斯钙素1在肾细胞癌患者外周血清中的表达及临床意义

目的检测斯钙素1（stanniocalcin1,STC1）在肾细胞癌患者外周血清中的表达情况,探讨STC1在判断肾细胞癌预后中的临床意义。 方法收集50例肾细胞癌患者术前外周血清（试验组）和同期50 例正常人群外周血清（对照组）,通过实时荧光定量-聚合酶链反应（real-time polymerase chain reaction,Real-time PCR）和酶联免疫吸附法(enzyme-linked immunosorbent assay,ELISA)检测2组外周血清中STC1在基因和蛋白水平表达情况,并结合患者临床病理特征进行分析,通过Kaplan-Meier方法描制生存曲线和log-rank检验生存差异。 结果试验组患者血清STC1在基因和蛋白水平表达均较对照组升高（P＜0.01）,STC1高表达与肾细胞癌患者出现临床症状、肿瘤分化差、伴坏死、临床分期晚及出现淋巴转移和远处转移等密切相关（P＜0.05）,STC1高表达患者预后较差。 结论STC1 在肾细胞癌患者血清中高表达,外周血STC1基因表达水平与肾细胞癌患者的临床病理参数及不良预后密切相关,STC1升高可能对于肾细胞癌患者判断预后有一定临床价值。     

膀胱孤立性纤维性肿瘤一例报告

患者,男,50岁.因无痛性终末肉眼血尿6 d于2008年10月15日入院.查体:耻骨上区轻压痛.尿红细胞(+++),蛋白(+).B超检查示膀胱右侧壁占位.CT检查示膀胱右侧壁6.0 cm×7.0 cm×7.5 cm肿块,肿块突入膀胱腔,怀疑膀胱癌;盆腔未见肿大淋巴结,双侧输尿管及肾脏未见积水.     

预防经尿道前列腺增生症电切术中出血的措施

我科自2002年12月至2011年5月,经尿道前列腺电切术(TURP)共348例,成功经验告诉我们对防止和减少术中出血有显著作用,能有效降低手术操作难度和风险,疗效满意,供同道探讨.     

根治性经尿道汽化电切术治疗浸润性膀胱癌的探讨

目的 探讨根治性经尿道膀胱肿瘤汽化电切术治疗浸润性膀胱癌的疗效.方法 2008年2月至2010年2月对36例浸润性膀胱癌患者,施行了根治性经尿道膀胱肿瘤汽化电切术,手术参照根治性经尿道膀胱肿瘤电切术原则,肿瘤部位切除至膀胱外脂肪层.术后给予卡介苗膀胱灌注治疗,随访3～24个月.结果 2年内复发12例,复发率33.3%(12/36),对复发者再次行经尿道膀胱肿瘤汽化电切术.2年内死亡6例,病死率16.7%(6/36).结论 对年老体弱不能耐受或不愿意接受膀胱全切的浸润性膀胱癌患者可施行根治性经尿道膀胱肿瘤汽化电切术,以达到延长生命,提高生活质量的目的.

Abstract：

Objective To assess the efficacy of radical transurethral electrovaporization for invasive bladder cancer. Methods Thirty-six patients with invasive bladder cancer from february 2008 to February 2010 were treated by transurethral electrovaporization resection of bladder tumor (TURBT). The operation procedure was based upon the principle of radical transurethral resection for bladder tumor. The tumor was resected to fatty layer outside the bladder wall. After operation Bacillus Calmette-Guerin (BCG) irrigation of bladder was given,all patients were followed up for 3 to 24 months. Results The recurrence occurred in 12 cases in 2 years,with a recurrence rate of 33. 3% (12/36). These recurrence cases were treated with TURBT again. Six cases dead in 2 years,with a mortality of 16. 7% (6/36). Conclusion TURBT is suitable for those who are older or weak,and not medically fit for radical cystectomy or those who refuse the open surgery,which can prolong the survival time and improve the quality of life.     

斯钙素2在肾细胞癌患者外周血清中的表达及临床意义

目的 探讨斯钙素2 (stanniocalcin 2,STC2)在肾细胞癌(renal cell carcinoma,RCC)患者外周血清中的表达及其临床意义.方法 通过荧光实时定量-聚合酶链反应(real time-polymerase chain reaction,real time-PCR)和酶联免疫吸附法(enzyme-linked immunosorbent assay,ELISA)检测60例肾细胞癌患者(RCC组)和60例正常人群(对照组)血清中STC2基因和蛋白水平表达,并结合患者临床病理参数及生存情况进行预后分析.结果 RCC组患者血清中STC2在基因和蛋白水平表达均较对照组升高(P＜0.001),外周血清STC2基因高表达者更多见于出现血尿、腰痛及腹部肿块等临床表现、肿瘤WHO/ISUP分级高、AJCC临床分期晚及出现淋巴转移和远处转移RCC患者(P＜0.001),STC2低表达RCC组患者总体生存期长于高表达者(P＞0.05).结论 RCC组患者血清中STC2表达升高,术前外周血STC2高表达RCC患者预后较差,STC2有望成为RCC患者新的预后判断指标.     

盆腔韧带样型纤维瘤病致右侧输尿管狭窄1例报告

韧带样型纤维瘤病是一种罕见的呈浸润性生长的良性肿瘤,可发生于全身各处,多见于腹壁、腹内及骨骼肌内,但累及泌尿系统周围者罕见。本文报道1例盆腔韧带样型纤维瘤病致右侧输尿管狭窄患者,行盆腔肿物切除术＋回盲部切除术＋输尿管膀胱再植术,术后随访18个月,无局部复发和远处转移。     

The Expression and Implication of TRPV5,Calbindin-D28k and NCX1 in Idiopathic Hypercalciuria

The expression of calcium epithelium TRPV5, alcium binding protein Calbindin-D28k and Na＋/Ca2＋ exchanger NCX1 was detected in renal distal convoluted tubule, and their effects on urine calcium reabsorption and the possible pathogenic mechanism in idiopathic hypercalciuria （IH） were investigated. Genetic hypercalciuric stone-forming （GHS） rats were chosen as animal models to study urine calcium reabsorption and IH. The cognate female and male rats that had maximal urine calcium were matched to breed next generation. Twelve GHS rats and 12 normal control （NC） SD rats were selected. Western blot and real time quantitative PCR were used to detect the protein and gene expression of TRPV5, Calbindin-D28k and NCX1 respectively. The expression levels of TRPV5 protein and mRNA in GHS rats were significantly lower than in NC rats （P〈0.05）. Western blot revealed that the expression levels of Calbindin-D28k in GHS rats and NC rats were 0.49±0.02 and 0.20±0.01 respectively, with the difference being significant between them （P〈0.05）. By using real time quantitative PCR, it was found that there was no significant difference in Calbindin-28k mRNA expression levels between GHS rats and NC rats （P〉0.05）. There was no significant differ- ence in the NCX1 expression between GHS rats and NC rats （P〉0.05）. It was suggested that TRPV5 and Calbindin-D28k might play an important role in urine calcium reabsorption and IH, but they dif- ferently contributed to the pathogenesis： The down-regulation of TRPV5 decreases urine calcium reabsorption, directly leading to loss of the urine calcium and resulting in hypercalciuria, and the increased Calbindin-D28k expression could relieve, neutralize and decrease intracellular Ca2＋ concentration to maintain calcium balance. NCX1 is not the key protein in urine calcium reabsorption.     

阴囊富于细胞性血管纤维瘤一例报告

患者,52岁.因左侧阴囊肿物伴坠胀不适1年于2010年5月5日入院.查体:左侧阴囊可触及6.0 cm×5.0 cm×4.0 cm大小肿物,质韧,无压痛,与睾丸附睾界限尚清,透光试验阴性.阴囊彩色多普勒超声检查示左侧睾丸下方可探及一大小5.6 cm ×5.6 cm ×3.9 cm的不均匀中低回声团,其内可探及条索状血流信号.蛛网膜下腔阻滞麻醉下行左侧阴囊肿物探查术.术中见阴囊一类球形5.5 cm×5.5 cm ×4.0 cm大小肿物,有完整包膜,与睾丸上端、附睾及精索有粘连,分离粘连组织,将肿物完整切除.病理检查:切面呈灰白色,质地柔韧,境界清楚.     

肾混合性上皮间质瘤二例并文献复习

肾混合性上皮间质瘤(mixed epithelial and strorealtumor of the kidney,MESTK)好发于绝经期前中年女性,是临床少见的肾脏肿瘤,男性罕见.近年来,文献报道极少数MESTK具有复发及潜在恶变的特征[1],2005-2013 年我们收治2 例特殊的MESTK 患者,1 例术后2年复发,另1例为男性患者,现报道如下: