Urinary system tumors affect a huge number of individuals, and are frequently recurrent and progressing following surgery, necessitating lifelong surveillance. As a result, early and precise diagnosis of urinary system cancers is important for prevention and therapy. Histopathology is now the golden stan-dard for the diagnosis, but it is invasive, time-consuming, and inconvenient for initial diagnosis and re-gular follow-up assessment. Endoscopy can directly witness the tumor's structure, but intrusive detection is likely to cause harm to the patient's organs, and it is apt to create other hazards in frequently examined patients. Imaging is a valuable non-invasive and quick assessment tool; however, it can be difficult to define the type of lesions and has limited sensitivity for early tumor detection. The conventional approaches for detecting tumors have their own set of limitations. Thus, detection methods that combine non-invasive detection, label-free detection, high sensitivity and high specificity are urgently needed to aid clinical diagnosis. Optical diagnostics and imaging are increasingly being employed in healthcare settings in a variety of sectors. Raman scattering can assess changes in molecular signatures in cancer cells or tissues based on the interaction with vibrational modes of common molecular bonds. Due to the advantages of label-free, strong chemical selectivity, and high sensitivity, Raman scattering, especially coherent Raman scattering microscopy imaging with high spatial resolution, has been widely used in biomedical research. And quantity studies have shown that it has a good application in the detection and diagnosis of bladder can-cer, renal clear cell carcinoma, prostate cancer, and other cancers. In this paper, several nonlinear imaging techniques based on Raman scattering technology are briefly described, including Raman spectroscopy, coherent anti-Stokes Raman scattering, stimulated Raman scattering, and surface-enhanced Raman spectroscopy. And we will discuss the application of these techniques for detecting urologic malignancy. Future research directions are predicted using the advantages and limitations of the aforesaid methodologies in the research. For clinical practice, Raman scattering technology is intended to enable more accurate, rapid, and non-invasive in early diagnosis, intraoperative margins, and pathological grading basis for clinical practice.
Humans ; Male ; Microscopy/methods* ; Radiopharmaceuticals ; Spectrum Analysis, Raman/methods* ; Technology ; Urologic Neoplasms/diagnosis*

Lymphedema is a frequent complication after the treatment of various cancers, particularly breast cancer, gynecological cancers, melanomas, and other skin and urological cancers. Lymphedema patients have chronic swelling of the affected extremity, recurrent infections, limited mobility and decreased quality of life. Once lymphedema develops, it is usually progressive. Over time, lymphedema leads to fat deposition and subsequent fibrosis of the surrounding tissues. However, there is no cure for lymphedema. Recently, the development of microsurgery has led to introduction of new surgical techniques for lymphedema, such as vascularized lymph node transfer. We report here the latest trends in the surgical treatment of lymphedema, as well as diagnosis and conventional treatments of lymphedema.
Anastomosis, Surgical ; Breast Neoplasms ; Diagnosis ; Extremities ; Fibrosis ; Humans ; Lymph Nodes ; Lymphedema* ; Melanoma ; Microsurgery ; Quality of Life ; Skin ; Urologic Neoplasms

INTRODUCTIONPenile cancer is an uncommon disease affecting only about one in 100,000 men worldwide in a year. The diagnosis of the condition is frequently delayed, and the disease and its treatment frequently result in significant morbidity in patients.

METHODSWe herein describe seven cases of penile tumours: six cases of squamous cell carcinomas and one case of B-cell lymphoma that presented to our hospital's urology department between March 2011 and October 2012. We reviewed the literature to discuss the clinical presentation, natural history and current management of penile cancer.

RESULTSThe patients were followed up for 1-24 months. They were managed according to their disease stage and lymph node status. Four out of seven patients showed disease progression during the follow-up period.

CONCLUSIONThe accurate staging of inguinal nodes in cases of low-risk disease is important to prescribe appropriate surgery for the inguinal nodes. Aggressive management of inguinal and pelvic lymph nodes remains the cornerstone in the treatment of high-risk disease cases.

Aged ; Carcinoma, Squamous Cell ; diagnosis ; secondary ; surgery ; Humans ; Lymph Node Excision ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Staging ; Penile Neoplasms ; diagnosis ; pathology ; surgery ; Urologic Surgical Procedures, Male ; methods

PURPOSE: The aim of this study is to evaluate the incidence of de novo malignancy after liver transplantation (LT) and compare with those among the general Chinese population. METHODS: A total of 466 patients who had a minimum follow-up time of 6 months were enrolled in the study. All data of medical records and follow up were retrospectively reviewed. RESULTS: The incidence rate of de novo malignancy was 3.0% (14 in 466 patients). The median elapsed time from transplant to the diagnosis of de novo malignancy was 42 months (range, 6 to 106 months). The cumulative risk for development of de novo malignancy was 1.6%, 2.7%, and 8.2% at 3, 5 and 10 years after LT, respectively. The patients were all male. The types of de novo tumors included digestive system tumor (8 in 14), lung cancer (2 in 14), urologic neoplasm (2 in 14), and hematologic malignant tumor (2 in 14). Over a mean follow-up of 24 months after diagnosis of de novo malignancy, 7 patients (50.0%) died; the overall 5-year patient survival rate was 54.5%. The relative risk of malignancy following LT was 9.5 folds higher than the general Chinese population. CONCLUSION: The relative risk of malignancy following LT was much higher than the general Chinese population. Digestive system tumor is the most common type of de novo malignancy after LT in China.
Asian Continental Ancestry Group ; China ; Diagnosis ; Digestive System ; Follow-Up Studies ; Humans ; Incidence ; Liver Transplantation* ; Lung Neoplasms ; Male ; Medical Records ; Retrospective Studies ; Survival Rate ; Transplantation ; Urologic Neoplasms

PURPOSE: MicroRNAs (miRNAs) in biological fluids are potential biomarkers for the diagnosis and assessment of urological diseases such as benign prostatic hyperplasia (BPH) and prostate cancer (PCa). The aim of the study was to identify and validate urinary cell-free miRNAs that can segregate patients with PCa from those with BPH. METHODS: In total, 1,052 urine, 150 serum, and 150 prostate tissue samples from patients with PCa or BPH were used in the study. A urine-based miRNA microarray analysis suggested the presence of differentially expressed urinary miRNAs in patients with PCa, and these were further validated in three independent PCa cohorts, using a quantitative reverse transcriptionpolymerase chain reaction analysis. RESULTS: The expression levels of hsa-miR-615-3p, hsv1-miR-H18, hsv2-miR-H9-5p, and hsa-miR-4316 were significantly higher in urine samples of patients with PCa than in those of BPH controls. In particular, herpes simplex virus (hsv)-derived hsv1-miR-H18 and hsv2-miR-H9-5p showed better diagnostic performance than did the serum prostate-specific antigen (PSA) test for patients in the PSA gray zone. Furthermore, a combination of urinary hsv2-miR-H9-5p with serum PSA showed high sensitivity and specificity, providing a potential clinical benefit by reducing unnecessary biopsies. CONCLUSIONS: Our findings showed that hsv-encoded hsv1-miR-H18 and hsv2-miR-H9-5p are significantly associated with PCa and can facilitate early diagnosis of PCa for patients within the serum PSA gray zone.
Biomarkers ; Biopsy ; Cohort Studies ; Diagnosis ; Early Diagnosis ; Herpes Simplex ; Humans ; Microarray Analysis ; MicroRNAs* ; Passive Cutaneous Anaphylaxis ; Prostate ; Prostate-Specific Antigen ; Prostatic Hyperplasia ; Prostatic Neoplasms* ; Sensitivity and Specificity ; Simplexvirus ; Urologic Diseases

OBJECTIVE: To establish logistic regression model for prostate cancer and provide basis for prostate biopsy.
 METHODS: A total of 117 cases of prostate biopsy were retrospectively analyzed in chronological sequence. All cases were assigned into a model group (n=78) and a validation group (n=39). Logistic regression model was established and its value was estimated by receiver operating characteristic (ROC) curve. 
 RESULTS: Digital rectal examination(DRE), transrectal ultrasound(TRUS), MRI, prostate-specific antigen density (PSAD), and free PSA/total PSA (fPSA/tPSA) were the influential factors for prostate biopsy (P<0.01). The established logistic regression model for prostate cancer by regression coefficient was: logit P=-2.362+2.561×DRE+1.747×TRUS+2.901×MRI+1.126×PSAD-
2.569×fPSA/tPSA and area under curve was 0.907. When the cutoff aimed at 0.12, the sensitivity and specificity were 81.80% and 89.30%, respectively.
 CONCLUSION Logistic regression model for prostate cancer can provide sufficient basis for prostate biopsy. Prostate biopsy should be performed when P value is more than 0.12.
Biopsy ; Humans ; Logistic Models ; Male ; Prostate-Specific Antigen ; blood ; Prostatic Neoplasms ; diagnosis ; pathology ; ROC Curve ; Retrospective Studies ; Sensitivity and Specificity ; Urologic Surgical Procedures

Local recurrence after radical nephroureterectomy (RNU) owing to urothelial carcinoma of the upper urinary tract is rare. The usual treatment is systemic chemotherapy followed by optional resection of the mass. We introduce the case of a 73-year-old male patient with multiple comorbidities in whom retroperitoneal carcinoma recurrence of 31 mm was diagnosed via positron emission tomography-computed tomography scan with 18-fluorodeoxyglucose about 5 years after he had undergone RNU owing to urothelial carcinoma of the upper urinary tract. The patient was treated with computed tomography-guided percutaneous radiofrequency ablation. Later scans with contrast controls showed lack of contrast uptake and a decrease of the lesion's size. Twenty-four months after the procedure, the patient is free of the disease. To date, this is the first case of recurrence of urothelial carcinoma that was treated with percutaneous radiofrequency ablation, thus establishing an alternative to chemotherapy in patients with substantial comorbidities.
Aged ; Carcinoma, Transitional Cell/diagnosis/*surgery ; Catheter Ablation/*methods ; Humans ; Male ; Neoplasm Recurrence, Local/diagnosis/*surgery ; Nephrectomy/methods ; Positron-Emission Tomography ; Tomography, X-Ray Computed ; Urologic Neoplasms/diagnosis/*surgery

OBJECTIVETo investigate the role of contrast-enhanced ultrasound in the differential diagnosis of high- and low-grade urothelial carcinoma.

METHODSThe radiological data of 96 patients with urothelial carcinomas who had undergone gray-scale contrast-enhanced ultrasound from August 2010 to April 2011 were analyzed retrospectively. Pathological examination demonstrated that the tumors were high-grade in 55 cases (high-grade group) and low-grade in 41 cases (low-grade group). The dynamic images were analyzed by time-intensity curve, and the arrival time (AT), peak intensity (PI), time to peak (TTP), and washout time (WT) were measured. The enhancement patterns of different urothelial carcinomas were analyzed.

RESULTSBoth PI (P=0.005) and WT (P=0.002) were significantly higher in high-grade group than in low-grade group, whereas AT (P=0.374) and TTP (P=0.386) showed no significant difference between these two groups. In the high-grade group, 47 cases (85.5%) were identified as fast wash-in and slow wash-out; in the low-grade group, 35 (85.4%) were identified as fast wash-in and fast wash-out. When the enhancement pattern was used as a diagnostic indicator for differentiating urothelial carcinomas, the sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were 85.5%, 90.2%, 87.5%, 92.2%, and 82.2% for high-grade tumor and 85.4%, 90.9%, 88.5%, 87.5%, and 89.3% for low-grade tumor.

CONCLUSIONSDifferent grade urothelial carcinomas show different enhancement finding on contrast-enhanced ultrasound. The enhancement pattern can serve as an important diagnostic indicator.

Aged ; Aged, 80 and over ; Carcinoma ; diagnostic imaging ; Diagnosis, Differential ; Female ; Humans ; Male ; Middle Aged ; Sensitivity and Specificity ; Ultrasonography ; Urologic Neoplasms ; diagnostic imaging

OBJECTIVE: To determine the validity of NMP-22 (Bladder Check Protein Test Pack Kit) in the diagnosis of bladder cancer.

MATERIALS: From May 1, 2009 to October 31, 2009 all patients with bladder mass by ultrasound, IVP or CT scan from three different urology training institutions were enrolled in this prospective study. These patients underwent urine cytology and NMP-22 qualitative assay. The diagnosis determined from the cytoscopic and histopathologic findings from CTURBT was accepted as the gold standard.

RESULTS: Thirty nine subjects were enrolled in this study, whom of 31 patients were diagnosed of malignancy and 8 were benign in pathology. The sensitivity of urine cytology, NMP-22 assay and cytoscopy was 34.6%, 96.8% and 92.3% respectively and the specificity was 37.5% for NMP-22 and 66.1% for the cytoscopy.

CONCLUSION: The result of this study suggests that NMP-22 is a very sensitive test, however is less specific in identifying bladder cancer.

Human ; Male ; Female ; Middle Aged ; Neoplasms ; Urologic Neoplasms ; Urinary Bladder Neoplasms-cytology, diagnosis, pathology ; nuclear matrix protein 22 ; ultrasonography ; Tomography Scanners, X-Ray Computed ; ;

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