (LINC00963) on lipopolysaccharide (LPS) induced apoptosis in rat renal tubular epithelial cells via microRNA-150-5p (miR-150-5p)/interleukin-1 receptor-associated kinase 1 (IRAK1) axis. Methods Rat renal tubular epithelial cells NRK-52E were cultured in vitro. NRK-52E cells were divided into control group (Con),LPS group,LPS+si-NC group,LPS+si-LINC00963 group,LPS+si-LINC00963+inhibitor NC group,LPS+si-LINC00963+miR-150-5p inhibitor group,LPS+si-LINC00963+oe-NC group,and LPS+si-LINC00963+oe-IRAK1 group. MTT and EdU methods were used to detect cell proliferation. Flow cytometry was used to detect cell apoptosis rate. ELISA kits were used to detect TNF-α,IL-6,and IL-10 levels,and commercial reagent kits were used to analyze malondialdehyde (MDA),superoxide dismutase (SOD),glutathione peroxide dismutase (GSH-Px) levels. The qRT-PCR was used to detect the expression levels of LINC00963,miR-150-5p,and IRAK1 genes in each group. Western blot was used to detect the expression of cysteine aspartic acid specific protease-3(Caspase-3),Bax,Bcl-2,and IRAK1 proteins in cells. Dual luciferase reporter gene and RNA pull down experiment were used to verify the relationship between miR-150-5p and LINC00963 and IRAK1. Results Compare with the Con group,the expression of LINC00963 and IRAK1 mRNA,the levels of TNF-α,IL-6,the content of MDA,apoptosis rate,the expression of Caspase-3,Bax,and IRAK1 proteins in NRK-52E cells were obviously increased (P<0.05),the expression of miR-150-5p,A490 (24 hours,48 hours) values,proliferation rate,the level of IL-10,the activities of SOD and GSH-Px,and the expression of Bcl-2 protein were obviously reduced (P<0.05) in the LPS group and LPS+si-NC group. Compare with the LPS+si-NC group,the expression of LINC00963 and IRAK1 mRNA,the levels of TNF-α,IL-6,the content of MDA,apoptosis rate,the expression of Caspase-3,Bax,and IRAK1 proteins in NRK-52E cells were obviously reduced (P<0.05),the expression of miR-150-5p,A490 (24 hours,48 hours) values,proliferation rate,the level of IL-10,the activities of SOD and GSH-Px,and the expression of Bcl-2 protein were obviously increased (P<0.05) in the LPS+si-LINC00963 group. Down-regulation of miR-150-5p expression or overexpression of IRAK1 could reduce the improvement effect of interference LINC00963 on LPS induced NRK-52E cell damage (P<0.05). Conclusions Interference with LINC00963 can regulate the miR-150-5p/IRAK1 axis to alleviate LPS-induced oxidative stress,inflammatory response,and apoptosis in NRK-52E cells.
9.Clinical analysis of squamous cell carcinoma of renal pelvis
Jiwei HUANG ; Xingyun CAI ; Zaoyu WANG ; Wen CAI ; Hongyang QIAN ; Yonghui CHEN ; Jin ZHANG ; Haige CHEN ; Ming CAO ; Wei XUE ; Yiran HUANG
Chinese Journal of Urology 2020;41(5):348-351
Objective:To investigate the diagnosis, treatment and prognosis of squamous cell carcinoma of renal pelvis.Methods:The clinic data of 28 cases with squamous cell carcinoma of renal pelvis confirmed by pathologic examination treated during June 2007 and September 2019 was retrospectively analyzed. There were 19 male and 9 female patients, with a median age of 56 years. Hematuria was present in 18 cases, flank pain was present in 11 cases, and abdominal mass was present in 1 case. All 28 cases accepted CT or MRI examination. Renal pelvis or renal tumors were found in 26 cases, and severe hydronephrosis was observed in 2 cases. 2 cases underwent PET/CT, and bone metastasis was found in 1 case. Preoperative diagnoses were renal pelvic tumor in 13 cases, renal tumor in 13 cases and renal abscess in 2 cases. Coexisting renal calculi or renal pelvic calculus was detected in 19 cases. All 28 cases underwent surgical excision, including radical nephroureterectomy in 13 cases, radical nephrectomy in 12 cases, palliative resection in 1 case, and pyonephrenectomy in 2 cases. Enlarged lymph nodes were found in 9 cases during the surgery, and local lymph node dissection was performed in these cases.Results:The mean diameter of the tumors was 8.5 cm. Histopathological examination revealed that 9 cases were well differentiated, 11 cases were moderately differentiated, and 8 case was poorly differentiated. 1 case had pT 2 stage, 15 cases had pT 3 stage and 12 cases had pT 4 stage. 9 cases had lymph node metastasis. 5 cases had renal vein thrombosis. Immunohistochemistry staining exhibited consistent characteristics including CK5(+ ), 34βE12(+ ), p63(+ ), CK20(-) and GATA3(-). Postoperatively, 12 cases received adjuvant therapy including chemotherapy, radiotherapy and/or immunotherapy. Within a median follow-up of 6.0 months (ranging 1-80 months), median overall survival was 10.0 months. 15 cases died of tumor progression. Conclusion:Squamous cell carcinoma is a rare and highly aggressive neoplasm, typically associated with long-lasting renal calculi, hydronephrosis and chronic inflammation. The diagnosis should be established on pathologic examination.CK5, 34βE12 and p63 positivity contribute to the diagnosis of squamous cell carcinoma. Surgery is the foremost choice of treatment, but the risk of recurrence and metastasis is high. The prognosis is extremely poor as the majority of patients are diagnosed with advanced stages.
10.The diagnosis and treatment of primary adenocarcinoma of the upper urinary tract
Xingyun CAI ; Jiwei HUANG ; Yueming WANG ; Zaoyu WANG ; Wen CAI ; Hongyang QIAN ; Yonghui CHEN ; Jin ZHANG ; Haige CHEN ; Ming CAO ; Yiran HUANG ; Wei XUE
Chinese Journal of Urology 2020;41(5):352-355
Objective:To study the pathological characteristics, diagnosis and treatment of primary adenocarcinoma of renal pelvis and ureter.Methods:The clinical pathological characteristics, treatment and prognosis of 5 patients with adenocarcinoma of upper urinary tract treated between January 2007 and May 2019 was retrospectively reviewed. There were 4 male and 1 female patients, with a median age of 60 years. The major symptoms were hematuria in 5 cases and low back pain in 4 cases. All cases underwent B-ultrasound and CT examination, and 4 cases accepted cystoscopy. Preoperative diagnoses were ureter tumor in 2 cases, renal pelvis tumor in 1 case, renal tumor in 1 case and renal calculus in 1 case.Results:5 cases were treated with surgery. Radical nephroureterectomy was performed in 3 cases, and nephrectomy in one case. 1 case underwent first-stage percutaneous nephrolithotomy and second-stage radical nephroureterectomy due to the discovery of tumor. 1 case was treated with radiotherapy and immune checkpoint inhibitor postoperatively. The mean diameter of the tumors was 4.4 cm. There were 3 renal pelvis adenocarcinomas and 2 ureter adenocarcinomas confirmed by pathologic examination, including 3 cases of pT 3 stage and 1 case of pT 4 stage. Lymph node metastasis was found in 2 cases. Immunohistochemistry revealed that CDX2(+ ), p63(-), GATA3(-), β-catenin(-)were the common features of five cases. The median survival was 12 months with a median follow-up of 6 months. 2 cases died of tumor progression within 1 year. Conclusions:Adenocarcinoma is an extremely rare malignancy, typically associated with long-standing calculi and chronic inflammation. Given the fact that clinical and imaging findings are nonspecific, the diagnosis is based on pathologic examination, supported by glandular structure of histology. Immunohistochemical staining exhibited CDX2 and CK20 positivity and β-catenin negativity, moreover, GATA3, p63 and CK7 was usually negative or partially positive. Surgery is the foremost choice of treatment. The prognosis is correlated with subtypes, whereas the overall prognosis is poor due to high rates of recurrence and metastasis.

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