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Background The clinical pathologic stages (stage I, II, III-IV) of hepatocellular carcinoma (HCC) are closely linked to the clinical prognosis of patients. This study aims at investigating the gene expression and mutational profile in different clinical pathologic stages of HCC. Methods Based on the TCGA-LIHC cohort, we utilized a series of analytical approaches, such as statistical analysis, random forest, decision tree, principal component analysis (PCA), to identify the differential gene expression and mutational profiles. The expression patterns of several targeting genes were also verified by analyzing the Chinese HLivH060PG02 HCC cohort, several GEO datasets, HPA database, and diethylnitrosamine-induced HCC mouse model. Results We identified a series of targeting genes with copy number variation, which is statistically associated with gene expression. Non-synonymous mutations mainly existed in some genes (e.g.,TTN, TP53, CTNNB1). Nevertheless, no association between gene mutation frequency and pathologic stage distribution was detected. The random forest and decision tree modeling analysis data showed a group of genes related to different HCC pathologic stages, including GAS2L3 and SEMA3F. Additionally, our PCA data indicated several genes associated with different pathologic stages, including SNRPA and SNRPD2. Compared with adjacent normal tissues, we observed a highly expressed level of GAS2L3, SNRPA, and SNRPD2 (P = 0.002) genes in HCC tissues of our HLivH060PG02 cohort. We also detected the high expression pattern of GAS2L3, SEMA3F, SNRPA, and SNRPD2 in the datasets of GSE102079, GSE76427, GSE64041, GSE121248, GSE84005, and the qPCR assay using diethylnitrosamine-induced HCC mouse model. Moreover, SEMA3F and SNRPD2 protein were highly stained in the HCC tissues of the HPA database. The high expression level of these four genes was associated with the poor survival prognosis of HCC cases. Conclusions Our study provides evidence regarding the gene expression and mutational profile in different clinical pathologic stages of TCGA HCC cases. Identifying four targeting genes, including GAS2L3, SNRPA, SNRPD2, and SEMA3F, offers insight into the molecular mechanisms associated with different prognoses of HCC.

To characterize the clinical and pathologic staging of patients with urothelial carcinoma (UC) in bladder diverticula (BD) after undergoing radical cystectomy (RC) and determine the impact of UCBD on recurrence and survival. We reviewed our institutional database of patients who underwent RC for UC (1971–2009). Outcomes were compared between patients with and without UCBD. Kaplan–Meier curves estimated recurrence-free survival (RFS) and overall survival (OS). Multivariable Cox regression evaluated associations between UCBD and survival. Inclusion criteria were met in 1991 patients. UCBD was seen in 77 (4 %) patients and occurred exclusively in men (mean age 68 ± 8.5 years). The highest pathologic stage tumor was found in the BD in 44 (57 %) of these patients. Pathologic upstaging was more common with UCBD compared with UC not in BD (48 vs. 39 %, p = 0.031). On univariate analysis, no differences in RFS or OS were observed comparing patients with or without UCBD stratified by clinically organ-confined (≤T2) and extravesical (>T2) disease. On multivariable analysis, the presence of UCBD was not associated with differences in RFS (HR 0.92, 95 % CI 0.59–1.42, p = 0.69) or OS (HR 0.98, 95 % CI 0.74–1.31, p = 0.92). Upstaging was common in patients with UCBD, observed in almost half of the patients. There were no differences in RFS or OS after RC when comparing patients with or without UC in a diverticulum stratified by stage.

Magnetic resonance imaging (MRI) has a wide reported variation in sensitivity and specificity for staging prostate cancer (PCA). We examined the accuracy of MRI in detecting PCA, and in identifying extracapsular extension (ECE) and seminal vesicle invasion (SVI) in PCA patients at our institution. We retrospectively reviewed pre-biopsy MRI findings and correlated the same with subsequent radical prostatectomy pathology reports in all patients undergoing radical prostatectomy between 2010 and 2012. Specifically, comparison was made between MRI and pathologic stage. Age, serum prostate-specific antigen level and Gleason score were recorded. MRI detected signal abnormalities in 50 out of 88 PCA patients undergoing radical prostatectomy. Of these, 12 had ECE and 7 had SVI on final histology. The sensitivity and specificity of MRI for detecting ECE were 75 and 100 %, respectively. The sensitivity and specificity of MRI for detecting SVI were 16.7 and 100 %, respectively. The positive predictive values for determining ECE and SVI were 100 % and negative predictive values were 96.2 and 90.6 %, respectively. MRI may be reliable for excluding ECE and SVI in PCA patients where the lesion is visible on MRI. It has a good diagnostic ability for ECE, but is less accurate for identifying SVI. This article supports the use of MRI in the preoperative evaluation of PCA.

A PSA velocity (PSAV)0.35 ng/ml/year approximately 10-15 years prior to diagnosis is associated with a greater risk of lethal prostate cancer. Some have recommended that a PSAV0.35 ng/ml/year should prompt a prostate biopsy in men with a low serum PSA (4 ng/ml) and benign DRE. However, less is known about the utility of this PSAV cutpoint for the prediction of treatment outcomes among men undergoing radical prostatectomy (RP).Between 1992 and 2007, 339 men underwent RP at our institution with a preoperative PSA4 ng/ml, benign DRE, and multiple preoperative PSA measurements. PSAV was calculated by linear regression analysis using all PSA values within 18 months prior to diagnosis. Kaplan-Meier survival analysis was performed, and biochemical progression rates were compared between PSAV strata using the log-rank test.The preoperative PSAV was0.35 ng/ml/year in 124 (36.6%) of 339 men. Although there were no significant differences in clinico-pathological characteristics based upon PSAV, men with a PSAV0.35 ng/ml/year were significantly more likely to experience biochemical progression after RP at a median follow-up of 4 years (P=0.022).In this low-risk population with a preoperative PSA4 ng/ml and benign DRE, approximately 1/3 had a preoperative PSAV0.35 ng/ml/year. Physicians should carefully monitor men with a preoperative PSA0.35 ng/ml/year as they are at increased risk of biochemical progression following RP.

The importance of pancreatic cancer staging is uncertain. The aim of this report was to evaluate the accuracy of combined standard imaging techniques in predicting the pathologic stage and to evaluate the prognostic effect of clinical staging to identify patient groups in which laparoscopy and laparotomy could be beneficial.Fifty-four patients were included in this analysis. The techniques used for clinical staging were endoscopic retrograde cholangiopancreatography, abdominal computed tomographic scan, and ultrasonography. All patients underwent both clinical and surgical/pathologic staging. A comparison was performed between presurgical stage and surgical/pathologic stage. The prognostic effect of different factors on survival was evaluated with both univariate (log-rank) and multivariate (Cox) analysis.Sensitivity and specificity for vascular involvement were 73.9% and 96.3%, respectively. Sensitivity and specificity for nodal involvement were 63.6% and 95.4%, respectively. A total of 33.3% of patients showed a higher than expected pathologic stage, and 3.7% showed a lower than expected pathologic stage, by comparing clinical and pathologic evaluation. A highly significant correlation was observed between clinical T stage (P = .0067) and tumor diameter (P = .0037) and patient survival. Maximal prognostic differentiation was observed by dividing patients into two groups based on imaging results: group A (favorable prognosis) and group B (unfavorable prognosis). The median survival was 25.1 and 8.0 months for group A and B, respectively. Five-year survival was 20.1% and 0%, respectively (multivariate analysis: P = .0007).Integrated standard imaging studies achieved reasonable diagnostic accuracy in our analysis. A single classification based on clinical stage and tumor diameter evaluated by imaging predicts prognosis in patients with pancreatic carcinoma.

Radical prostatectomy represents the mainstay of therapy for clinically localized prostate cancer. The combination of diagnostic parameters such as PSA or biopsy Gleason grade in nomograms allows a safe prediction of pathologic stage and prognosis of the disease. Imaging techniques are useful in a subset of patients. International studies have proven a high cancer control rate of radical prostatectomy. A nerve-sparing modification of the operative technique does not compromise radicality of the procedure if patients are carefully selected. For this purpose simple and reliable algorithms are available.

The purpose of this study was to report the CT findings of renal cell carcinoma of clear type (RCCCT) and to determine if there are characteristic morphologic features in RCCCT with respect to tumor size, architectural patterns, and pathologic stage. The CT scans of 35 patients with RCCCT were reviewed retrospectively. The CT findings (tumor size, attenuation patterns, presence of calcifications, encapsulation, margins of neoplasms, venous involvement by neoplasms) were correlated with tumor size, architectural patterns, and pathologic staging. Of the 35 neoplasms, 28 (80 %) were solid, 4 (11 %) were papillary, and 3 (9 %) were cystic. Complete encapsulation was more frequent in lower pathologic stages (40 % in stages 1 and 2 vs 0 % in stages 3 and 4; p < 0.05). Venous involvement was less frequent with completely encapsulated neoplasms (0 of 10, 0 %) than with incompletely or nonencapsulated neoplasms (8 of 25, 32 %; p < 0.05). Encapsulated RCCCT are more likely to have lower pathologic stage. Nonencapsulated neoplasms are more likely to have a higher pathologic stage.

Should physicians use the updated Partin tables to predict pathologic stage in patients with prostate cancer?

Should patients with pathologic stage pT3 and pT4 RCC be reclassified to improve prognostic accuracy?