The expression of ras-p21 and p53 protein in inguinal lymph nodes and clinical significance with penile cancer

Objective: The aim of this study was to investigate the expression and clinical significance of ras-p21 and p53 proteins in inguinal lymph nodes with penis carcinoma. Methods: The clinical data of 44 patients of penis (squamous) carcinoma and 40 non-tumor patients from 1990 to 2002 in our hospital were added to our research, 84 inguinal lymph nodes were got by lymph node biopsy from each patient at random. Pathological examination showed that 18 cases of cancer group were metastatic carcinoma as group A, the other 26 cases were inflammatory affection as group B. 20 cases of non-tumor group were nonspecific inflammatory inguinal lymph nodes as group C and the other 20 cases were normal lymph nodes as group D, all the 84 cases in our research were investigated by immunohistochemistry to detect the expression of ras-p21 and p53 protein. Results: Immunohistochemistry demonstrated that the expression of as-p21 and p53 protein were significantly higher in cancer group A (88.89%, 72.22%) and B (30.77%, 23.08%) than in control group C (5%, 0%) and group D (0%, 0%.). The expression of two proteins showed significant differences between group A and group B (P < 0.01), and no significant differences between group B and group C (P > 0.05). The expression of two proteins showed significant difference between group A and control group (C + D) (P < 0.01). The expression of two proteins showed significant differences between cases of cancer groups (A + B) and control groups (C + D) (P < 0.01). Significant differences were showed between group (A + B) and group D with the expression of ras-p21 and p53 (P < 0.01). The expression of ras-p21 and p53 in three different differentiated groups were G1 (well-differentiated) group: (22.73%, 13.64%), G2 (moderate-differentiated) group: (81.25%, 68.75%), G3 (poorly differentiated) group: (100%, 83.33%). There was significant differences between G1 group and G3 group (P < 0.05), and no significant differences between G1 group and G2 group, G2 group and G3 group (P > 0.05). There was significant differences between three clinical stages with the expression of ras-p21 and p53 (P < 0.05). Conclusion: Ras-p21 and p53 protein were highly expressed in cancer groups in this study, while, two proteins hardly detected from control groups. If the inflammatory lymph nodes of penile cancer patients show the positive expression of p21 and p53 protein, the inguinal lymph nodes also need dissection, which is important to improve the diagnosis of inguinal lymph node metastasis rate and patient survival of penile cancer. Ras-p21 and p53 protein detection can act an objective indicator of tumor metastasis and prognosis, and also for our treatment of penile cancer in the inguinal lymph node dissection surgery provides determine indicators.

Histological subtype is a significant predictor for inguinal lymph node metastasis in patients with penile squamous cell carcinoma

The present study aimed to investigate the relationship between histopathological subtype and the probability of inguinal lymph node metastasis （ILNM） in patients with penile squamous cell carcinoma （PSCC）. The clinical records of 198 consecutive patients with PSCC were analyzed retrospectively. Primary lesions were reevaluated according to the 2016 World Health Organization （WHO） histopathological classification. We retrieved the clinicopathological factors from the medical records including age, clinical lymph node stage, pathological tumor stage, lymphatic invasion, and nerve invasion. Uni- and multivariate logistic regression analyses were used to explore the risk factors of ILNM. Multivariate analyses identified clinical lymph node stage （P = 0.000）, pathological tumor stage （P = 0.016）, histologic grade （P = 0.000）, and risk group of histological subtypes （P = 0.029） as independent predictors for ILNM. Compared with the low-risk group of PSCC subtypes, the intermediate- （HR： 3.66, 95% CI. 1.30-10.37, P = 0.021） and high-risk groups （HR： 28.74, 95% Ch 2.37-348.54, P = 0.008） were significantly associated with ILNM. In conclusion, the histopathological subtype of the primary lesion is a significant predictor for ILNM in patients with PSCC.

Superiorly based perforator plus fl ap for inguinal defects

Aim:Inguinal block dissections for metastasis to inguinal lymph nodes and occasionally trauma are always associated with soft tissue loss over the groin region.A clinical study was undertaken to demonstrate the ability to utilize a superiorly-based perforatorflap with reliable vascularity and less donor site morbidity to cover defects in the inguinal region.Methods:A prospective study was performed on 7 patients with inguinal soft tissue defects managed in our institution from January 2013 to September 2013.During the study period,a“superiorly-based perforator plusflap”was used for soft tissue coverage over the femoral vessels in the inguinal region.Hyperbaric oxygen therapy was administered postoperatively.The postoperative period,hospital course,and follow-up after radiotherapy was documented in patients with inguinal block dissection.Results:Seven patients presented with soft tissue defects in the inguinal region.Five of the defects were secondary to prior surgery,and 2 were secondary to trauma.A superiorly-based perforator plusflap was performed in all patients.The defect sizes ranged from 9 cm×4 cm to 17 cm×8 cm.Theflap dimensions ranged from 12 cm×5 cm to 20 cm×10 cm.No secondary procedures were necessary following surgery.Postoperatively,there was no evidence of partial or totalflap loss.Noflap revisions were required,and no complications were experienced at either the donor or recipient site following radiotherapy.Patients were followed-up for 10-18 months.Conclusion:Inguinal defects require stable soft tissue coverage to withstand radiotherapy following inguinal block dissection surgery,and are susceptible to wound complications.The superiorly-based perforator plusflap technique is simple,requires little operative time,and is a reliableflap for coverage of the femoral vessels and inguinal region with improved tolerance to postoperative radiotherapy.