Objective To develop and externally validate a novel nomogram in biopsy‐naïve patients with prostate‐specific antigen (PSA) <10 ng/ml and PI‐RADS v2.1 = 3 lesions. Methods We retrospectively collected 307 men that underwent initial biopsy from October 2015 to January 2022 in Cohort 1 (The First Affiliated Hospital of Soochow University). External cohort (Cohort 2, Kunshan Hospital) included 109 men that met our criteria from July 2016 to June 2021. By Slicer‐3D Software, the volume of all lesions was divided into two subgroups (PI‐RADS v2.1 = 3a and 3b). Logistic regression analysis was performed to screen for variables and construct nomogram by analyzing clinical data from Cohort 1. Receiver operating characteristics curve analysis, calibration plot and decision curve analysis (DCA) were plotted to validate the nomogram in external cohort. Results A total of 70 (22.8%) patients was diagnosed with prostate cancer in Institution 1. Among them, 34 (11.1%) had clinically significant prostate cancer (csPCa). Age, prostate‐specific antigen density, digital rectal examination, PI‐RADS v2.1 = 3 subgroups (3a and 3b) and apparent diffusion coefficient (ADC, <750 mm 2 /s) were predictive factors for prostate cancer (PCa) and csPCa. High area under the curve of the nomogram was found in Cohort 1 and Cohort 2 for PCa (0.857 vs. 0.850) and for csPCa (0.896 vs. 0.893). Calibration curves showed excellent agreement between the predicted probability and actual risk for the models in internal and external validation. The DCA demonstrated net benefit of our nomogram. Conclusion Until now, this is the first nomogram that predicts PCa and csPCa in biopsy‐naïve patients with PSA <10 ng/ml and PI‐RADS v2.1 = 3 lesions. Furthermore, PI‐RADS v2.1 = 3 subgroups were considered to be an independent risk factor in our model. Our nomogram may assist urologists in biopsy decision making for these so‐called “double gray zone” patients.
Objective: This study aimed to identify the risk factors for postoperative recurrence of unilateral upper ureteral calculi and develop a predictive nomogram. Patients and Methods: A retrospective analysis was conducted on 243 patients diagnosed with unilateral upper ureteral calculi who were treated at our hospital between January 1, 2016 and December 31, 2018. Patients were divided into two groups: recurrence or non-recurrence cohort. Differences in age, gender, smoking and/or drinking habit, laterality, stone diameter, ureteral stricture, stone incarceration, urinary tract infection, surgical intervention, operation time, body mass index, and metabolic syndrome were analyzed. Discrete risk factors were screened, and a nomogram was developed to predict the probability of stone recurrence. Results: The study found that the recurrence of ureteral calculi was associated with factors including stone diameter, ureteral stricture, stone incarceration, surgical intervention, operation time, metabolic syndrome, body mass index, triglycerides, diabetes, and high blood pressure ( p < 0.05). Ureteral stricture, surgical intervention, metabolic syndrome, and triglycerides were found to be discrete risk factors for stone recurrence ( p < 0.05). In addition, the study revealed that the stone recurrence rate of metabolic syndrome patients was significantly elevated ( p < 0.05), as demonstrated by the survival curve. Lastly, using the nomogram, with an area under the curve value of 0.929, the recurrence rate of ureteral calculi was predicted. Conclusions: The study identified that preoperative ureteral stricture, laparoscopic ureterolithotomy, metabolic syndrome, and triglycerides are closely related to postoperative recurrence of ureteral calculi. The nomogram developed in this study can be used as a predictive tool for the recurrence rate of ureteral calculi.
Background. Biological processes serve crucial functions in the initiation and development of cancer. Therefore, we constructed and validated a model for bladder cancer (BLCA) with good predictive power for immunity, prognosis, and therapy. Methods. Using the expression of the gene sets based on biological processes, BLCA patients were divided into three clusters by consensus cluster analysis. By performing LASSO regression analysis twice, key genes were selected, and the biological processes-related genes’ (BPRG) score was calculated. Differences in immune infiltration, tumor microenvironment, tumor mutation burden, immunotherapy, and sensitivity towards chemotherapy were analyzed between two groups divided by BPRG score. Results. Good accuracy was observed for the three clusters. They showed different prognoses and levels of immune cell infiltration. The selected key genes were mainly enriched in immune-related pathways. The high-BPRG score group was related to poor prognosis, higher immune cell infiltration, interstitial scores, and increased tumor mutation. Moreover, the effects of immunotherapy were good, and those of chemotherapy were poor. Conclusion. Overall, key genes may be involved in various complex immune regulation processes. Therefore, the quantification and verification of the BPRG score are expected to facilitate the understanding of the immunosuppressive microenvironment in BLCA and guide the choice of chemotherapeutic drugs and immunotherapeutic regimens and help predict the prognoses of patients with BLCA.
BackgroudMiR-29a belongs to one of the subtypes of miRNAs known as non-coding single-stranded RNAs, and is preferentially expressed in normal tissues. B7-H3, a member of the B7/CD28 immunoglobulin superfamily, was shown to be overexpressed in several solid malignant tumors, including colon cancer. In addition, it is associated with tumor progression and poor prognosis.MethodsWe used immunohistochemical and western blotting to assess B7-H3 protein expression levels in colon cancer and adjacent normal tissues, and then compared their relationships with clinicopathological factors. Quantitative real time reverse transcription PCR was used to assess B7-H3 and miRNA-29a mRNA expression levels, and then their relationship and clinical significance were evaluated. In addition, colon cancer Caco-2 cells, which constitutively overexpress B7-H3, were transfected with lentivirus particles for miR-29a upregulation. Invasion and migration assays were carried out in vitro along with the establishment of a subcutaneous xenograft model in vivo to determine the role of miRNA-29a in colon cancer progression.ResultsThe B7-H3 protein showed elevated expression in colon carcinoma, and was relevant to TNM staging, lymph node metastasis and reduced survival. Meanwhile, miR-29a was preferentially expressed in normal colon tissues while B7-H3 transcript levels had no marked differences between tumor and normal tissue specimens. In vitro, miR-29a upregulation resulted in reduced B7-H3 expression. Furthermore, miR-29a upregulation reduced the invasive and migratory abilities of colon carcinoma cells. In animal models, upregulation of miR-29a slowed down the growth of subcutaneous xenotransplanted tumors, and resulted in prolonged survival time.ConclusionMiR-29a downregulates B7-H3 expression and accordingly inhibits colon cancer progression, invasion and migration, indicating miR-29a and B7-H3 might represent novel molecular targets for advanced immunotherapy in colon cancer.
Background To measure expression levels of interleukin-9 (IL-9) in renal tumors and to determine the clinical significance of those levels. Methods We enrolled 66 patients who underwent surgical resection of renal tumors between January and December 2018 at the First Affiliated Hospital of Soochow University. Their tumor tissues were paired with adjacent normal tissues and IL-9 expression levels were measured using immunohistochemistry. We determined the correlation of IL-9 expression with clinicopathological features and progression-free survival (PFS). Results Expression of IL-9 in renal tumors was significantly lower than in adjacent normal tissues (P <0.0001). There was a significant negative correlation between IL-9 expression levels and R.E.N.A.L. scores (P = 0.0277) as well as with differentiation (P = 0.0041). However, no significant correlation was found between IL-9 levels and clinicopathological features, including gender (P = 0.0716), age (P = 0.0.2566), BMI (P = 0.7941), tumor size (P = 0.4193) or TNM staging (P = 0.5402). PFS time in renal tumor patients with positive IL-9 expression was similar to that of patients with negative IL-9 expression. Conclusions IL-9 expression was higher in adjacent normal tissues than in renal tumors. Low expression of IL-9 was detected when R.E.N.A.L. score was high or cell differentiation was poor, suggesting that IL-9 may positively participate in renal tumor microenvironments.
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