Benign Urological Diseases Research Articles

Role of circular RNAs (CircANXA2 and CircFBXW7) in bladder cancer

BackgroundThe most prevalent malignancy in the urinary tract is bladder cancer, which is becoming more commonplace globally. Circular RNAs, or circRNAs, have a role in cancer pathogenesis as they can be used as biomarkers to help identify new cases and predict the likelihood of recurrence. The current work examined the gene expression of CircANXA2 and CircFBXW7 and evaluated their potential utility in bladder cancer diagnosis.Subjects and methodologySeventy people with benign urologic diseases, seventy people with bladder cancer, and seventy healthy controls participated in the study. The polymerase chain reaction in real time quantified the gene expressions of CircANXA2 and CircFBXW7.ResultsCompared to the benign group and controls, bladder cancer patients had significantly greater levels of CircANXA2 expression (p < 0.001). In contrast to the benign group and controls, bladder cancer patients had significantly decreased levels of CircFBXW7 expression (p < 0.001). CircANXA2 and CircFBXW7 have comparable sensitivity and specificity; CircANXA2 had sensitivity, and specificity (77.14% and 76.43) and CircFBXW7 had sensitivity, and specificity (80.0% and 70.0%) respectively in detecting bladder cancer. CircANXA2 and CircFBXW7 were found to be the risk variables for bladder cancer using multivariate analysis. The odds ratios (OR) for CircANXA2 and CircFBXW7 were 1.240 (1.135–1.354) and 0.026 (0.006–0.107), in that order. In conclusion, CircANXA2 and CircFBXW7 may be highly specific and sensitive diagnostic markers for bladder cancer.

Assessment of interleukin 17A and 23 in the course of bladder cancer and selected benign urological diseases.

Several cytokines have been indicated to be significantly involved in urological diseases. Interleukin 17A (IL-17A) and interleukin 23 (IL-23) have recently received attention for their involvement in inflammatory diseases and cancers. The aim of the study was to show changes in the level of pro-inflammatory interleukins IL-17A and IL-23 in patients with bladder cancer (BC) and selected urological diseases. An important cognitive aspect was to study the interdependencies between the studied interleukins and to assess their diagnostic value for such diseases. The material for the study was urine sample from patients with BC, urinary tract infection (UTI), urolithiasis, benign prostatic hyperplasia (BPH), US (urethral stricture), which was compared to the urine sample of healthy people without urological disorders. Interleukin concentrations were measured by the immunoenzymatic method. The levels of IL-17A and IL-23 in the urine of patients with BC, UTI, BPH and US were significantly higher compared to the control group. Statistically significant differences were found in the level of both interleukins compared to the control group in all diseases except urolithiasis. IL-17A and IL-23 correlated with each other in patients with all urological diseases except urolithiasis. The results of the conducted studies showed that selected urological diseases changed the levels of IL-17A and IL-23 in the urine of patients. The observations made confirmed the participation of these interleukins in the course of the urological diseases, especially in BC, and allowed to classify them as potentially useful parameters for diagnostic purposes.

Benign urologic diseases that cause hematuria

Background: Hematuria is defined by the presence of red blood cells in the urine, usually treated by primary care physicians. Various urologic conditions cause this common finding. While malignancies are often considered in the differential diagnosis, benign urologic conditions also need to be recognized as potential causes of hematuria. A better understanding of these benign conditions can help avoid unnecessary diagnostic procedures and improve patient outcomes.Current Concepts: This review provides an overview of the current concepts regarding benign urologic conditions associated with hematuria. These include urinary tract infections, urolithiasis, benign prostatic hyperplasia, vascular conditions affecting the urinary tract, and hemorrhagic cystitis. Based on the latest literature, we discuss the epidemiology, clinical presentation, diagnostic evaluation, and management options for each benign condition.Discussion and Conclusion: Clinical presentation, diagnostic evaluation, and management of each condition are discussed. A comprehensive understanding of these benign urologic conditions is essential for accurately diagnosing and effectively managing hematuria.

PD32-11 IMPACT OF SOCIAL DETERMINANTS OF HEALTH ON CARE OF URETHRAL STRICTURES: A PILOT EVALUATION OF THE AREA DEPRIVATION INDEX

You have accessJournal of UrologyCME1 Apr 2023PD32-11 IMPACT OF SOCIAL DETERMINANTS OF HEALTH ON CARE OF URETHRAL STRICTURES: A PILOT EVALUATION OF THE AREA DEPRIVATION INDEX Evan Watkins, Abimbola Ayangbesan, George Koch, Rohan Bhalla, Jackson Cabo, Helen Gambrah, Theresa Zwaschka, and Niels Johnsen Evan WatkinsEvan Watkins More articles by this author , Abimbola AyangbesanAbimbola Ayangbesan More articles by this author , George KochGeorge Koch More articles by this author , Rohan BhallaRohan Bhalla More articles by this author , Jackson CaboJackson Cabo More articles by this author , Helen GambrahHelen Gambrah More articles by this author , Theresa ZwaschkaTheresa Zwaschka More articles by this author , and Niels JohnsenNiels Johnsen More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003325.11AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Living in socioeconomically disadvantaged neighborhoods affects health behaviors and outcomes. How neighborhood disadvantage impacts care of benign urologic disease has not been previously studied. In this pilot study, we sought to evaluate how patient-level social risk determinants impact care of urethral stricture patients. METHODS: Patients treated with urethroplasty between 9/4/2019 and 12/29/2021 were analyzed. Those with a history of urethroplasty and under the age of 18 were excluded. To evaluate neighborhood disadvantage, we used the area deprivation index (ADI), a 17-component index composed of education, employment, housing-quality, and poverty measures utilizing data from the American Community Survey. Patient addresses were geocoded and assigned a national ADI rank, with scores normalized to a percentile from 0 to 100, with higher numbers representing higher levels of disadvantage. For this analysis, patients were grouped into ADI quartiles. Multiple endoscopic procedures was defined as >2 procedures prior to urethroplasty. Impact of ADI on treatment and processes of care was analyzed utilizing univariate and multivariate models. RESULTS: 104 patients were included, with a median age 54.5 (IQR 38, 66) and ADI of 63.5 (IQR 38.8, 79.3). When separated into quartiles, 15.4%, 21.2%, 31.7% and 31.7% were in the first, second, third and fourth ADI quartiles, respectively, with higher quartiles representing increased levels of deprivation. There were no significant differences in race or insurance status by ADI quartile. Patients in the highest ADI quartile underwent significantly more endoscopic procedures prior to urethroplasty than those in the lowest, at 0 (0, 1) versus 2 (1, 4) (p=0.01). On multivariate analysis adjusting for age and insurance status, ADI quartile was associated with an increased likelihood of undergoing multiple endoscopic procedures, with OR 4.97 (95% CI 1.22-26.14) and OR 5.05 (95% CI 1.23 – 26.53) for third and fourth quartiles, respectively. A one-point increase in ADI was associated with a 2% increased risk of repeat endoscopic procedures prior to urethroplasty (OR 1.02 [95% CI 1.01 – 1.04]). CONCLUSIONS: This is the first analysis evaluating how a patient’s physical neighborhood can mediate processes of care for urethral stricture disease. We found that increased neighborhood deprivation, regardless of race or insurance status, can lead to increased endoscopic treatments and delays to urethroplasty. Utilization of this methodology can help further identify disparities in care and highlight the impact of social determinants on urologic care. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e911 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Evan Watkins More articles by this author Abimbola Ayangbesan More articles by this author George Koch More articles by this author Rohan Bhalla More articles by this author Jackson Cabo More articles by this author Helen Gambrah More articles by this author Theresa Zwaschka More articles by this author Niels Johnsen More articles by this author Expand All Advertisement PDF downloadLoading ...

Identification and validation of methylated PENK gene for early detection of bladder cancer using urine DNA

BackgroundEarly detection of bladder cancer (BCa) offers patients a favorable outcome and avoids the need for cystectomy. Development of an accurate and sensitive noninvasive BCa diagnostic test is imperative. DNA methylation is an early epigenetic event in the development of BCa. Certain specific aberrant methylations could serve as useful biomarkers. The aim of this study was to identify methylation biomarkers for early detection of BCa.MethodsCpG methylation microarray analysis was conducted on primary tumors with varying stages (T1—T4) and paired nontumor tissues from nine BCa patients. Bisulfite-pyrosequencing was performed to confirm the methylation status of candidate genes in tissues and urine sediments (n = 51). Among them, PENK was selected as a potential candidate and validated using an independent set of 169 urine sediments (55 BCa, 25 benign urologic diseases, 8 other urologic cancers, and 81 healthy controls) with a quantitative methylation-specific real time PCR (mePENK-qMSP). All statistical analyses were performed using MedCalc software version 9.3.2.0.ResultsCpG methylation microarray analysis and stepwise validation by bisulfite-pyrosequencing for tissues and urine sediments supported aberrant methylation sites of the PENK gene as potential biomarkers for early detection of BCa. Clinical validation of the mePENK-qMSP test using urine sediment-DNA showed a sensitivity of 86.5% (95% CI: 71.2 – 95.5%), a specificity of 92.5% (95% CI: 85.7 – 96.7%), and an area under ROC of 0.920 (95% CI: 0.863 – 0.959) in detecting Ta high-grade and advanced tumor stages (T1-T4) of BCa patients. Sensitivities for Ta low-grade, Ta high-grade, T1 and T2-T4 were 55.6, 83.3, 88.5, and 100%, respectively. Methylation status of PENK was not correlated with sex, age or stage, while it was associated with the tumor grade of BCa.ConclusionsIn this study, we analyzed the comprehensive patterns of DNA methylation identified that PENK methylation possesses a high potential as a biomarker for urine-based early detection of BCa. Validation of PENK methylation confirms that it could significantly improve the noninvasive detection of BCa.

Phytotherapy in urological benign disease: A systematic review

AbstractWhat is the state of knowledge on the use of phytotherapy in the following urological benign diseases: prostatic hyperplasia, erectile dysfunction, male infertility, urolithiasis and low‐urinary tract symptoms? Supplements derived from natural products are used in medicine alone or in combination with drugs. In urology, there are many products used for symptom management in benign conditions. The aim of this review was to investigate the use of herbal medicines to treat benign urological diseases. A systematic review was conducted using the PubMed, CINAHL, Cochrane Library, Embase and Scopus (2010–2021) databases. The inclusion criteria were studies describing the use of phytotherapeutic strategies to treat adult patients with urological diseases. Quality assessments were performed using the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) approach. Nineteen studies were included in this systematic review: 13 randomized controlled trials, 3 pilot studies, 1 quasi‐experimental study, 1 retrospective observational study and 1 post hoc analysis. Phytotherapeutic agents used to treat benign prostatic hyperplasia included royal jelly, Viola odorata, Echium amoenum, Physalis alkekengi, soy isoflavones, Serenoa repens, Trigonella foenum‐graecum, lycopene and selenium. Tribulus terrestris is widely used to treat erectile dysfunction and male infertility. Lycopene, Korean ginseng berries, Indian ginseng and Curcuma improve sperm characteristics and motility. Lupeol therapy reduces kidney stone size, improving urolithiasis symptoms and accelerating the expulsion of small stones. No standard of care has been established for the use of phytotherapeutic agents to manage patients with symptomatic urological disorders. Although randomized controlled trials were the most common study type in our review, the sample sizes were limited, and the study duration and follow‐up periods were often very short.

Initial Evaluation of Uroplakins UPIIIa and UPII in Selected Benign Urological Diseases.

Background: Uroplakins (UPs) are glycoproteins that play a specific role in the structure and function of the urothelium. Disorders which affect the normal expression of UPs are associated with the pathogenesis of infections and neoplasms of the urinary tract, primary vesicoureteral reflux, hydronephrosis and renal dysfunction. The appearance of uroplakins in the urine and/or plasma may be of potential importance in the detection of urinary tract dysfunction. The aim of the present study was to investigate uroplakin IIIa (UPIIIa) and uroplakin II (UPII) expression in patients with selected urological diseases. Methods: Plasma and urine from patients with benign prostatic hyperplasia (BPH), urethral stricture (US), urinary tract infection (UTI) and urolithiasis were compared to healthy people without urological disorders. UPs concentrations were measured by the immunoenzymatic method. Results: In patients with BPH and UTI, concentrations of UPIIIa in urine and plasma, as well as UPII in urine, were statistically significantly higher than in the control groups. In the US group, only the plasma UPIIIa concentration differed significantly from the control. Conclusion: The conducted research shows that benign urological diseases may affect the state of the urothelium, as manifested by increased concentrations of both UPs in patients’ urine and plasma, especially in BPH and UTI.

Medical uses for phenol in the urinary tract: A possible forgotten treatment (Review).

Phenol is a chemical compound that was first used medically as an antiseptic. At low concentrations, phenol exerts local anesthetic effects achieved through denervation; at high concentrations, it exerts a potent protein-denaturing effect that induces apoptosis. Phenol injection therapy has a long history of use in urology. It is reportedly effective for hemorrhagic cystitis, benign prostate hyperplasia, overactive bladder, hydrocele, bladder tumors, interstitial cystitis and other benign urologic diseases, and it is also used as a tool to decrease bleeding during prostate surgery. The present review article summarizes the medical applications of phenol in urological field. The articles available on the medical uses of phenol are primarily older and retrospective, involving small numbers of patients. In the absence of comparative studies with other treatments, it is impossible to determine the relative benefit of phenol. However, the treatment outcomes of phenol injection are fairly well-established. Phenol therapy may be an option for patients who are poor candidates for invasive treatment. Further studies are required, however, as are improvements in the injection technique to reduce the rate of complications.

A single institution experience: Robotic-assisted laparoscopic renal calyceal diverticulectomies, heminephrectomy and bladder diverticulectomies

Introduction: The use of a robotic surgical system has transformed modern urological surgeries. There is little reported, however, on the use of robotic surgical systems in the management of benign urological diseases. We aim to report our experience in robotic-assisted surgery in renal calyceal diverticulectomies, heminephrectomy and bladder diverticulectomies. Methodology: We retrospectively collected the data of patients who had robotic-assisted surgery in our institution from 1 January 2014 to 31 December 2019. Results: Over the last five years, our institution has performed over 1500 robotic-assisted urological surgeries. In this five-year period, four robotic surgeons have performed a total of 25 robotic assisted operations to treat benign urological diseases including three renal calyceal diverticulectomies, one heminephrectomy and two bladder diverticulectomies. All patients were satisfied with the outcomes of their surgery when reviewed at their follow up consultations. Conclusion: We report a very positive experience in using robotic surgical systems in managing our series of benign urological conditions in our hospital. We should not restrict the use of this tool to cancer surgery, but consider the technology in our surgical armamentarium for all aspects of our urological practice.

Lifestyle in urology: Benign diseases.

Modifiable lifestyle-related risk factors are the object of increasing attention, with a view to primary and tertiary prevention, to limit the onset and development of diseases.Also in the urological field there is accumulating evidence of the relationship between urological diseases and lifestyle-related risk factors that can influence their incidence and prognosis. Risk factors such as nutrition, physical activity, sexual habits, tobacco smoking, or alcohol consumption can be modified to limit morbidity and reduce the social impact and the burdensome costs associated with diagnosis and treatment.This review synthesizes the current clinical evidence available on this topic, trying to satisfy the need for a summary on the relationships between the most important lifestyle factors and the main benign urological diseases, focusing on benign prostatic hyperplasia (BPH), infections urinary tract (UTI), urinary incontinence (UI), stones, erectile dysfunction, and male infertility.

Risk Factors of Post PCNL Systemic Inflamatory Response Syndrome (SIRS)

Background: urolithiasis is one of the most common benign urologic diseases, with a nearly 10% of lifetime incidence. In addition, the prevalence of urolithiasis has been rising through the decade worldwide. Objective: To determine the parameters and contributing factors that are associated with SIRS following PCNL. Materials and Methods: an observational retrospective case control study, the medical records of all patients who underwent PCNL for renal stones in-between 10/2017 and 4/2019 (320 patients) at Al-Hussein and Sayed Galal, AlAzhar University Hospitals had been reviewed. The demographic and perioperative data of these patients had been collected. Results: the study comprised 307 patients, the mean age of the studied patients was 40.9±15.8 years (range: 2.5 to 70 years). The mean BMI was 26±3 (range: 18 to 35). There were 193(62.9%) males and 114(37.1%) females. Twenty two patients had bilateral renal stone. In 170(55%) cases the targeted stone was in left side and the rest was in the right one. Forty eight (15.6%) cases developed SIRS post-operative. The age, gender, residual stones, hepatitis and diabetes were found to be independent risk factors for SIRS. Conclusions: good preoperative assessment and strict control of DM and haptic diseases before the procedure, try to render the patient stone free intraoperative as much we can and strict follow up to these categories of patients postoperatively to detect inflammatory response and infectious complications as early as possible.

Development of a fully automated chemiluminescence immunoassay for urine monomeric laminin-\u03b32 as a promising diagnostic tool of non-muscle invasive bladder cancer

BackgroundMonomeric laminin-γ2 in urine is a potential biomarker for bladder cancer. However, the current detection system uses an antibody that cannot discriminate between monomeric laminin-γ2 and the heterotrimeric γ2 chain of laminin-332, which may cause false-positive reactions. The present study aimed to develop a fully automated chemiluminescence immunoassay system using a specific monoclonal antibody against monomeric laminin-γ2.MethodsIn total, 237 urine specimens (84 from patients with bladder cancer, 48 from patients with benign urological disease, and 105 from healthy donors) were collected, and monomeric laminin-γ2 values in the urine were measured using a fully automated chemiluminescence immunoassay.ResultsThe results revealed that laminin-γ2 values in patients with benign urological disease were comparable to those of healthy donors and that the chemiluminescence immunoassay’s lower limit of detection was 10 pg/mL (approximately 20-fold better than the sandwich enzyme-linked immunosorbent assay’s limit of 200 pg/mL). Moreover, the chemiluminescence immunoassay demonstrated that patients with bladder cancer, including non-muscle invasive bladder cancer (≤pT1), had higher laminin-γ2 values than patients with benign urological disease or healthy donors.ConclusionsThese results suggest that urine monomeric laminin-γ2 may be a promising biomarker to diagnose cases of non-muscle invasive bladder cancer using a fully automated chemiluminescence immunoassay system.

MP15-15 URINE SAMPLE DERIVED CK20- AND IGF2-EXPRESSION AS BIOMARKER FOR THE DETECTION OF BLADDER CANCER

You have accessJournal of UrologyBladder Cancer: Non-invasive I1 Apr 2017MP15-15 URINE SAMPLE DERIVED CK20- AND IGF2-EXPRESSION AS BIOMARKER FOR THE DETECTION OF BLADDER CANCER Karsten Salomo, Doreen Huebner, Manja U. Boehme, Alexander Herr, Ulrike Heberling, Oliver W. Hakenberg, Daniela Jahn, Marc-Oliver Grimm, Astrid Enkelmann, Daniel Steinbach, Susanne Fuessel, and Manfred P. Wirth Karsten SalomoKarsten Salomo More articles by this author , Doreen HuebnerDoreen Huebner More articles by this author , Manja U. BoehmeManja U. Boehme More articles by this author , Alexander HerrAlexander Herr More articles by this author , Ulrike HeberlingUlrike Heberling More articles by this author , Oliver W. HakenbergOliver W. Hakenberg More articles by this author , Daniela JahnDaniela Jahn More articles by this author , Marc-Oliver GrimmMarc-Oliver Grimm More articles by this author , Astrid EnkelmannAstrid Enkelmann More articles by this author , Daniel SteinbachDaniel Steinbach More articles by this author , Susanne FuesselSusanne Fuessel More articles by this author , and Manfred P. WirthManfred P. Wirth More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.500AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Cytokeratin 20 (CK20) and Insulin-like growth factor 2 (IGF2) were previously proposed to be elevated in patients with bladder cancer (BCa). A two cohort design validation study was used to assess the relevance for BCa detection of both markers in urine samples. The results were compared to voided urine cytology (VUC). METHODS RNA isolation was carried out using 5 ml spontaneous urine samples of 196 and 97* histologically positive BCa patients for the test and validation* cohort, respectively. Additionally patients with benign urological diseases, nephrolithiasis and unconfirmed BCa suspicion as well as healthy control subjects were included for a total of 103/50* control subjects in the test and validation* cohort. Urinary mRNA levels were determined by qPCR and the results were normalized as molecule ratio to RPLP0. Receiver operating characteristic curves and corresponding AUC values were used to evaluate the diagnostic performance of both markers. Optimal cut-off values were determined by Youden Index. RESULTS Urinary mRNA levels were significantly elevated 3.4/11*-fold for CK20 and 188/64*-fold for IGF2 in BCa patients compared to controls in the test and validation* cohort, respectively. IGF2 performed slightly better with an AUC of 0.83 for both cohorts compared to CK20 with an AUC of 0.78 and 0.82* for the test and validation* cohort, respectively. Combined analysis of IGF2 and CK20 with at least one positive marker resulted in a sensitivity (0.78/0.90*) and specificity (0.88/0.84*) similar to that of VUC. The sensitivity of VUC in combination with IGF2 and CK20 was considerably increased (0.95/0.93*) while specificity was slightly reduced (0.72/0.84*) compared to VUC alone in the test and validation* cohort. CONCLUSIONS Expressions of IGF2 and CK20 correlated significantly with BCa with a diagnostic performance similar to VUC. Combined analysis of voided urine cytology together with expression levels of CK20 and IGF2 clearly enhances overall test performance. Therefore, its relevance for BCa diagnosis should be evaluated in a larger cohort. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e176 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Karsten Salomo More articles by this author Doreen Huebner More articles by this author Manja U. Boehme More articles by this author Alexander Herr More articles by this author Ulrike Heberling More articles by this author Oliver W. Hakenberg More articles by this author Daniela Jahn More articles by this author Marc-Oliver Grimm More articles by this author Astrid Enkelmann More articles by this author Daniel Steinbach More articles by this author Susanne Fuessel More articles by this author Manfred P. Wirth More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Clinical and preclinical treatment of urologic diseases with phosphodiesterase isoenzymes 5 inhibitors: an update.

Phosphodiesterase isoenzymes 5 inhibitors (PDE5-Is) are the first-line therapy for erectile dysfunction (ED). The constant discoveries of nitric oxide (NO)/cyclic guanosine monophosphate (cGMP) cell-signaling pathway for smooth muscle (SM) control in other urogenital tracts (UGTs) make PDE5-Is promising pharmacologic agents against other benign urological diseases. This article reviews the literature and contains some previously unpublished data about characterizations and activities of PDE5 and its inhibitors in treating urological disorders. Scientific discoveries have improved our understanding of cell-signaling pathway in NO/cGMP-mediated SM relaxation in UGTs. Moreover, the clinical applications of PDE5-Is have been widely recognized. On-demand PDE5-Is are efficacious for most cases of ED, while daily-dosing and combination with testosterone are recommended for refractory cases. Soluble guanylate cyclase (sGC) stimulators also have promising role in the management of severe ED conditions. PDE5-Is are also the first rehabilitation strategy for postoperation or postradiotherapy ED for prostate cancer patients. PDE5-Is, especially combined with α-adrenoceptor antagonists, are very effective for benign prostatic hyperplasia (BPH) except on maximum urinary flow rate (Qmax) with tadalafil recently proved for BPH with/without ED. Furthermore, PDE5-Is are currently under various phases of clinical or preclinical researches with promising potential for other urinary and genital illnesses, such as priapism, premature ejaculation, urinary tract calculi, overactive bladder, Peyronie's disease, and female sexual dysfunction. Inhibition of PDE5 is expected to be an effective strategy in treating benign urological diseases. However, further clinical studies and basic researches investigating mechanisms of PDE5-Is in disorders of UGTs are required.

Urinary laminin-γ2 is a novel biomarker of non-muscle invasive urothelial carcinoma.

Lack of appropriate biomarkers has hampered early detection of urothelial cancer (UC), therefore, development of biomarkers for its diagnosis at earlier stages is of importance. Laminin-332 (Ln-332, formerly Ln-5), a component of basement membranes, consists of Ln-α3, Ln-β3, and Ln-γ2 polypeptides. However, monomeric Ln-γ2 alone is frequently expressed in malignant neoplasms. If Ln-γ2 is also expressed in UC and secreted into the urine, its detection could be useful for UC diagnosis. Here, we evaluated Ln-γ2 levels from 60 patients with urinary diseases (including UC) by Western blotting, and detected it in approximately 53% of UC cases. Using immunohistochemistry, we confirmed Ln-γ2 expression in UC tissues that were positive for Ln-γ2, whereas Ln-α3 expression was absent. We next developed a sandwich enzyme-linked immunosorbent assay and applied it for screening 39 patients with non-muscle invasive UC and 61 patients with benign urologic diseases. The Ln-γ2 levels were higher in UC patients than in those with benign urologic diseases. Ln-γ2 was detected even in patients with earlier stages of UC, such as Ta, T1, or carcinoma in situ. The sensitivity of Ln-γ2 testing for UC was 97.4%, and the specificity was 45.9%, using a cut-off of 0.5 μg/g∙crn. Ln-γ2 had greater diagnostic value for detecting non-muscle invasive UC compared to conventional urine cytology and available biomarkers for UC, and may be useful as a urine biomarker for the diagnosis and monitoring of UC.

Prospects of stem cell treatment in benign urological diseases.

Stem cells (SCs) are undifferentiated cells that are capable of self-renewal and differentiation and that therefore contribute to the renewal and repair of tissues. Their capacity for division, differentiation, and tissue regeneration is highly dependent on the surrounding environment. Several preclinical and clinical studies have utilized SCs in urological disorders. In this article, we review the current status of SC use in benign urological diseases (erectile dysfunction, Peyronie disease, infertility, and urinary incontinence), and we summarize the results of the preclinical and clinical trials that have been conducted.

ITRAQ-Based Quantitative Proteomic Analysis Identified HSC71 as a Novel Serum Biomarker for Renal Cell Carcinoma.

Renal cell carcinoma (RCC) is one of the most lethal urologic cancers and about 80% of RCC are of the clear-cell type (ccRCC). However, there are no serum biomarkers for the accurate diagnosis of RCC. In this study, we performed a quantitative proteomic analysis on serum samples from ccRCC patients and control group by using isobaric tag for relative and absolute quantitation (iTRAQ) labeling and LC-MS/MS analysis to access differentially expressed proteins. Overall, 16 proteins were significantly upregulated (ratio > 1.5) and 14 proteins were significantly downregulated (ratio < 0.67) in early-stage ccRCC compared to control group. HSC71 was selected and subsequently validated by Western blot in six independent sets of patients. ELISA subsequently confirmed HSC71 as a potential serum biomarker for distinguishing RCC from benign urologic disease with an operating characteristic curve (ROC) area under the curve (AUC) of 0.86 (95% confidence interval (CI), 0.76~0.96), achieving sensitivity of 87% (95% CI 69%~96%) at a specificity of 80% (95% CI 61~92%) with a threshold of 15 ng/mL. iTRAQ-based quantitative proteomic analysis led to identification of serum HSC71 as a novel serum biomarker of RCC, particularly useful in early diagnosis of ccRCC.

Primary Bladder Amyloidosis Mimicking Bladder Malignancy: A Case Report and Literature Review

Introduction and Objectives: We report a rare case of localized primary bladder amyloidosis, and we conducted a literature review. Materials and Methods: A 70-year-old man with gross haematuria and storage bladder symptoms was diagnosed with primary bladder amyloidosis with clinical and radiological features of bladder tumor. A comprehensive review of English literature was done. PubMed, NCBI and Science Direct were searched using the following search terms: primary; Bladder; Amyloidosis. Results: Primary localized bladder amyloidosis is a rare and benign urological disease with approximately 210 reported cases in the English literature. It is usually of the AL type and commonly presents with gross painless haematuria and storage bladder symptoms, mimicking bladder malignancy. Imaging investigations such as ultrasound scan, CT scan and MRI are not diagnostic, whereas histopathological examination confirms the diagnosis. Transurethral resection of the bladder lesion is the treatment of choice; however local recurrence is common (50% of cases).

Plasma thymosin-α1 level as a potential biomarker in urothelial and renal cell carcinoma

ObjectivesTo determine the plasma levels of thymosin-α1 (TA1) and prothymosin-α (PTMA) proteins in renal cell carcinoma (RCC) or urothelial carcinoma (UC) patients, and explore the potential of these 2 molecules as biomarkers. Materials and methodsBlood samples were taken from 50 consecutive patients with RCC, 97 with UC, and 55 with benign urologic diseases before surgery. Their clinical characteristics were obtained from medical record review. Plasma TA1 and PTMA levels were measured using enzyme-linked immunosorbent assay and their correlation with tumor grade, pathologic stage, and survival were explored. ResultsPlasma TA1 levels were significantly lower in RCC patients than in UC or benign patients, particularly in UC of the renal pelvis patients (P < 0.0001). Plasma PTMA levels were also significantly lower in UC patients compared with RCC patients and benign patients (P < 0.05). Plasma TA1 levels inversely correlated with pathologic stage both in bladder cancer and RCC patients (P = 0.03 and 0.02, respectively). Both plasma TA1 and PTMA did not correlate with tumor grade. Plasma TA1 was a prognostic indicator for progression-free and disease-specific overall survival in bladder cancer patients (P = 0.008 and 0.04, respectively). ConclusionsPlasma TA1 level may be a biomarker for differentiating between UC and RCC. It may also be a prognostic factor for disease progression and disease-specific survival in bladder cancer patients. These findings warrant more studies for validation.

Polymorphic Enzymes, Urinary Bladder Cancer Risk, and Structural Change in the Local Industry

In the 1990s, an uncommonly high percentage of glutathione S-transferase M1 (GSTM1) negative bladder cancer cases (70%) was reported in the greater Dortmund area. The question arose as to whether this uncommonly high percentage of GSTM1 negative bladder cancer cases was due to environmental and/or occupational exposure decades ago. Thus, 15 years later, another study on bladder cancer was performed in the same area after the coal, iron, and steel industries had finally closed in the 1990s. In total 196 bladder cancer patients from the St.-Josefs-Hospital Dortmund-Hörde and 235 controls with benign urological diseases were assessed by questionnaire and genotyped for GSTM1, glutathione S-transferase T1 (GSTT1), and the N-acetyltransferase 2 (NAT2) tag SNP rs1495741. The frequency of the GSTM1 negative genotype was 52% in bladder cancer cases and thus lower compared to a previous study performed from 1992 to 1995 in the same area (70%). NAT2 genotypes were distributed equally among cases and controls (63% slow acetylators). Fewer GSTT1 negative genotypes were present in cases (17%) than in controls (20%).