Expression of Pigment Epithelium-derived Factor in Bladder Tumour Is Correlated with Interleukin-8 yet Not with Interleukin-1α

Pigment epithelium-derived factor （PEDF） is an antiangiogenic factor which is effective in tumour inhibition in a variety of tumours and has not yet been studied in bladder tumour before. In this study the expression of PEDF, interleukin-1α （IL-1α） and -8 （IL-8） in bladder tumours was investigated. Immunohistochemistry was performed on 64 bladder tumour and 23 normal uroepithelium samples. Expression change of the factors was compared with clinicopathological parameters. Correlations between PEDF, IL-1α and IL-8 were analyzed. None of the factors was in relation to gender, tumour occurrence, and size or onset pattern. PEDF （P=0.014） and IL-1α （P=0.049） expression was down-regulated with grade progression. PEDF expression was lower in normal uroepithelium than in papillary urothelial neoplasm of low malignant potential （PUNLMP） （P=0.000） and carcinoma （P=0.009） whilst IL-1α （P=0.000 and P=0.000 respectively） and IL-8 （P=0.000 and P=0.023 respectively） expression was higher in the same grouping. PEDF expression had a negative correlation with IL-8 in PUNLMP （P=0.049, r=-0.578） as well as in tumour grouping （P=0.033, r=-0.276）. Deranged expressional change of PEDF, IL-1α and IL-8 could be in relation to loss of differentiation from normal uroepithelium to papillary lesion and eventually to carcinoma.

Epidemiological and Clinical Aspects of Bladder Tumours at the Nianankoro Fomba Hospital in Segou in the Urology Department

Objectives: To study the epidemiological, diagnostic and prognostic aspects of bladder tumours in Segou Hospital. Patients and Methods: We conducted a descriptive cross-sectional study of bladder tumours over the period from 1 April 2012 to 1 April 2017, in the urology department of the Nianankoro Fomba Hospital in Segou. The first three years were used for patient recruitment, and the last two years for follow-up of the patients in the series. Results: Over a period of three years, we collected 165 cases of bladder tumours hospitalised out of 1308 hospitalisations from 7007 consultations, i.e. 12.6% of hospitalisations and 2.3% of consultations. The sex ratio was 1.2 in favour of men. A history of treated bilharzia was reported in 78.8% of cases and untreated bilharzia in 9.1% of cases. Haematuria was the most common reason for consultation. The majority of our patients were at stage T4 and T3 at the time of diagnosis, i.e. 53.3% and 44.3% respectively. Most patients consulted within 13 to 24 months after the first sign, i.e. 44.8%. Conclusion: The prognosis is still clouded by the delay in management. All the patients diagnosed had a bladder tumour infiltrating the muscle.

Uro-Scanner Aspects of Bladder Tumours at the Mali Hospital about 17 Cases

Introduction: Bladder tumours are frequent, have a poor prognosis and are the second most common genitourinary tumour in men. In Mali, recent statistical data on the prevalence of bladder tumours show a progression with 6.71% in 2006. The euro scanner is used in the diagnostic workup. The work was initiated in order to specify the role of the scanner in the diagnosis of these tumors. Patients and Methods: Prospective descriptive study was carried out in the medical imaging department of Mali Hospital from February to November 2018. Were included any patient with a bladder tumour on euro scanner. The patients had benefited from a preliminary preparation and a renal biological assessment in order to eliminate renal insufficiency. Our examinations were performed with a Siemens 16-slice scanner. These were axial slices performed without, with iodine injection from the pulmonary base to the pubic bones. Results: We had collected 17 patients out of 541 scans i.e. a frequency of 3.76%. The age range of 21 to 40 years was 58.8% with an average age of 25 years. The antecedents (ATCD) found were urinary bilharzia (47%) and smoking (17%). The clinic was dominated by haematuria. It was associated with a bladder mass (52%) and dysuria (23.52%). The CT scan showed a budding appearance, a size greater than 3 cm (82%), infiltration of peri-vesical fat (47.05%), and adenopathy (94%). Associated lesions were: utero-hydronephrosis (58.82%) and metastases (bone and liver in 11.76% of cases each). Conclusion: They are frequent and the history of urinary bilharziasis remains the main risk factor in endemic countries. CT scans are essential in the management of this disease. The diagnosis of certainty remains histology.

Synergic anti-tumour effect of B7.1 gene modified tumour vaccine combined with allicin for murine bladder tumour

In the previous study, we found that B7.1 gene transduction failed to inducesufficient anti-tumour response when it is used as a tumour vaccine. It is necessary to developimmunity by a combination of appropriate cytokines to stimulate effective tumour immunity in atherapeutic setting. To address the possibility of B7.1 modified tumour vaccine combined withallicin, a highly active component in extracts of freshly crushed garlic, we prepared geneticallyengineered murine bladder tumour cells ( MBT-2 ) to express the B7. 1 molecule, then evaluated thesynergic effect of MBT-2-B7. 1 combined with allicin in vivo.

PKRBT术后联合不同膀胱灌注化疗方案对浅表性膀胱癌患者的疗效及对其sICAM-1等指标和预后的影响评估

目的探讨PKRBT术后联合不同膀胱灌注化疗方案对浅表性膀胱癌患者的疗效及对其sICAM-1等指标和预后的影响。方法选取113例浅表性膀胱癌患者,均行PKRBT术,术后根据膀胱灌注化疗方案差异分为2组。研究组患者75例采用吡柔比星联合吉西他滨膀胱灌洗治疗,而对照组患者38例则采用吡柔比星膀胱灌洗治疗,比较2组患者的临床疗效等差异。结果研究组的临床总有效率(77.3%)高于对照组(44.7%)(P<0.05);研究组术后治疗后不良反应发生率(5.3%)显著低于对照组(31.6%)(P<0.05)。治疗后2组的血清指标均较术前降低,且研究组下降更甚(P<0.05)。术后1年,研究组的复发率(2.7%)显著低于对照组(23.7%)(P<0.05)。结论PKRBT术后给予吡柔比星联合吉西他滨膀胱灌洗治疗浅表性膀胱癌可显著提高疗效,同时可改善患者预后,值得临床推广应用。

Urethrocystoscopy: Indications and Results in the Urology Department of the Ignace Deen National Hospital in Conakry

Introduction: Urethrocystoscopy is an examination of choice in the assessment of voiding disorders and especially macroscopic hematuria. The objective of this study was to analyze the indications and results of urethrocystoscopy in the urology department of the Ignace Deen National Hospital in Conakry. Material and Methods: We carried out a prospective descriptive study over 6 months, from 1st June to 30th November 2022, which included all patients who underwent urethrocystoscopy in the Urology Department of the Ignace Deen National Hospital in Conakry. We studied the following parameters: sex, age, indications and results of the examination, and complications. Results: 77 patients were included. The average age was 56.5 ± 19.5 years with extremes of [15 to 88 years]. The sex ratio was 2.9. Hematuria (50.7%) and lower urinary tract symptoms (32.4%) were the most frequent indications. Cystocystoscopy was normal in 14.3% of patients. Bladder tumors (29.9%) and prostatic hypertrophy (18.2%) were the most found lesions. Conclusion: Rigid urethrocystoscopy occupies an important place in the exploration of hematuria and lower urinary tract symptoms in our department. Bladder tumors and prostatic hypertrophy were the main lesions observed.

改良经尿道膀胱肿瘤切除术治疗非肌层浸润性膀胱癌的效果

目的 探讨改良经尿道膀胱肿瘤切除术(TURBT)治疗非肌层浸润性膀胱癌(NMIBC)的效果。方法 选取2020年10月至2022年3月新乡医学院第一附属医院收治的85例NMIBC患者,随机分为对照组(42例)和研究组(43例)。对照组接受常规TURBT,研究组接受改良TURBT。比较两组手术情况、并发症、手术前后复发相关标志物[血骨髓来源抑制细胞(MDSC)、表达Tie2的单核细胞(TEMs)、CXC趋化因子配体5(CXCL5)、人软骨糖蛋白39(YKL-40)]、生活质量、功能状态。结果 研究组出血量较对照组少,尿管留置时间、住院时间均较对照组短(P<0.05);研究组术后1个月、3个月外周血MDSC、TEMs水平及血清CXCL5、YKL-40水平低于对照组(P<0.05);研究组术后1、3个月生活质量、功能状态评分高于对照组(P<0.05)。结论 改良TURBT治疗NMIBC能减少术中出血量,恢复机体功能,加快恢复进程,提高患者生活质量,同时能抑制复发因子表达。

经尿道红激光膀胱肿瘤切除术和经尿道膀胱肿瘤电切术治疗非肌层浸润性膀胱癌的疗效及安全性评价

目的探讨经尿道红激光膀胱肿瘤切除术和经尿道膀胱肿瘤电切术治疗非肌层浸润性膀胱癌的疗效及安全性。方法回顾性选取2016年5月至2017年10月成都大学附属医院收治的75例非肌层浸润性膀胱癌患者,根据手术方法不同分为对照组(n=30)和观察组(n=45)。对照组患者采用经尿道膀胱肿瘤电切术治疗,观察组患者采用经尿道红激光膀胱肿瘤切除术治疗。比较两组手术相关指标、生存率和复发率。结果观察组患者的手术时间、术后留置导尿管时间分别为(22.6±3.6)min、(1.45±0.78)d;对照组患者的手术时间、术后留置导尿管时间分别为(30.5±7.5)min、(2.6±1.5)d;两组比较差异具有统计学意义(P<0.05)。观察组患者的术中出血量为(17.8±3.2)ml,对照组患者的术中出血量为(26.7±3.1)ml,观察组明显少于对照组,差异具有统计学意义(P<0.05)。观察组患者的手术相关并发症发生率(0)明显低于对照组(30.00%),差异具有统计学意义(P<0.05)。两组患者的生存率(93.3%vs.90.0%)、复发率(7.1%vs.11.1%)比较,差异无统计学意义(P>0.05)。结论经尿道红激光膀胱肿瘤切除术与传统的经尿道膀胱肿瘤电切术相比,在非肌层浸润性膀胱癌手术操作过程中具有时间短、术中出血量少、并发症发生率低的优势,可作为治疗非肌层浸润性膀胱癌的一种安全可靠的手术方式。

浸润性膀胱肿瘤的治疗(附11例报告)

目的 评估双侧髂内动脉灌注化疗 +手术在治疗浸润性膀胱肿瘤中的价值。方法 对 11例浸润性膀胱肿瘤患者行双侧髂内动脉灌注化疗 +手术。结果 术后 11例随访 1～ 3年。 1年时死亡 1例 ,1例多发膀胱肿瘤患者于术后 3个月复发 ,第 3次做灌注化疗 ;余 9例 2年内死亡 4例 ,5例生存 3年以上。 1年存活率 91%。结论 双侧髂内动脉灌注化疗治疗浸润性膀胱肿瘤 ,安全可靠 ,不良反应小 ,可延缓病情发展 ,为手术切除肿瘤提供宝贵的时机 ,两者结合 。

TURBT术后丝裂霉素定时灌注膀胱预防膀胱癌复发的护理

目的:探讨TURBT术后丝裂霉素定时灌注膀胱预防膀胱癌复发的疗效和安全性.方法:表浅性膀胱癌66例,在TURBT术后定时用丝裂霉素灌注膀胱,观察疗效和副作用,并针对患者的病情实施心理护理、饮食护理与锻炼指导.结果:66例患者均顺利完成了膀胱内灌注治疗,随访3个月～2年,12例术后3～12个月复发,复发率18%.再次行TURBT及灌注化疗,复发1例,无明显的毒副作用和并发症.结论:TURBT术后定时灌注丝裂霉素可预防术后复发,且毒副反应小、创伤小、费用低,为膀胱癌治疗提供了可靠的方法.

膀胱血管周上皮样细胞肿瘤1例

患者女,60岁,B超发现＂盆腔包块＂1年。CT：膀胱左前壁肿块,边界清晰,大小4.2cm×5.2cm×3.8cm,位于膀胱壁内外,密度略不均匀;动脉期明显不均匀强化,瘤周较多纡曲血管影;延迟期持续强化。CTA示病灶由膀胱下动脉分支供血,呈血管包绕征（图1A）。MRI：膀胱肿块呈T1WI等、低信号,T2WI等、高信号;DWI示病灶不均匀高信号（图1B）;增强扫描明显不均匀持续强化,瘤周血管扩张（图1C）。行膀胱全切除术,术中见肿瘤位于膀胱左前壁,质韧。病理：瘤组织由梭形和上皮样细胞组成,间质血窦丰富。免疫组化：HMB45（＋,图1D）,PNL2（＋）,PGP9.5（＋）,CD99（＋）。

放射和高聚生对小鼠膀胱癌生长的抑制作用

目的 研究放射和高聚生 (HASL)对小鼠膀胱癌生长的抑制作用。方法 将BTT739肿瘤细胞接种于T739小鼠皮下制成模型 ,观察不同放射剂量及高聚生对局部肿瘤的抑制作用。结果 接种后即给予HASL治疗 ,第 16dHASL组、放射 5Gy组、放射 5Gy加HASL组的抑瘤率依次为 34%、5 3.2 %、5 2 .9%。接种后 7d给予HASL治疗 ,抑瘤率依次为 2 7.0 %、5 4.9%、6 4.6 % ,放射 8Gy组、放射 8Gy加HASL组依次为 80 .7%、84 .1%。结论 HASL对局部肿瘤生长有抑制作用 ,但与放射联合时不增加放射对肿瘤的抑制作用。

人乳头瘤病毒与膀胱癌相关性的研究

目的:进一步证实人乳头瘤病毒(HPV)与膀胱癌的相关性。方法:采用高敏感聚合酶链反应(PCR)技术检测42例膀胱癌组织标本,并用20例前列腺增生症患者之正常膀胱组织标本作对照。结果:膀胱癌HPV感染率为52.4%,正常膀胱组织标本HPV感染率为10.0%,其中1例阳性者1年后发生膀胱癌。结论:HPV感染与膀胱癌有一定的相关性,并在膀胱癌的发生中起着相关作用。

微创时代的膀胱根治性切除和尿流改道术

传统开放性膀胱根治性切除术是治疗肌层浸润的局限性膀胱癌和复发性高级别膀胱癌的金标准。目前,腹腔镜膀胱根治性切除术因其出血少、术后疼痛轻、恢复快和切口小、美观性好等优点,越来越多地应用于临床。此外,单通道腹腔镜与机器人辅助腹腔镜技术也逐渐发展起来并应用于该领域。这些微创技术显示出广阔应用前景,但安全性和有效性仍需进一步证实。

经尿道膀胱肿瘤等离子整块剜除术治疗浅表性膀胱肿瘤的近期疗效

目的探讨经尿道膀胱肿瘤等离子整块剜除术治疗浅表性膀胱肿瘤的近期疗效。方法将80例浅表性膀胱肿瘤患者按照治疗方式不同分为电切术组(37例)和等离子整块剜除术组(43例)。比较两组患者手术情况[手术时间、术中出血量、留置导管时间、膀胱穿孔率]、炎症指标[降钙素原(PCT)、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)]、氧化应激指标[超氧化物歧化酶(SOD)、皮质醇(Cor)]、膀胱功能[国际前列腺症状评分(IPSS)、最大尿流率(Q_(max))]及术后并发症发生情况。结果等离子整块剜除术组患者手术时间明显长于电切术组,术中出血量明显少于电切术组,留置导管时间明显短于电切术组,差异均有统计学意义(P﹤0.01)。术前,两组患者PCT、CRP、TNF-α、SOD、Cor水平比较,差异均无统计学意义(P﹥0.05);术后,两组患者PCT、CRP、TNF-α、SOD水平均明显上升,Cor水平均明显下降,且等离子整块剜除术组患者PCT、CRP、TNF-α、SOD水平均明显低于电切术组,Cor水平明显高于电切术组,差异均有统计学意义(P﹤0.01)。术前、术后,两组患者IPSS评分、Q_(max)水平比较,差异均无统计学意义(P﹥0.05)。两组患者术后并发症总发生率比较,差异无统计学意义(P﹥0.05)。结论给予浅表性膀胱肿瘤患者经尿道膀胱肿瘤等离子整块剜除术治疗,能够抑制炎症因子、氧化应激因子,不影响患者膀胱功能,且有着一定的安全性。

磁场定位下磁化丝裂霉素C膀胱灌注预防膀胱肿瘤复发

目的 :观察磁化丝裂霉素C(MMC)和磁场在膀胱灌注预防膀胱癌术后复发中的作用。方法 :40例膀胱癌术后患者为磁化MMC组 ,制作磁化MMC溶液行膀胱灌注 ,膀胱外设置恒定磁场 ;对照组为 30例接受MMC膀胱灌注的膀胱癌术后患者。结果 :磁化MMC组的标准肿瘤复发率为 7.1%,显著低于对照组的 19.3%;膀胱局部副作用发生率为 2 0 .0 %,对照组为 5 6 .7%。结论 :在磁场定位下行膀胱内磁化MMC灌注治疗 ,可减少膀胱癌术后复发率 ,提高化疗的质量。

膀胱癌相关肿瘤标志物的研究进展

膀胱癌在我国是泌尿系统中最常见的恶性肿瘤,膀胱癌相关肿瘤标志物可以用作早期诊断、监测复发及评估预后,因此膀胱癌肿瘤标志物一直是泌尿外科的研究热点。笔者就膀胱癌相关肿瘤标志物的研究进展作一综述。

加速康复外科在经尿道膀胱肿瘤电切术患者围术期中应用研究

目的探讨加速康复外科(enhanced recovery after surgery,EARS)理念应用于经尿道膀胱肿瘤电切术围术期的安全性及有效性。方法将74例患者随机分为传统治疗组37例和EARS治疗组37例,传统治疗组采用传统的治疗方法和护理措施,EARS治疗组应用加速康复外科理念进行治疗和护理。比较两组患者围手术期指标:术后并发症发生率,平均禁食时间、下地时间、尿管留置时间、术后住院天数、住院费用等指标。结果 EARS治疗组平均禁食时间、下地时间、尿管留置时间、术后住院天数、住院费用低于传统治疗组。结论 EARS应用于经尿道膀胱肿瘤电切术的患者护理安全可靠,适宜泌尿外科临床应用。

人类重组肝细胞生长因子影响膀胱癌细胞株生长和抑制丝裂霉素C诱导细胞凋亡的研究

目的 :观察人类重组肝细胞生长因子 (rhHGF)对膀胱移行细胞癌T2 4细胞增殖和丝裂霉素C(MMC)诱导的细胞凋亡的影响。方法 :以T2 4细胞为研究材料 ,用不同浓度rhHGF干预T2 4细胞生长及MMC诱导的细胞凋亡作用。利用MTT实验、流式细胞仪技术来判定rhHGF对细胞增殖和凋亡的影响。结果 :不同浓度rhHGF组间 ,T2 4相对增殖细胞数差异无统计学意义 (P >0 .0 5 ) ;rhHGF预处理后 ,MMC诱导的T2 4细胞凋亡率明显下降 ,在一定范围内有量效关系。结论 :HGF并不显著诱导T2 4细胞增殖 ,而一定剂量范围内的HGF能抑制MMC诱导的细胞凋亡 ,可能与膀胱癌的复发。

三磷酸腺苷法肿瘤药敏检测在膀胱癌化疗中的临床研究

目的:采用三磷酸腺苷法对膀胱癌组织标本进行肿瘤药物敏感筛选,为化疗选择方案确定提供客观依据。方法:80例膀胱癌新鲜标本行原代培养,同时用6种化疗药物进行检测。结果:标本均顺利完成检测,可评估率为100%,单药强敏感率为甲氨蝶呤(15.00%)、阿霉素(37.50%)、丝裂霉素(31.25%)、顺铂(26.25%)、羟基喜树碱(41.25%),吡柔比星(56.25%),不同药物对膀胱癌的敏感程度有差异(P<0.01);不同个体对不同药物的敏感度差异有统计学意义(P<0.01)。结论:不同膀胱癌标本对化疗药物的敏感程度有明显不同,三磷酸腺苷法可为膀胱尿癌的化疗方案确定提供指导作用。