International Urology and Nephrology最新文献

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Comparison between the effect of angiotensin-converting enzyme inhibitors and angiotensin receptor blockers and their combination on mortality in maintenance dialysis patients: a systematic review and meta-analysis.
IF 1.8 4区 医学
International Urology and Nephrology Pub Date : 2024-12-19 DOI: 10.1007/s11255-024-04322-z
Omar Elkoumi, Ahmed Elkoumi, Mariam Khaled Elbairy, Hamza Irfan, Ahmad Beddor, Mostafa Adel T Mahmoud, Omar K Habib, Nada Ibrahim Hendi, Ayah Abdulgadir, Bandar Alawlaqi, Sarah Hamed, Ahmed K Ghanem
{"title":"Comparison between the effect of angiotensin-converting enzyme inhibitors and angiotensin receptor blockers and their combination on mortality in maintenance dialysis patients: a systematic review and meta-analysis.","authors":"Omar Elkoumi, Ahmed Elkoumi, Mariam Khaled Elbairy, Hamza Irfan, Ahmad Beddor, Mostafa Adel T Mahmoud, Omar K Habib, Nada Ibrahim Hendi, Ayah Abdulgadir, Bandar Alawlaqi, Sarah Hamed, Ahmed K Ghanem","doi":"10.1007/s11255-024-04322-z","DOIUrl":"https://doi.org/10.1007/s11255-024-04322-z","url":null,"abstract":"<p><strong>Introduction: </strong>Patients undergoing maintenance dialysis have a higher mortality rate compared to the general population. It is known that angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) have protective effects on the kidney; however, few studies have directly compared their impact on mortality in patients undergoing dialysis. This study aims to evaluate the effectiveness of ACEIs, ARBs, or their combination in reducing all-cause and cardiovascular mortality in maintenance dialysis patients.</p><p><strong>Methods: </strong>We systematically searched PubMed, Cochrane Central, Web of Science (WOS), and Scopus databases from inception until August 23rd, 2024. We included all observational studies and clinical trials that assessed the effectiveness of ACEIs versus ARBs or their combination on mortality outcomes, in patients with CKD on maintenance dialysis. We used Review Manager 5.4 for all statistical analyses.</p><p><strong>Results: </strong>Five observational studies, including 126,612 patients, met the eligibility criteria and were included in the final analysis. Among all patients, no statistically significant difference was found between ACEIs and ARBs in reducing all-cause mortality (RR: 1.12, 95% CI [0.98, 1.27], P = 0.10) or cardiovascular mortality (RR: 1.10, 95% CI [0.92, 1.33], P = 0.30). In patients on hemodialysis, ARBs were associated with a statistically significant reduction in cardiovascular mortality (P < 0.0001).</p><p><strong>Conclusion: </strong>Our results suggest no differences between ACEIs and ARBs in reducing all-cause or cardiovascular mortality in maintenance dialysis patients. However, ARBs may reduce cardiovascular mortality more effectively in hemodialysis patients. Conducting randomized controlled clinical trials to validate our results is warranted.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Efficacy and safety of tenapanor vs placebo in treating CKD patients on dialysis and with hyperphosphatemia: a systematic review and meta-analysis of 2251 patients.
IF 1.8 4区 医学
International Urology and Nephrology Pub Date : 2024-12-19 DOI: 10.1007/s11255-024-04316-x
Ahmed A Abo Elnaga, Ibrahim Serag, Mohamed A Alsaied, Basma Badrawy Khalefa, Jaisingh Rajput, Shrouk Ramadan, Abdelrahman M Elettreby
{"title":"Efficacy and safety of tenapanor vs placebo in treating CKD patients on dialysis and with hyperphosphatemia: a systematic review and meta-analysis of 2251 patients.","authors":"Ahmed A Abo Elnaga, Ibrahim Serag, Mohamed A Alsaied, Basma Badrawy Khalefa, Jaisingh Rajput, Shrouk Ramadan, Abdelrahman M Elettreby","doi":"10.1007/s11255-024-04316-x","DOIUrl":"https://doi.org/10.1007/s11255-024-04316-x","url":null,"abstract":"<p><strong>Background: </strong>Hyperphosphatemia is common in chronic kidney disease (CKD) patients, especially patients on hemodialysis. Tenapanor is a novel drug with fewer side effects and high compliance compared to traditional phosphate binders. We conducted a systematic review and meta-analysis to evaluate the efficacy and safety of tenapanor.</p><p><strong>Methods: </strong>A comprehensive search was conducted on PubMed, Scopus, Web of Science, and Cochrane Library, from inception to June 25, 2024. Nine randomized controlled trials (RCTs) and three single-arm studies comparing tenapanor to placebo were included. By adopting a random-effect empirical Bayes model, STATA and RevMan were used to pool dichotomous and continuous data. The primary outcome assessed was serum phosphate. Secondary outcomes included intact parathyroid hormone (iPTH), serum calcium, potassium, and sodium, bowel movement frequency, stool consistency using BSFS score and safety outcomes.</p><p><strong>Results: </strong>Twelve studies with a total of 2,251 patients were included. Tenapanor was superior to placebo in reducing phosphate at all assessed end points, week 1 (MD = -1.28 mg/dL, P < 0.001), week 2 (MD = -1.07 mg/dL, P < 0.001), week 3 (MD = -1.22 mg/dL, P < 0.001), and week 4 (MD = -0.91 mg/dL, P < 0.001). In addition, iPTH was almost statistically significantly lower in the tenapanor group (MD = -36.53 ng/L, P = 0.07). Moreover, it led to a statistically significant reduction in sodium level (MD = -0.7 mmol/L, P = 0.0003). On the contrary, tenapanor had no statistically significant effect on calcium or potassium levels. Bowel movement frequency and stool consistency were significantly higher in the tenapanor group at all assessed end points. Regarding safety analysis, diarrhea and nausea were statistically significantly higher in the tenapanor group, (RR = 3.71, P < 0.001) and (RR = 1.97, P < 0.001), respectively. There were no significant differences in other adverse events.</p><p><strong>Conclusion: </strong>Based on our meta-analysis, tenapanor can effectively reduce serum phosphate, iPTH, and sodium. Additionally, it improves bowel movement frequency and stool consistency. However, it is associated with a higher risk of GIT symptoms that should be considered and managed during treatment. We recommend conducting further RCTs to perform head-to-head comparisons against other active comparators such as phosphate binders.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Beyond blood pressure: identifying factors associated with rapid kidney function decline in patients with CKD and coexisting COPD.
IF 1.8 4区 医学
International Urology and Nephrology Pub Date : 2024-12-19 DOI: 10.1007/s11255-024-04325-w
Areti Georgiou, Marieta Theodorakopoulou, Fotini Iatridi, Pantelis Sarafidis
{"title":"Beyond blood pressure: identifying factors associated with rapid kidney function decline in patients with CKD and coexisting COPD.","authors":"Areti Georgiou, Marieta Theodorakopoulou, Fotini Iatridi, Pantelis Sarafidis","doi":"10.1007/s11255-024-04325-w","DOIUrl":"https://doi.org/10.1007/s11255-024-04325-w","url":null,"abstract":"","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142853950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Assessing the outcomes of subinguinal microsurgical varicocelectomy: pulling technique compared to the conventional method.
IF 1.8 4区 医学
International Urology and Nephrology Pub Date : 2024-12-18 DOI: 10.1007/s11255-024-04326-9
Muhammet Fırat Özervarlı, Ahmet Halil Sevinç, Samet Şenel, Yavuz Karaca, Yasin Ateş, Seyfettin Anıl Tantekin, Rıfat Burak Ergül, Reşat Aydın, Yaşar Pazır, Murat Dursun, Ateş Kadıoğlu
{"title":"Assessing the outcomes of subinguinal microsurgical varicocelectomy: pulling technique compared to the conventional method.","authors":"Muhammet Fırat Özervarlı, Ahmet Halil Sevinç, Samet Şenel, Yavuz Karaca, Yasin Ateş, Seyfettin Anıl Tantekin, Rıfat Burak Ergül, Reşat Aydın, Yaşar Pazır, Murat Dursun, Ateş Kadıoğlu","doi":"10.1007/s11255-024-04326-9","DOIUrl":"https://doi.org/10.1007/s11255-024-04326-9","url":null,"abstract":"<p><strong>Introduction: </strong>The positive effect of varicocelectomy on sperm parameters (sperm morphology, concentration, motility) and fertility and pregnancy rates has been proven. Although various techniques have been defined for varicocele treatment, varicocelectomy with the pulling technique was first defined in 2017. The aim of this retrospective study is to compare the effectiveness and reliability of subinguinal microsurgical varicocelectomy with the \"pulling\" technique and conventional subinguinal varicocelectomy.</p><p><strong>Methods: </strong>A total of 841 patients who underwent subinguinal microsurgical varicocelectomy using the \"pulling\" or conventional technique between January 2015 and January 2024 were examined retrospectively. Patients with missing and/or inaccessible data, who were using empirical treatments, were excluded from the study. Demographic data, laboratory and imaging results, and peroperative and postoperative 3rd and 6th month semen analysis results of the remaining 231 patients were evaluated.</p><p><strong>Results: </strong>The mean age of 231 patients who underwent varicocelectomy was 31.1 ± 5.5 years. 202 of the patients (87.4%) were primary infertile. Conventional technique was applied to 124 (53.7%) of the 231 patients, while pulling technique was applied to 107 (46.3%) patients. No significant difference was found between the demographic and clinical data of the patients. The median number of ligated pampiniform plexus veins in the patient group who underwent pulling technique was statistically significantly less than that in the patient group that underwent the conventional method (4 vs 5, p = 0.03). In all patients who underwent varicocelectomy, semen volume, spermatozoa concentration, and progressive motile spermatozoa proportion increased significantly in the postoperative period (p = 0.002, p = 0.006, p = 0.001, respectively). No significant change was found in the proportion of spermatozoa with normal morphology (p = 0.617). The changes in semen analysis data from the preoperative period to the third and sixth postoperative months after varicocelectomy with conventional and pulling techniques were compared. No significant difference was found between the two techniques.</p><p><strong>Conclusion: </strong>Subinguinal microsurgical varicocelectomy with the \"pulling\" technique may be a safe and effective treatment option with fewer vein ligations compared to the standard surgical method.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Effect of three-drug single-pill antihypertensive combinations in patients with uncontrolled hypertension.
IF 1.8 4区 医学
International Urology and Nephrology Pub Date : 2024-12-17 DOI: 10.1007/s11255-024-04323-y
Xuan Zhao, Shamikha Cheema, Muhammad Shaheer Bin Faheem, Muhammad Ahmad Abbasi, Farhan Ahmed
{"title":"Effect of three-drug single-pill antihypertensive combinations in patients with uncontrolled hypertension.","authors":"Xuan Zhao, Shamikha Cheema, Muhammad Shaheer Bin Faheem, Muhammad Ahmad Abbasi, Farhan Ahmed","doi":"10.1007/s11255-024-04323-y","DOIUrl":"https://doi.org/10.1007/s11255-024-04323-y","url":null,"abstract":"","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142836633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Etiology of panurethral strictures in a low socioeconomic status population.
IF 1.8 4区 医学
International Urology and Nephrology Pub Date : 2024-12-17 DOI: 10.1007/s11255-024-04328-7
Kunj Jain, Radhika Patel, Aleksandar Popovic, Meher Pandher, Amjad Alwaal
{"title":"Etiology of panurethral strictures in a low socioeconomic status population.","authors":"Kunj Jain, Radhika Patel, Aleksandar Popovic, Meher Pandher, Amjad Alwaal","doi":"10.1007/s11255-024-04328-7","DOIUrl":"https://doi.org/10.1007/s11255-024-04328-7","url":null,"abstract":"<p><strong>Introduction: </strong>Panurethral strictures represent the most severe form within the anterior urethral stricture spectrum, requiring more technically complex repairs and resulting in poorer outcomes compared to localized anterior urethral strictures (penile or bulbar). This abstract aims to describe the distinct characteristics of patients with panurethral strictures in a low socioeconomic status population.</p><p><strong>Methods: </strong>Patients presenting with localized anterior (penile or bulbar) or panurethral strictures at University Hospital in Newark, NJ, between 2021 and 2023 were retrospectively identified. Data were extracted from electronic medical records and analyzed statistically using IBM SPSS Software.</p><p><strong>Results: </strong>Among the patients, 33 had localized anterior urethral strictures, and 22 had panurethral stricture disease. Hispanic and African American patients accounted for the majority of stricture cases (63.6%), including 59% of the panurethral stricture cohort. The only statistically significant factor contributing to panurethral disease was lichen sclerosis (p < 0.05). Patients with panurethral strictures had a higher incidence of inflammatory and systemic diseases such as STDs, recurrent UTIs, diabetes, and hypertension, while those with localized anterior urethral strictures showed a higher incidence of iatrogenic factors, including prior catheterizations and transurethral surgeries. However, these factors did not reach a statistical significance. Hypospadias repair was observed in 6% of localized anterior urethral stricture cases, compared to 13.6% of panurethral stricture cases.</p><p><strong>Conclusion: </strong>While iatrogenic causes remain the predominant contributors, inflammatory and systemic conditions, particularly lichen sclerosis, significantly influence the development of panurethral strictures. Early surgical intervention and better management of systemic diseases may prevent the progression of localized anterior urethral strictures to panurethral disease, but further studies utilizing larger number of patients may shed light on the significance of these systemic factors.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142836645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Pyeloduodenal fistula: a review of the current literature. 十二指肠瘘:现有文献综述。
IF 1.8 4区 医学
International Urology and Nephrology Pub Date : 2024-12-17 DOI: 10.1007/s11255-024-04327-8
K Spanggaard, N K Hvid, M Diatchikhine, T H Olesen, L Lund
{"title":"Pyeloduodenal fistula: a review of the current literature.","authors":"K Spanggaard, N K Hvid, M Diatchikhine, T H Olesen, L Lund","doi":"10.1007/s11255-024-04327-8","DOIUrl":"https://doi.org/10.1007/s11255-024-04327-8","url":null,"abstract":"<p><strong>Purpose: </strong>Pyeloduodenal fistula (PDF) is a communication between the renal pelvis and the duodenum. It is often secondary to other diseases. It is a rare condition and therefore infrequently described in the literature. The aim is to present a review of the current literature on PDF and to give an update of its aetiology, symptoms, investigations and treatments.</p><p><strong>Methods: </strong>Pubmed, Cochrane Library and Embase were used to search for existing literature in English and Scandinavian languages with available abstracts in the period Jan 2000-Dec 2023.</p><p><strong>Results: </strong>No meta-analysis or reviews were found. In total, 24 original articles were found, including 25 cases all in all of both traumatic and spontaneous pyeloduodenal fistulas. Only four cases (15%) represented traumatic pyeloduodenal fistulas, and all of the spontaneous cases involved the right kidney and occurred due to calculi and pyonephrosis in 81% and 76% of the cases, respectively. Fever and flank pain were reported in 67% and 57% of the cases, respectively. Diagnosis was done by a CT urography or antegrade pyelography in 80% of the cases. More than 50% of all cases were managed by nephrectomy. Total parenteral nutrition (TPN) was administered alongside the nephrectomy in 28% of all cases.</p><p><strong>Conclusion: </strong>A pyeloduodenal fistula often involves the right kidney and often occurs as a result of chronic renal inflammatory disease. The fistulas are most efficiently diagnosed with a CT scanning with contrast or retrograde pyelography. The most frequently used management of pyeloduodenal fistula is nephrectomy after closure of the duodenum with somatostatin and TPN.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142836648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Research progress of traditional Chinese medicines in regulating acute kidney injury-related ferroptosis: a literature review. 中药调节急性肾损伤相关铁中毒的研究进展:文献综述。
IF 1.8 4区 医学
International Urology and Nephrology Pub Date : 2024-12-16 DOI: 10.1007/s11255-024-04302-3
Tao Peng, Mingquan Li
{"title":"Research progress of traditional Chinese medicines in regulating acute kidney injury-related ferroptosis: a literature review.","authors":"Tao Peng, Mingquan Li","doi":"10.1007/s11255-024-04302-3","DOIUrl":"https://doi.org/10.1007/s11255-024-04302-3","url":null,"abstract":"<p><p>Ferroptosis plays a significant role in the pathological mechanism of acute kidney injury (AKI) for many etiologies. The characteristics of ferroptosis involve many aspects, including iron metabolism, lipid metabolism, and glutathione metabolism. In terms of iron metabolism, ferroptosis involves the accumulation of labile iron; in terms of lipid metabolism, ferroptosis involves the peroxidation of lipids, especially certain phospholipids; in terms of glutathione metabolism, ferroptosis involves the reduction of reduced glutathione (GSH) levels, leading to a decrease in the activity of glutathione peroxidase 4 (GPX4). A lot of traditional Chinese medicines (TCMs) have been reported to have a protective effect against AKI, and many of these TCMs have shown a close association with regulating ferroptosis in ameliorating AKI. While the mechanisms through which these TCMs regulate ferroptosis associated with AKI are intricate, many of their targets are linked to the inhibition of lipid peroxidation or the regulation of iron metabolism. This article discusses some aspects of AKI and ferroptosis, and reviews some research progress on the regulation of AKI-related ferroptosis by TCMs.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142828548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
PLAP expression is linked to invasive tumor growth in urothelial carcinoma of the bladder. PLAP 的表达与膀胱尿路上皮癌的浸润性肿瘤生长有关。
IF 1.8 4区 医学
International Urology and Nephrology Pub Date : 2024-12-16 DOI: 10.1007/s11255-024-04319-8
Henning Plage, Kira Furlano, Sebastian Hofbauer, Florian Roßner, Simon Schallenberg, Sefer Elezkurtaj, Maximilian Lennartz, Andreas Marx, Henrik Samtleben, Margit Fisch, Michael Rink, Marcin Slojewski, Krystian Kaczmarek, Thorsten Ecke, Tobias Klatte, Stefan Koch, Nico Adamini, Sarah Minner, Ronald Simon, Guido Sauter, Joachim Weischenfeldt, Thorsten Schlomm, David Horst, Henrik Zecha, Martina Kluth, Sarah Weinberger
{"title":"PLAP expression is linked to invasive tumor growth in urothelial carcinoma of the bladder.","authors":"Henning Plage, Kira Furlano, Sebastian Hofbauer, Florian Roßner, Simon Schallenberg, Sefer Elezkurtaj, Maximilian Lennartz, Andreas Marx, Henrik Samtleben, Margit Fisch, Michael Rink, Marcin Slojewski, Krystian Kaczmarek, Thorsten Ecke, Tobias Klatte, Stefan Koch, Nico Adamini, Sarah Minner, Ronald Simon, Guido Sauter, Joachim Weischenfeldt, Thorsten Schlomm, David Horst, Henrik Zecha, Martina Kluth, Sarah Weinberger","doi":"10.1007/s11255-024-04319-8","DOIUrl":"https://doi.org/10.1007/s11255-024-04319-8","url":null,"abstract":"<p><strong>Purpose: </strong>Placental alkaline phosphatase (PLAP) is a protein with a poorly understood function that is normally only expressed in the placenta. In cancer, PLAP expression is a hallmark of germ cell neoplasms, but it can also occur in urothelial carcinoma. To evaluate the potential clinical significance of PLAP expression in bladder cancer, METHODS: PLAP protein was analyzed by immunohistochemistry in more than 2500 urothelial bladder carcinomas in a tissue microarray format.</p><p><strong>Results: </strong>PLAP staining was absent in normal urothelial cells but was observed in 15.9% of urothelial carcinomas, including 282 (11.5%) with weak, 57 (2.3%) with moderate, and 51 (2.1%) with strong staining. PLAP positivity occurred in 4.1% of 413 pTa G2 low-grade, 10.2% of 176 pTa G2 high-grade, and 7.2% of 97 pTa G3 tumors (p = 0.0636). As compared to pTa tumors, the PLAP positivity rate was markedly higher in 1341 pT2-4 carcinomas (19.8%, p < 0.0001). Within pT2-4 carcinomas, PLAP staining was unrelated to pT, pN, grade, L-status, V-status, overall survival, recurrence-free survival, and cancer-specific survival (p > 0.25). However, PLAP positivity was linked to p16 positivity (p = 0.0185), GATA3 positivity (p < 0.0001), and p63 expression loss (p = 0.0456).</p><p><strong>Conclusion: </strong>In summary, these data show that PLAP is expressed in a significant fraction of pT2-4 urothelial carcinomas, unrelated to cancer aggressiveness but associated with specific molecular features. Once anti-PLAP cancer drugs become effective, urothelial carcinoma is a candidate tumor entity for clinical evaluation.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142828544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Deep learning-based prediction of tumor aggressiveness in RCC using multiparametric MRI: a pilot study.
IF 1.8 4区 医学
International Urology and Nephrology Pub Date : 2024-12-13 DOI: 10.1007/s11255-024-04300-5
Guiying Du, Lihua Chen, Baole Wen, Yujun Lu, Fangjie Xia, Qian Liu, Wen Shen
{"title":"Deep learning-based prediction of tumor aggressiveness in RCC using multiparametric MRI: a pilot study.","authors":"Guiying Du, Lihua Chen, Baole Wen, Yujun Lu, Fangjie Xia, Qian Liu, Wen Shen","doi":"10.1007/s11255-024-04300-5","DOIUrl":"https://doi.org/10.1007/s11255-024-04300-5","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the value of multiparametric magnetic resonance imaging (MRI) as a non-invasive method to predict the aggressiveness of renal cell carcinoma (RCC) by developing a convolutional neural network (CNN) model and fusing it with clinical characteristics.</p><p><strong>Methods: </strong>Multiparametric abdominal MRI was performed on 47 pathologically confirmed RCC patients between 2019 and 2023. Preoperative MRI was performed on all patients to assess their clinical characteristics. The CNN model was developed and validated to assess the predictive value of b value images, combined b value images, apparent diffusion coefficient (ADC), intravoxel incoherent motion (IVIM), diffusion kurtosis imaging (DKI), and their parametric maps for RCC aggressiveness. The least absolute shrinkage and selection operator (LASSO) regression was used to identify clinical features highly correlated with RCC aggressiveness. These clinical features were combined with selected b values to develop a fusion model. All models were evaluated using receiver operating characteristic (ROC) curve analysis.</p><p><strong>Results: </strong>A total of 47 patients (mean age, 56.17 ± 1.70 years; 37 men, 10 women) were evaluated. LASSO regression identified renal sinus/perirenal fat invasion, tumor stage, and tumor size as the most significant clinical features. The combined b values of b = 0,1000 achieved an area under the curve (AUC) of 0.642 (95% CI: 0.623-0.661), and b = 0,100,1000 achieved an AUC of 0.657 (95% CI: 0.647-0.667). The fusion model combining clinical features with b = 0,1000 yielded the highest performance with an AUC of 0.861 (95% CI: 0.667-0.992), demonstrating superior predictive accuracy compared to the other models.</p><p><strong>Conclusion: </strong>Deep learning using a CNN fusion model, integrating multiple b value images and clinical features, could effectively promote the preoperative prediction of tumor aggressiveness in RCC patients.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142818161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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