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// Zai-Shang Li 1, 2, 3, * , Chuang-Zhong Deng 1, 2, 3, * , Yun-Lin Ye 1, 2, 3, * , Kai Yao 1, 2, 3 , Sheng-Jie Guo 1, 2, 3 , Jie-Ping Chen 1, 2, 3 , Yong-Hong Li 1, 2, 3 , Zi-Ke Qin 1, 2, 3 , Zhuo-Wei Liu 1, 2, 3 , Bin Wang 4 , Qi Zhao 1, 2, 5 , Peng Chen 6 , Qi-Wu Mi 7 , Xiao-Feng Chen 8 , Hui Han 1, 2, 3 and Fang-Jian Zhou 1, 2, 3 1 Department of Urology, Sun Yat-sen University Cancer Center, Guangzhou, P. R. China 2 State Key Laboratory of Oncology in Southern China, Guangzhou, P. R. China 3 Collaborative Innovation Center of Cancer Medicine, Guangzhou, P. R. China 4 Department of Urology, Cancer Center of Guangzhou Medical University, Guangzhou, P. R. China 5 School of Life Science, Sun Yat-sen University, Guangzhou, P. R. China 6 Department of Urology, Affiliated Tumor Hospital of Xinjiang Medical University, Urumchi, P. R. China 7 Department of Urology, Dong Guan People’s Hospital, Guang Dong, P. R. China 8 Department of Urology, The First People's Hospital of Chenzhou, Chenzhou, P. R. China * First authors, they contributed equally to this research Correspondence to: Hui Han, email: hanhui@sysucc.org.cn Fang-Jian Zhou, email: zhoufj@sysucc.org.cn Keywords: casein kinase 2α, penile neoplasm, squamous cell carcinoma Received: September 13, 2016 Accepted: February 21, 2017 Published: May 16, 2017 ABSTRACT Purpose: In this study, we assess the CK2α expression in human penile squamous cell carcinoma (SCC) and its clinical significance. Methods: A total of 157 human penile SCC tissue samples were immunohistochemically analyzed. In addition, 12 human penile SCC and adjacent normal tissues were examined for CK2α protein and mRNA expression by Western blotting and real-time quantitative PCR, respectively. Survival was analyzed using the Kaplan-Meier test and the log-rank test. Multivariate Cox proportional hazard regression analysis was performed to determine the impacts of CK2α expression and the clinicopathological features on patient disease-specific survival (DSS). Likelihood ratios (LRs), Akaike information criterion (AIC) values, and concordance indexes (C-indexes) were investigated to evaluate the accuracies of the factors. Bootstrap-corrected C-indexes were used for internal validation (with sampling 1000 times). Results: A significant difference in the distribution of CK2α was observed between the normal and penile carcinoma tissues ( P

Current guidelines recommend pelvic lymphadenectomy (PLND) for patients with pelvic lymph node metastasis and special state. However, these data and recommendations do not distinguish the role of PLND in different patient groups and confirm the final benefits. The aim of this study was to confirm the efficacy of pelvic lymphadenectomy (PLND) for the different groups of patients. Data obtained from 7 centers were retrospectively analyzed. Of the patients, 190 pN2-3 penile carcinoma patients confirmed by bilateral inguinal lymph node excision were included in this study. Sixty-nine and 121 of these patients did and did not undergo bilateral PLND, respectively. The baseline differences from the patients were matched by propensity score analysis. In this study, the Kaplan–Meier estimated disease-specific survival (DSS) was not significantly different between the PLND and no-PLND groups (P = 0.796). According to the propensity score matching for T stage, N stage, grade, adjuvant therapies, and lymph node stage (number of inguinal lymph node metastasis and extranodal extension), 48 patients were selected for each group. Among the pN2 patients, the PLND group showed higher DSS rates than the no-surgery group (P = 0.030). However, even after matching, survival did not differ between the PLND and no-PLND patients among all patients (P = 0.609) and pN3 patients (P = 0.417) with comparable DSS. Bilateral PLND may improve survival in pN2 patients. Men with pN3 may not benefit from bilateral PLND.

Object: In this study, we evaluated the role of lymph node density (LND) and validated whether LND increases the accuracy of survival prediction when combined with the American Joint Committee on Cancer (AJCC) pathological node (N) staging system for penile cancer (7th edition). Methods: A total of 270 Chinese penile cancer patients treated between March 1999 and October 2014 were retrospectively analyzed. LND was analyzed as a trichotomous variable for the prediction of DSS in this cohort. We developed a new prediction model, which we refer to as the ND staging system, that is based on LND and pathological N staging. The predictive accuracy of this model was further assessed using the concordance index. Results: LND was correlated with the laterality of lymph node metastasis, extranodal extension, pelvic lymph node metastases, and pathologic tumor (T) and N stages (P

Background The 8th American Joint Committee on Cancer tumor–node–metastasis (AJCC-TNM) staging system is based on a few retrospective single-center studies. We aimed to test the prognostic validity of the staging system and to determine whether a modified clinicopathological tumor staging system that includes lymphovascular embolization could increase the accuracy of prognostic prediction for patients with stage T2–3 penile cancer. Methods A training cohort of 411 patients who were treated at 2 centers in China and Brazil between 2000 and 2015 were staged according to the 8th AJCC-TNM staging system. The internal validation was analyzed by bootstrap-corrected C-indexes (resampled 1000 times). Data from 436 patients who were treated at 15 centers over four continents were used for external validation. Results A survivorship overlap was observed between T2 and T3 patients (P = 0.587) classified according to the 8th AJCC-TNM staging system. Lymphovascular embolization was a significant prognostic factor for metastasis and survival (all P

OBJECTIVE To evaluate the relevance of C-reactive protein (CRP) and squamous cell carcinoma antigen (SCC-Ag) levels in relation to clinicopathological factors and prognosis in penile cancer. PATIENTS AND METHODS A total of 124 Chinese patients with penile squamous cell carcinoma (SCC), treated between November 2007 and October 2014, were analysed retrospectively. Receiver-operating characteristic curves were used to identify the combination of markers with the best sensitivity and specificity for prognosis prediction. Statistical data analysis was performed using a non-parametric method, and survival analysis was performed using the log-rank test and Cox proportional hazard model. RESULTS Levels of CRP ≥4.5 mg/L and SCC-Ag ≥1.4 ng/mL were both significantly associated with lymph node metastasis (LNM) laterality (chi-squared trend test, P = 0.041), extranodal extension (chi-squared trend test, P < 0.001), pelvic LNM (chi-squared trend test, P = 0.024), pathological tumour status (chi-squared trend test, P = 0.002), pathological nodal status (chi-squared trend test, P < 0.001), and disease-specific survival (DSS; log-rank test, P < 0.001). Moreover, the influence of CRP and SCC-Ag levels on DSS (P = 0.033, hazard ratio 3.390, 95% confidence interval 1.104-10.411) remained after adjusting for smoking history, phimosis, tumour status, tumour cell differentiation and nodal status. CONCLUSIONS The present study shows that the combined measurement of preoperative CRP and SCC-Ag levels may serve as an independent biomarker for LNM, advanced tumour stage and DSS in patients with penile SCC.

The aim of the present study was to evaluate the clinical value of preoperative computed tomography angiography (CTA) imaging for guiding the superselective clamping of renal arterial branches during a laparoscopic partial nephrectomy (LPN). A total of 42 patients with renal masses of

// Zai-Shang Li 1,2,3,* , Peng Chen 4,* , Kai Yao 1,2,3,* , Bin Wang 5,* , Jing Li 5 , Qi-Wu Mi 6 , Xiao-Feng Chen 7 , Qi Zhao 8 , Yong-Hong Li 1,2,3 , Jie-Ping Chen 1,2,3 , Chuang-Zhong Deng 1,2,3 , Yun-Lin Ye 1,2,3 , Ming-Zhu Zhong 9 , Zhuo-Wei Liu 1,2,3 , Zi-Ke Qin 1,2,3 , Xiang-Tian Lin 10 , Wei-Cong Liang 10 , Hui Han 1,2,3 and Fang-Jian Zhou 1,2,3 1 Department of Urology, Sun Yat-sen University Cancer Center, Guangzhou, P. R. China 2 State Key Laboratory of Oncology in Southern China, Guangzhou, P. R. China 3 Collaborative Innovation Center of Cancer Medicine, Guangzhou, P. R. China 4 Department of Urology, Affiliated Tumor Hospital of Xinjiang Medical University, Urumchi, P. R. China 5 Department of Urology, Cancer Center of Guangzhou Medical University, Guangzhou, P. R. China 6 Department of Urology, Dong Guan People’s Hospital, Guang Dong, P. R. China 7 Department of Urology,The First People’s Hospital of Chenzhou, Chenzhou, P. R. China 8 School of Life Science, Sun Yat-sen University, School of Life Science, Guang Dong, P. R. China 9 Department of Urology, The People’s Hospital of Jiangmen, Jiangmen, P. R. China 10 Zhongshan School of Medicine, Sun Yat-sen University, Guang Dong, P. R. China * These authors have contributed equally to this work Correspondence to: Hui Han, email: // Fang-Jian Zhou, email: // Keywords : penile neoplasms, neoplasm staging, prognosis, body mass index, C-reactive protein Received : October 25, 2015 Accepted : January 24, 2016 Published : March 11, 2016 Abstract Purpose: To determine the predictive value and feasibility of the new outcome prediction model for Chinese patients with penile squamous cell carcinoma. Results: The 3-year disease-specific survival (DSS) was 92.3% in patients with < 8.70 mg/L CRP and 54.9% in those with elevated CRP ( P < 0.001). The 3-year DSS was 86.5% in patients with a BMI < 22.6 Kg/m2 and 69.9% in those with a higher BMI ( P = 0.025). In a multivariate analysis, pathological T stage ( P < 0.001), pathological N stage ( P = 0.002), BMI ( P = 0.002), and CRP ( P = 0.004) were independent predictors of DSS. A new scoring model was developed, consisting of BMI, CRP, and tumor T and N classification. In our study, we found that the addition of the above-mentioned parameters significantly increased the predictive accuracy of the system of the American Joint Committee on Cancer (AJCC) anatomic stage group. The accuracy of the new prediction category was verified. Methods: A total of 172 Chinese patients with penile squamous cell cancer were analyzed retrospectively between November 2005 and November 2014. Statistical data analysis was conducted using the nonparametric method. Survival analysis was performed with the log-rank test and the Cox proportional hazard model. Based on regression estimates of significant parameters in multivariate analysis, a new BMI-, CRP- and pathologic factors-based scoring model was developed to predict disease-specific outcomes. The predictive accuracy of the model was evaluated using the internal and external validation. Conclusion: The present study demonstrated that the TNCB score group system maybe a precise and easy to use tool for predicting outcomes in Chinese penile squamous cell carcinoma patients.

To screen and verify differentially expressed genes in prostate cancer.Using DNA microarray, we screened differentially expressed genes in prostate cancer tissue and its adjacent tissue followed by verification by PCR.A total of 1 444 genes were found to be differentially expressed (differentiation ≥ 1.5-fold; P≤ 0.05) in the prostate cancer tissue, of which 769 (53%) were up-regulated and 675 (47%) down-regulated. Fifty percent of the differentially expressed genes showed a 1.5- to 2-fold differentiation, including 396 up-regulated and 182 down-regulated ones. Additionally, 308 up-regulated and 334 down-regulated genes exhibited a2- to 5-fold, 46 up-regulated and 78 down-regulated genes a5- to 10-fold, and 19 up-regulated and 81 down-regulated genes a10-fold differentiation. Verification by subjecting 15 most significantly up-regulated and another 15 most markedly down-regulated genes to quantitative real-time PCR (qRT-PCR) showed that most of the genes had a transcriptional profile similar to that in the microarray data, with a Pearson correction coefficient of 0.83 between the microarray data and qRT-PCR results. Totally, 10 significantly differentially expressed genes were identified.DNA microarray analysis provides reliable information on differentially expressed genes in prostate cancer and benign tissues. The 10 significantly differentially expressed genes verified by qRT-PCR could possibly become new bio-markers and specific molecules for tumor identification.

To study the safety, effectiveness and feasibility of suprapubis-assisted umbilical laparoendoscopic mini-dual-site surgery (SAU-LEMDS) in the treatment of varicocele.This study included 80 varicocele patients aged 24 - 44 (mean 28.5 +/- 2.6) years, 25 cases of grade I, 45 cases of grade II and 10 cases of grade III, 58 cases in the left side, 6 in the right and 16 in both sides, and all with asthenospermia. The patients were treated by SAU-LEMDS under subarachnoid anesthesia combined with general anesthesia in a supine position with a head-down-feet-up slope of 15 degrees. Two 5 mm trocars were inserted bilaterally at the umbilical edge, one with a 5 mm 30 degrees laparoscope placed in it, and another into the abdominal cavity below the pubic hairline with a 5 mm laparoendoscopic clipper placed in it. The operation procedure was similar to that of standard laparoscopic ligation of spermatic veins, with reservation of the spermatic artery and double-ligation of spermatic veins. And the procedure was repeated for the contralateral lesion in the bilateral cases. Postoperative follow-up was conducted for the incidences of orchiatrophy and testicular hydrocele and changes of seminal parameters.All the operations were successful, with the mean operation time of (10 +/- 5.0) min (range 8 to 25 min) for the unilateral cases and (18 +/- 6.5) min (range 15 to 30 min) for the bilateral cases, the mean blood loss of (1.5 +/- 0.5) ml (range 1 to 2 ml), and the mean postoperative hospital stay of (2 +/- 0.5) d (range 1.5 to 3 d). The patients were followed up for 6 -24 (12 +/- 2.5) months, which showed significant improvement in sperm motility as compared with the baseline ([28.53 +/- 5.21] vs [19.62 +/- 3.56]%, P0.05), with 28 cases (35.0%) restored to normal. Recurrence was found in 4 cases (5.0%). Testicular hydrocele occurred in 7 cases (8.75%), but orchiatrophy in none. The scars in the umbilicus and suprapubis were invisible because of the wrinkles and pubic hair.SAU-LEMDS is safe, effective and feasible for the treatment of varicocele. It is superior to umbilical laparoendoscopic single-site surgery (U-LESS) for its less invasiveness, simpler operation, and better cosmetic appearance.

This study was designed to evaluate the safety and efficacy of suprapubic-assisted umbilical laparoendoscopic mini-dual-site surgery (SAU-LEMDS) with satisfied cosmetic outcome in minimal size of surgical incision for the treatment of simple kidney cyst at large size. Twenty-six consecutive patients (16 male and 10 female), aged 48.5 ± 4.1 years (range: 18 to 70 years), were enrolled in this study. All cases had simple kidney cysts including 18 cases on the left side and 8 cases on the right, with a mean cyst maximum diameter of 7.5 ± 0.8 cm. Under general anesthesia, the patients were placed in flank position with affected side elevated by 70°. Two trocars (5.5 mm in diameter) were inserted via the umbilical port. The third trocar was inserted into abdominal cavity above the pubic hairline for the placement of a 5-mm 30° laparoscope. The surgery procedures were successfully performed in the same manner as standard laparoscope-assisted kidney cyst decortication in all cases. The specimens were obtained through either of two umbilical ports without additional enlarge incisions. The mean operation time was 30 ± 8.2 min and the mean blood loss was 10.3 ± 2.1 ml. The duration of hospitalization was 4.2 ± 0.9 days, and the mean follow-up was two months (range: 1 to 3 months). Postoperatively, surgical wounds were small and healed well and cosmetic outcomes were satisfactory. No recurrent kidney cysts were found during follow up. SAU-LEMDS appears to be a feasible, safe and effective surgical option for simple kidney cyst, which not only leads to better cosmetic effects, but also decreases the complexity of umbilical laparoendoscopic single site surgery (U-LESS).

To investigate the effect of the photodynamic therapy (PDT) with the new water-soluble metalloporphyrin compound on human prostate cancer PC-3 cells in vitro and the anticancer mechanism of PDT.The new water-soluble manganese, 5,10,15, 20-tetra (N-methyl4-pyridyl) porphinato (2-) tetraiodide salt, was synthesized. The PC-3 cells were treated with the compound of serial concentrations(0, 0.1, 1, 1.0 micromol/L) followed by irradiation of different dosages of visible light. The techniques of MTT and Annexin-V/propidium iodide double-labeled flow cytometry (FCM) were applied to measuring the inhibitory effect of the compound on the growth activity and apoptosis of the cells.When the metalloporphyrin compound concentration was within 10 micromol/L and the irradiation time was within 30 min, the water-soluble metalloporphyrin compound had a significant inhibitory effect on the proliferation of PC-3 cells and induced PC-3 cell apoptosis, and the effects depended greatly on metalloporphyrin concentration and illumination dosages. Higher concentrations and dosages induced the death of the majority of PC-3 cells.The PDT of the water-soluble metalloporphyrin compound followed by light irradiation has a distinctive killing effect on PC-3 cells in vitro, and the rates of proliferation inhibition and cell apoptosis are correlated with metalloporphyrin concentration and the dosages of light irradiation. The results suggest that the mechanism of metalloporphyrin PDT may be involved with the induction of apoptosis in human prostate cancer cells.