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An analysis of disease burden of prostate, bladder and kidney cancers attributable to smoking in China from 1990 to 2019

ObjectiveTo analyze the disease burden of prostate, bladder and kidney cancers attributable to smoking in China from 1990 to 2019. MethodsBased on the global burden of disease study 2019, the current situation of the disease burden of prostate, bladder and kidney cancers attributable to smoking was analyzed by using the population attributable fraction (PAF), deaths and disability-adjusted life years (DALYs). Furthermore, the annual percent change (APC) and the average annual percent change (AAPC) were calculated by joinpoint regression analysis to describe the long-term trends of the smoking-attributable burden of these three cancers from 1990 to 2019. ResultsThere were an estimated 18 800 cases of deaths and 393 106 person-years of DALYs for bladder cancer caused by smoking in 2019. The age-standardized mortality and DALY rate decreased by 0.41% and 0.39% per year from 1990 to 2019, respectively. For prostate cancer, smoking was estimated to have caused 5 016 cases of deaths and 98 276 person-years of DALYs in 2019. The age-standardized mortality and DALY rate decreased by 0.28% and 0.25% per year from 1990 to 2019, respectively. For kidney cancer, the deaths and DALYs attributable to smoking were 4 935 cases and 120 620 person-years, respectively. The standardized mortality and DALY rates increased by 3.03% and 2.98% per year from 1990 to 2019. Additionally, males suffered from a higher disease burden of these three cancers attributable to smoking than females. The elderly population had a higher smoking-attributable disease burden than the younger population. ConclusionThe situation of the disease burden of bladder, prostate and kidney cancers attributable to smoking is still serious in China, which has substantial disparities in different groups. Specifically, males and the elderly are the high-risk groups for the smoking-attributable burden. Among the three cancers, bladder cancer has the highest burden and kidney cancer has the largest burden increase during 1990-2019.

The Immunohistochemistry Expressions and Significance of ΔNp63, Ki67 in the Transitional Cell Carcinoma of Bladder

目的:探讨ΔNp63和Ki67在膀胱移行上皮癌(transitional cell carcinoma of bladder,TCCB)中的免疫组化表达及与膀胱癌病理分级、临床病理分期和预后的相关性。方法:随机选择2006～2007年间56例TCCB和12例正常膀胱黏膜病理切片用SP免疫组化行ΔNp63和Ki67检测,将结果与病理分级、分期和预后进行分析。结果:ΔNp63和Ki67在膀胱移行细胞癌中的阳性表达率明显高于正常膀胱黏膜(Plt;005)。ΔNp63和Ki67在低分化、浸润性癌组织中的阳性表达率明显高于高分化、浅表性癌组织,在膀胱癌的病理分级和临床分期之间表达差异有统计学意义(Plt;005)。ΔNp63和Ki67在复发病例中的阳性表达率显著高于初发病例(Plt;005)。采用Spearman等级相关性分析对ΔNp63和Ki67在TCCB中的表达进行比较,ΔNp63与Ki67呈正相关,rs′为0316,且Plt;005。结论:ΔNp63和Ki67与膀胱癌的临床病理分级和分期及预后密切相关,随膀胱癌分化程度的降低和浸润程度的增加而增强。ΔNp63和Ki67在TCCB的进展中可能有相互协同作用,ΔNp63可能通过促进细胞增殖发挥促癌作用,联合检测ΔNp63和Ki67可以作为判断TCCB的预后的肿瘤标记物。

Research status and prospect of artificial intelligence technology in the diagnosis of urinary system tumors

With the rapid development of artificial intelligence technology, researchers have applied it to the diagnosis of various tumors in the urinary system in recent years, and have obtained many valuable research results. The article sorted the research status of artificial intelligence technology in the fields of renal tumors, bladder tumors and prostate tumors from three aspects: the number of papers, image data, and clinical tasks. The purpose is to summarize and analyze the research status and find new valuable research ideas in the future. The results show that the artificial intelligence model based on medical data such as digital imaging and pathological images is effective in completing basic diagnosis of urinary system tumors, image segmentation of tumor infiltration areas or specific organs, gene mutation prediction and prognostic effect prediction, but most of the models for the requirement of clinical application still need to be improved. On the one hand, it is necessary to further improve the detection, classification, segmentation and other performance of the core algorithm. On the other hand, it is necessary to integrate more standardized medical databases to effectively improve the diagnostic accuracy of artificial intelligence models and make it play greater clinical value.

Expression and clinical significance of HIST1H1B gene in bladder cancer

ObjectiveTo investigate the expression and clinical significance of HIST1H1B gene in bladder cancer.MethodsInformation on HIST1H1B in the dataset GSE13507 was downloaded from the GEO database. Discrepancy in expression of HIST1H1B in normal tissues and bladder cancer tissues was analyzed by t-test. Survival analysis was performed by using Log-rank algorithm. The association between HIST1H1B gene expression and clinicpathological features was analyzed using Chi-square test. Gene enrichment analysis (GSEA) was performed to explore possible pathways of HIST1H1B involved in bladder cancer.ResultsHIST1H1B was down-regulated in normal tissues and highly expressed in bladder cancer tissues (P=0.002 5). The expression of HIST1H1B was associated with age, gender, T stage, M stage, N stage, disease stage, but not associated with invasiveness and progression. Whether in overall survival (HR=1.732, 95%CI 1.070 to 2.803) or tumor-specific survival (HR=2.000, 95%CI 0.996 to 4.017), patients with high expression of HIST1H1B were significantly lower than that in patients with low expression (P<0.05). GSEA results showed that HIST1H1B may influence the occurrence and development of bladder cancer by regulating MYC signaling pathway V2, G2M checkpoint, E2F signaling pathway, spermatogenesis, mitotic spindle, etc.ConclusionsHIST1H1B may be a biomarker for determining the prognosis of bladder cancer and a target for treatment of bladder cancer.

Intravesical Adriamycin and It’s Derivative for Preventing Superficial Bladder Cancer Recurrance after TURB-t

Objective　To determine whether intravesically administered Adriamycin can prevent superficial bladder tumor to recur through assessing the efficacy of with intravesical Adriamycin and without intravesical Adriamycin after TURB-t. Method　The search strategy was made according to the demand of Cochrane Collaboration. Medline, Embase，CBMdisc and the Cochrane Library were searched for RCTs. Data were extracted by two reviewers using the designed extraction form. RevMan were used for data management and analysis. Results　Thirty three relevant trials were searched, of which eighteen trials were included and fifteen trials were excluded. Meta-analysis showed intravesically administered Pirarnbicin (THP), Epirubicin (EPI) and Adriamycin (ADM) can reduce the recurrence rate of superficial bladder cancer after operation during one or two years. Conclusions　Intravesically administered THP, EPI and ADM can reduce the recurrence rate of superficial bladder cancer after TUPB-t’s operation during one or two years. In addition, the factors affecting the prognosis should be performed, such as the dosage of irrigation of bladder, reserving time and the course.

Treatment and surveillance for non-muscle-invasive bladder cancer in China: an evidence-based clinical practice guideline (2018 simplified version)

Advances in neoadjuvant immunotherapy for bladder cancer

Bladder cancer is one of the most common cancers of the urinary system. Baesd on the involvement of the blandder muscle or not, bladder cancer can be generally classified into muscule-invasive bladder cancer (MIBC) and non-MIBC. Cisplatin-based neoadjuvant chemotherapy followed by radical cystectomy is the standard treament recommended by current guidelines for MIBC. Based on the good efficacy of immunocheckpoint inhibitors in advanced bladder cancer. More and more studies have explored the safety and efficacy of immunotherapy in MIBC neoadjuvant therapy, and analyzed biomarkers to explore the benefit groups. This article reviews the latest progress of various neoadjuvant immunomonotherapy in MIBC, and prospect the future direction of development.

Efficacy and Safety of Simultaneous Transurethral Resection of Bladder Cancer and Prostate in the Treatment of Bladder Cancer with Benign Prostatic Hyperplasia: A Systematic Review

ObjectiveTo systematically evaluate the efficacy and safety of simultaneous transurethral resection of bladder cancer and prostate (TURBT+TURP) in the treatment of bladder cancer with benign prostatic hyperplasia (BPH). MethodsWe searched PubMed, EMbase, The Cochrane Library, Web of Science, CBM, CNKI, WanFang Data and VIP from inception to January 2015, to collect randomized controlled trials (RCTs) and cohort studies investigating the efficacy and safety of TURBT with TURP in the treatment of bladder cancer with BPH. Two reviewers independently screened literature, extracted data, and assessed the risk bias of included studies, and then meta-analysis was performed using RevMan 5.3 software. Results3 A total of 3 RCTs (n=137) and 10 retrospective cohort studies (n=998) were included. The results of meta-analysis showed that there were no significant differences between the simultaneous resection group and the control group in the overall recurrence rate (RCT:OR=0.55, 95% CI:0.24 to 1.24, P=0.15; retrospective cohort study:OR=0.78, 95% CI:0.60 to 1.01, P=0.06), postoperative recurrence rate in the prostatic fossa/urethra (RCT:OR=1.40, 95% CI:0.28 to 7.60, P=0.68; retrospective cohort study:OR=1.36, 95% CI:0.49 to 3.74, P=0.55), progression rate (OR=0.93, 95% CI:0.53 to 1.61, P=0.79) and overall perioperative complication rate (RCT:OR=0.35, 95% CI:0.08 to 1.55, P=0.17; retrospective cohort study:OR=0.1.75, 95% CI:0.44 to 6.98, P=0.43). ConclusionCompared with only TURBT or sequential TURBT and TURP, simultaneous TURBT and TURP do not increase the overall recurrence rate, postoperative recurrence rate in the prostatic fossa/urethra, progression rate and overall postoperative complication rate. However, due to the limited quality and quantity of included studies, larger sample size and higher quality RCTs are needed to verify the above conclusion.

The incidence and mortality of global bladder cancer from 1990 to 2017

ObjectivesTo analyze the trend of incidence and mortality of bladder cancer from 1990 to 2017 and the effects of age, time period and birth cohort on bladder cancer incidence and mortality.MethodsData on age-standardized incidence rate (ASIR) and age-standardized death rate (ASDR) of bladder cancer from 1990 to 2017 were extracted from the Global Burden of Disease 2017 (GBD 2017) database. Joinpoint regression model was used to analyze the average annual percentage change of ASIR and ASDR of bladder cancer. The age-period-cohort model was established to analyze the age, period and birth cohort effects on ASIR and ASDR of bladder cancer.ResultsFrom 1990 to 2017, both ASIR and ASDR of bladder cancer decreased slightly. ASIR decreased from 6.42 per 100 000 in 1990 to 6.04 per 100 000 in 2017, with an average annual percentage change of −0.9% (−1.0% to −0.8%), and ASDR decreased from 3.15 per 100 000 in 1990 to 2017 2.57/100 000, with an average annual percentage change of −0.4% (−0.4% to −0.3%). The age-period-cohort model results showed that as age increased, the risk of bladder cancer incidence and mortality increased; as the birth cohort progressed, the risk of bladder cancer morbidity and mortality decreased. The time period had little effect on the incidence and mortality of bladder cancer.ConclusionsThe incidence and mortality of bladder cancer are declining globally. On the other hand, the increase of the aging global population could reverse the incidence and mortality trend, active measures should be taken to address the adverse effects of aging.

窄波成像在膀胱癌早期诊断中的应用进展

膀胱癌是泌尿系统最常见的恶性肿瘤、具有多发、易复发、复发后恶性程度提高等特点。虽然膀胱镜检查仍然是早期诊断膀胱癌的主要手段，但是目前常用的普通膀胱镜不易发现膀胱黏膜的细微病变，可能导致漏诊或手术治疗不彻底。窄波成像（NBI）是21世纪初新研发的全新诊断技术，其能够显著增强膀胱镜检查的对比度和清晰度，能够更加清楚地显示黏膜表层的毛细血管和腺管开口，不仅可以提高膀胱癌的早期诊断水平，还可以有效地为经尿道膀胱肿瘤电切术手术提供指导。尽管对NBI应用的远期效果以及能否减少膀胱癌患者术后膀胱灌注和膀胱镜检查的次数还有待进一步研究和观察，但是NBI技术所具有的独特优势为膀胱癌的早期诊断和治疗提供了新的契机。