Ratiometric detection of oligonucleotide stoichiometry on multifunctional gold nanoparticles by whispering gallery mode biosensing

A label-free method is developed to ratiometrically determine the stoichiometry of oligonucleotides attached to the surface of gold nanoparticle (GNP) by whispering gallery mode biosensing. Utilizing this scheme, it is furthermore shown that the stoichiometric ratio of GNP attached oligonucleotide species can be controlled by varying the concentration ratio of thiolated oligonucleotides that are used to modify the GNP.

Development and characterization of wheat lines carrying stem rust resistance gene Sr43 derived from Thinopyrum ponticum

Wheat lines carrying Ug99-effective stem rust resistance gene Sr43 on shortened alien chromosome segments were produced using chromosome engineering, and molecular markers linked to Sr43 were identified for marker-assisted selection. Stem rust resistance gene Sr43, transferred into common wheat (Triticum aestivum) from Thinopyrum ponticum, is an effective gene against stem rust Ug99 races. However, this gene has not been used in wheat breeding because it is located on a large Th. ponticum 7el(2) chromosome segment, which also harbors genes for undesirable traits. The objective of this study was to eliminate excessive Th. ponticum chromatin surrounding Sr43 to make it usable in wheat breeding. The two original translocation lines KS10-2 and KS24-1 carrying Sr43 were first analyzed using simple sequence repeat (SSR) markers and florescent genomic in situ hybridization. Six SSR markers located on wheat chromosome arm 7DL were identified to be associated with the Th. ponticum chromatin in KS10-2 and KS24-1. The results confirmed that KS24-1 is a 7DS·7el(2)L Robertsonian translocation as previously reported. However, KS10-2, which was previously designated as a 7el(2)S·7el(2)L-7DL translocation, was identified as a 7DS-7el(2)S·7el(2)L translocation. To reduce the Th. ponticum chromatin carrying Sr43, a BC(2)F(1) population (Chinese Spring//Chinese Spring ph1bph1b*2/KS10-2) containing ph1b-induced homoeologous recombinants was developed, tested with stem rust, and genotyped with the six SSR markers identified above. Two new wheat lines (RWG33 and RWG34) carrying Sr43 on shortened alien chromosome segments (about 17.5 and 13.7 % of the translocation chromosomes, respectively) were obtained, and two molecular markers linked to Sr43 in these lines were identified. The new wheat lines with Sr43 and the closely linked markers provide new resources for improving resistance to Ug99 and other races of stem rust in wheat.

Regulatory interplay between NFIC and TGF-β1 in apical papilla-derived stem cells

While transforming growth factor-β1 (TGF-β1) can regulate odontoblast differentiation in tooth crown morphogenesis, its effects on cells including stem cells from the apical papilla (SCAPs) involved in root formation are unclear. Nuclear factor I-C (NFIC) has been implicated in the regulation of root development, and interplay with TGF-β1 signaling has been reported in some cell types. We hypothesize that NFIC and TGF-β1 are important to the behavior of SCAPs and that the interplay between these molecules controls the regulation of the odontogenic differentiation of SCAPs. TGF-β1 inhibited the proliferation of SCAPs and their mineralization. Real-time polymerase chain-reaction (RT-PCR) and Western blot results showed that TGF-β1 significantly decreased osteogenic/dentinogenic gene expression. The inhibition of TGF-β/Smad signaling (SIS3) attenuated the suppressive effect of TGF-β1 on SCAPs. Importantly, overexpression of NFIC antagonized the effects of TGF-β1 on SCAPs, while knockdown of NFIC enhanced these effects, demonstrating a key regulatory role for NFIC in modulating TGF-β1 signaling in SCAPs. We conclude that this interplay between NFIC and TGF-β1 regulates SCAPs behavior and can determine the differentiation of these cells. These signaling interactions help inform the development of regenerative strategies aimed at root growth and development in immature teeth for endodontic treatment.

Expression pattern of Ngn3 in dairy goat testis and its function in promoting meiosis by upregulating Stra8

OBJECTIVES

Ngn3 is a typical transcription factor and marker of differentiating spermatogonial stem cells (SSCs) in mouse, belonging to the basic helix-loop-helix (bHLH) family. Its gene is specifically expressed in A type spermatogonia in mouse testis, thus plays a critical role in controlling differentiation of SSCs. However, roles of Ngn3 and its protein in dairy goat testis remain unknown.

MATERIALS AND METHODS

Testis development and expression patterns of Ngn3 were analysed by immunofluorescence and quantitative reverse transcription-polymerase chain reaction (QRT-PCR) in the dairy goat. Furthermore, effects of its overexpression on male germline stem cells (mGSCs) were evaluated by QRT-PCR, immunofluorescence, luciferase reporter assay and western blotting.

RESULTS

Revealed that Ngn3 was expressed more highly during puberty and in the adult than in testis of other ages. Overexpression of Ngn3 promoted expression of meiosis-related gene Stra8 and stem-cell differentiation marker CD117, but suppressed expression of Plzf, a classical marker of SSCs. Furthermore, Ngn3 did not promote expression of Stra8 directly as shown in transcription and translation levels detected by luciferase reporter assay and western blotting.

CONCLUSIONS

Taken together, these results suggest that Ngn3 plays an important role in spermatogenesis and that overexpression of Ngn3 can promote meiosis in testis of the dairy goat.

Clinicopathological significance of mesothelin expression in invasive breast cancer

OBJECTIVES

This study evaluated the expression profile of the mesothelin (MSLN) gene and its prognostic significance in breast cancer.

METHODS

To evaluate the diagnostic and prognostic significance of mesothelin, immunohistochemistry was used to assess the level of mesothelin protein in surgically resected, formalin-fixed, paraffin-embedded invasive breast carcinoma specimens. Associations between mesothelin and other biomarkers, including oestrogen receptor (OR), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2/neu), were also evaluated.

RESULTS

A total of 182 breast carcinoma specimens were included. Mesothelin protein was present in the membrane of malignant cells. There was correlation between the presence of mesothelin in tumour cells and tumour infiltration of the lymph node. There was no correlation between the presence of mesothelin and HER2/neu protein, OR and PR in tumour cells. Mesothelin levels were significantly associated with decreased overall survival.

CONCLUSIONS

Lymph node status, tumour size, HER2/neu and mesothelin protein levels in breast cancer cells were independent prognostic factors. Mesothelin could be useful as a prognostic marker of overall survival in invasive breast cancer.

Protein value of a new genotype oat (CDC SO-I) for the NRC dairy model: Protein degradation balance and kinetics, protein fractions and total metabolizable protein supply

Recently, a new genotype of oat has been developed specifically for feed purposes by the Crop Development Centre called CDC SO-I (“SuperOat”) containing a low-lignin hull and a high-fat groat. However, no quantitative evaluation of protein supply from CDC SO-I to dairy cow has been done in terms of potential protein degradation balance (PDB) and total metabolizable protein (MP) supply. These data are crucial in order to develop more efficient, competitive and optimal feeding the new genotype of oat (CDC SO-I) for livestock. Unlike DVE/OEB, PBI, ARC and NKJ-NJF models, NRC-2001 is a total digestible nutrient (TDN-) based model which is more popular in North America. The objectives of this study were to use the NRC model with inputs based on laboratory and in situ techniques to predict the potential nutrient supply to dairy cows from CDC SO-I in comparison with two conventional oat varieties, CDC Dancer and Derby, in western Canada. The quantitative predictions were made in terms of: (1) Rumen-synthesized microbial protein truly absorbed in the small intestine (AMCP); (2) Rumen undegraded feed protein truly absorbed in the small intestine (ARUP); (3) Endogenous protein in the digestive tract (AECP); (4) Total metabolizable protein supply in the small intestine (MP), and (5) Protein degraded balance (PDB). The results show that using the NRC model, the predicted PDB and total MP supplies to dairy cattle were significantly increased from the newly developed genotype of oat (CDC SO-I). Compared with the normal oat, CDC Dancer, CDC SO-I significantly increased (P < 0.05) ARUP, by 24%, and total MP supply by 9%, but did not change (P > 0.05) AMCP, AECP and PDB, with averages of 55.7, 4.5 and -11.96 g kg-1 dry matter (DM), respectively. Compared with the normal variety, Derby, CDC SO-I significantly increased (P < 0.05) AMCP, by 19%, total MP supply by 13% and increased PDB by 114%, but did not change (P > 0.05) ARUP and AECP values with averages of 19.2 and 4.5 g kg-1 DM, respectively. In conclusion, CDC SO-I oat increased total absorbed metabolizable protein supply to dairy cattle by 9–13% in comparison with the two conventional oat varieties used in western Canada. However, although CDC SO-I improved protein degraded balance, it still had a negative value (-10.6 g kg-1 DM), indicating the potential imbalance between microbial protein synthesis from available rumen-degradable crude protein (CP) and potential energy from fermentation in the rumen. Key words: TDN-based model, dairy cattle, oat genotype, protein degradation balance, metabolizable protein supply

Rapid characterization of molecular chemistry, nutrient make-up and microlocation of internal seed tissue

Wheat differs from corn in biodegradation kinetics and fermentation characteristics. Wheat exhibits a relatively high rate (23% h(-1)) and extent (78% DM) of biodegradation, which can lead to metabolic problems such as acidosis and bloat in ruminants. The objective of this study was to rapidly characterize the molecular chemistry of the internal structure of wheat (cv. AC Barrie) and reveal both its structural chemical make-up and nutrient component matrix by analyzing the intensity and spatial distribution of molecular functional groups within the intact seed using advanced synchrotron-powered Fourier transform infrared (FTIR) microspectroscopy. The experiment was performed at the U2B station of the National Synchrotron Light Source at Brookhaven National Laboratory, New York, USA. The wheat tissue was imaged systematically from the pericarp, seed coat, aleurone layer and endosperm under the peaks at approximately 1732 (carbonyl C=O ester), 1515 (aromatic compound of lignin), 1650 (amide I), 1025 (non-structural CHO), 1550 (amide II), 1246 (cellulosic material), 1160, 1150, 1080, 930, 860 (all CHO), 3350 (OH and NH stretching), 2928 (CH(2) stretching band) and 2885 cm(-1) (CH(3) stretching band). Hierarchical cluster analysis and principal component analysis were applied to analyze the molecular FTIR spectra obtained from the different inherent structures within the intact wheat tissues. The results showed that, with synchrotron-powered FTIR microspectroscopy, images of the molecular chemistry of wheat could be generated at an ultra-spatial resolution. The features of aromatic lignin, structural and non-structural carbohydrates, as well as nutrient make-up and interactions in the seeds, could be revealed. Both principal component analysis and hierarchical cluster analysis methods are conclusive in showing that they can discriminate and classify the different inherent structures within the seed tissue. The wheat exhibited distinguishable differences in the structural and nutrient make-up among the pericarp, seed coat, aleurone layer and endosperm. Such information on the molecular chemistry can be used for grain-breeding programs for selecting a superior variety of wheat targeted for food and feed purposes and for predicting wheat quality and nutritive value in humans and animals. Thus advanced synchrotron-powered FTIR technology can provide a greater understanding of the plant-animal interface.

Adaptation of the WHO guideline for residual DNA in parenteral vaccines produced on continuous cell lines to a limit for oral vaccines

Although there is a WHO guidance for a limit on residual DNA for parenterally administered vaccines produced on continuous cell lines, there is no corresponding guidance for oral vaccines. To help determine an oral limit, we performed a study of Vero cell DNA uptake in rats, in which the relative uptake and persistence of Vero cell DNA administered orally was compared to its uptake when delivered intramuscularly (IM). The results of this study allowed the generation of an empirically derived IM versus oral factor (10(6)) representing the relative inefficiency of DNA uptake by oral administration. This factor was then applied to the WHO recommended parenteral limit of 10 ng/dose to determine a corresponding upper limit on the level of residual Vero cell DNA for an oral vaccine of 10 mg. As a conservative approach, this empirically determined limit was reduced 100-fold to 100 microg. Thus, the results of this animal study, together with additional evidence in the literature, support a residual DNA safety limit of 100 microg per dose for an oral vaccine produced on a continuous cell line.

Detection of integration of plasmid DNA into host genomic DNA following intramuscular injection and electroporation

Plasmid vectors have been widely used for DNA vaccines and gene therapy. Following intramuscular injection, the plasmid that persists is extrachromosomal and integration into host DNA, if it occurs at all, is negligible. However, new technologies for improving DNA delivery could increase the frequency of integration. In the present study, we tested the effect of electroporation on plasmid uptake and potential integration following intramuscular injection in mice, using a plasmid containing the mouse erythropoietin gene. Electroporation increased plasmid tissue levels by approximately six- to 34-fold. Using a quantitative gel-purification assay for integration, electroporation was found to markedly increase the level of plasmid associated with high-molecular-weight genomic DNA. To confirm integration and identify the insertion sites, we developed a new assay - referred to as repeat-anchored integration capture (RAIC) PCR - that is capable of detecting rare integration events in a complex mixture in vivo. Using this assay, we identified four independent integration events. Sequencing of the insertion sites suggested a random integration process, but with short segments of homology between the vector breakpoint and the insertion site in three of the four cases. This is the first definitive demonstration of integration of plasmid DNA into genomic DNA following injection in vivo.

Present-day crustal deformation in China constrained by global positioning system measurements

Global Positioning System (GPS) measurements in China indicate that crustal shortening accommodates most of India's penetration into Eurasia. Deformation within the Tibetan Plateau and its margins, the Himalaya, the Altyn Tagh, and the Qilian Shan, absorbs more than 90% of the relative motion between the Indian and Eurasian plates. Internal shortening of the Tibetan plateau itself accounts for more than one-third of the total convergence. However, the Tibetan plateau south of the Kunlun and Ganzi-Mani faults is moving eastward relative to both India and Eurasia. This movement is accommodated through rotation of material around the eastern Syntaxis. The North China and South China blocks, east of the Tibetan Plateau, move coherently east-southeastward at rates of 2 to 8 millimeters per year and 6 to 11 millimeters per year, respectively, with respect to the stable Eurasia.

Plasmid DNA vaccines: tissue distribution and effects of DNA sequence, adjuvants and delivery method on integration into host DNA

A variety of factors could affect the frequency of integration of plasmid DNA vaccines into host cellular DNA, including DNA sequences within the plasmid, the expressed gene product (antigen), the formulation, delivery method, route of administration, and the type of cells exposed to the plasmid. In this report, we examined the tissue distribution and potential integration of plasmid DNA vaccines following intramuscular administration in mice and guinea pigs. We compared needle versus Biojector (needleless jet) delivery, examined the effect of aluminum phosphate adjuvants, compared the results of different plasmid DNA vaccines, and tested a gene (the human papilloma virus E7 gene) whose protein product is known to increase integration frequency in vitro. Six weeks following intramuscular injection, the vast majority of the plasmid was detected in the muscle and skin near the injection site; lower levels of plasmid were also detected in the draining lymph nodes. At early time points (1-7 days) after injection, a low level of systemic exposure could be detected. Occasionally, plasmid was detected in gonads, but it dissipated rapidly and was extrachromosomal - indicating a low risk of germline transmission. Aluminum phosphate adjuvant had no effect on the tissue distribution and did not result in a detectable increase in integration frequency. Biojector delivery, compared with needle injection, greatly increased the uptake of plasmid (particularly in skin at the injection site), but did not result in a detectable increase in integration frequency. Finally, injection of a plasmid DNA vaccine containing the human papilloma virus type 16 E7 gene, known to increase integration in vitro, did not result in detectable integration in mice. These results suggest that the risk of integration following intramuscular injection of plasmid DNA is low under a variety of experimental conditions.

Detection of interleukin-8 in exudates from normal and inflamed human dental pulp tissues

OBJECTIVE

The purpose of this study was to investigate the level of IL-8 in exudates clinically obtained from normal and inflamed human dental pulp tissues so as to reveal the possible relationship between IL-8 and pulpitis.

METHODS

Samples of 2 microliters of pulpal exudate from each normal or clinically diagnosed as acute or chronic pulpitis teeth was obtained by filter paper strips and IL-8 level was measured by ELISA method.

RESULTS

No IL-8 was detected in the samples from normal pulp, but significant amount of IL-8 appeared in inflamed pulp tissues, and the level of IL-8 in exudates of acute stage of pulpitis was higher than that of chronic stage (P < 0.01).

CONCLUSIONS

This study demonstrates that IL-8 is produced and accumulated in pulp inflammation and may play a role in the occurrence and development of human pulpitis.

[Relationship between serum epidermal growth factor and uterine leiomyoma]

OBJECTIVE

To study the effects of epidermal growth factor (EGF) on uterine leiomyoma and the relationship of EGF and estrogen, progesterone.

METHODS

Fourty patients with uterine leiomyoma and twenty normal women were studied. Serum EGF level was determined by radioimumunoassay, estradiol (E2) and progesterone (P) levels were measured by enzyme marked monoclonal antibody assay.

RESULTS

Serum EGF, E2 and P levels in observed group were significantly higher than those in control group during secretive phase (P < 0.005). The serum EGF level in observed group during prolifrative phase was significantly higher than that of secretive phase (P < 0.05). The serum EGF level increased while uterus enlarged; EGF wasn't related to E2(r = 0.25, P > 0.05) and was related to P (r = 0.71, P < 0.005). The EGF level was the highest when E2 and P both increased.

CONCLUSION

EGF has the effect on growth of uterine leiomyoma. It is possible that EGF secretion can be stimulated by E2 and the effect of P is stronger than E2.

The internal chondrocyte-specific promoter of the chick type III collagen gene is activated by AP1 and is repressed in fibroblasts by a complex containing an LBP1-related protein

The chick type III collagen gene contains an internal promoter in intron 23 in addition to the promoter preceding exon 1. The internal promoter, which is used preferentially in cultured chondrocytes, directs production of an alternative transcript that cannot encode type III collagen. This promoter is used ineffic-iently in skin fibroblasts, which transcribe the gene from the upstream promoter. We show below that the internal promoter is regulated by an activation element containing a potential activator protein 1 (AP1) site and a repressor element containing a potential binding site for leader binding protein 1 (LBP1). Electro-phoretic mobility shift assays indicate that the activation and repressor elements are bound by AP1 and an LBP1-related protein, respectively. Replacement of the AP1 site resulted in substantially decreased promoter activity in both chondrocytes and fibroblasts, indicating that this site is required for promoter function, but the low level of promoter activity in fibro-blasts is not due to loss of functional AP1. In contrast, replacement of the LBP1-like site increased activity only in fibroblasts, suggesting that this site is responsible in part for repression of promoter activity in fibroblasts.

Depressed IL-12-mediated signal transduction in T cells from patients with Sézary syndrome is associated with the absence of IL-12 receptor beta 2 mRNA and highly reduced levels of STAT4

Sézary syndrome (SS) is the leukemic phase of cutaneous T cell lymphoma characterized by the proliferation of clonally derived CD4+ T cells that release cytokines of the Th2 T cell phenotype (IL-4, IL-5, IL-10), whereas Th1 T cell cytokines (IL-2, IFN-gamma) are markedly depressed as is expression of IL-12, a pivotal cytokine for Th1 cell differentiation. Normal Th1 cells express both the beta 1 and beta 2 chains of the IL-12 receptor (IL-12R) and tyrosine phosphorylate STAT4 in response to IL-12. Th2 T cells express only the IL-12R beta 1 and thus do not tyrosine phosphorylate STAT4 in response to IL-12. To determine whether SS cells are Th2-like at the level of IL-12 signal transduction, we analyzed RNA from seven patients for the presence of message for the IL-12R beta 1 and beta 2 genes using RNase protection assays and assessed whether IL-12 induced tyrosine-phosphorylation of STAT4 by immunoblotting. In PBL from six of seven SS patients tested, beta 2 message was expressed at low to undetectable levels and its expression could not be stimulated by either IFN-alpha or IFN- gamma, which stimulated beta 2 expression in control PBL. The absence of beta 2 expression is further supportive evidence for the Th2 lineage of SS cells. However, unlike normal Th2 cells, SS cells also showed severely reduced levels of STAT4, suggesting that they have a depressed response to any inducer of the STAT4 signal transduction pathway, including IFN-alpha. This is the first observation linking STAT4 gene expression with a human disease and suggests that dysregulation of STAT4 expression may be significant to the development and/or progression of SS.

cDNA cloning and sequencing of MH2 domain of Smad2 from human dental pulp cells

OBJECTIVE

The purpose of this study was to clone and sequence the cDNA of MH2 domain of Smad2 from human dental pulp cells.

METHODS

In this study, total RNA was isolated from primary cultured human dental pulp cells and reverse-transcribed into cDNA. The desired DNA product was obtained by nested PCR with 4 smad2 MH2 domain-specific primers. The segment was inserted into pBluescript II SK vector and the resulting plasmid was transformed into E. coli JM109. The double-strand cDNA of positive clone was sequenced by PE317-A automatic sequencing.

RESULTS

cDNA of MH2 domain of Smad2 was obtained from human dental pulp cells. The sequence was consistent with that cloned from a human kidney cDNA library. No mutation was found.

CONCLUSION

This study provides the first evidence of expression of smad2 in human dental pulp cells, and indicates that TGF-beta signaling may be mediated by Smad2 in human dental pulp cells. The cDNA cloned in pBluescript/S2MH2 could be used for further functional studies of Smad2 and MH2 domain in dental pulp cells.

Retinoids synergize with interleukin-2 to augment IFN-gamma and interleukin-12 production by human peripheral blood mononuclear cells

We have demonstrated previously that cells from both the skin and peripheral blood from patients with cutaneous T cell lymphoma (CTCL) have elevated levels of protein and mRNA for Th2 cytokines, interleukin-4 (IL-4) and IL-5, and depressed levels of Thl cytokines, IL-2 and interferon-gamma (IFN-gamma). Furthermore, IL-12 in vitro can restore IFN-gamma production by these patients' cells to near normal levels. Because retinoids exert therapeutic activity in CTCL and are potent modulators of growth and differentiation of hematopoietic cells, we investigated the role of retinoids in modulating Thl cytokine production. Peripheral blood mononuclear cells (PBMC) from normal donors and patients with CTCL were cultured with medium, IL-2, 13-cis-retinoic acid, all-trans-retinoic acid, acetretin or etretinate alone, or IL-2 plus the retinoids for 24 h, and levels of IFN-gamma were determined using ELISA. IL-2 or retinoids alone could induce low but significant levels of IFN-gamma. However, when IL-2 was cultured with each retinoid, a synergistic augmentation of IFN-gamma levels (4-fold to 90-fold) was observed except in the case of etretinate. All-trans-retinoic acid (ATRA) was the most potent IFN-y inducer. Similar studies performed using PBMC from CTCL patients indicated the IFN-gamma augmentation occurred but in a blunted manner. The IFN-y-inducing effect of ATRA and 13-cis-retinoic acid could be abrogated by addition of anti-IL-12 antibodies, suggesting that IL-12 plays a role in the synergistic upregulation of IFN-gamma. Using an IL-12 p40-specific radioimmunoassay (RIA), we confirmed the presence of IL-12 in IL-2 plus retinoid-treated culture supernatants. Purified monocytes cultured with IL-2 plus ATRA did not secrete IL-12. Only when monocytes were cocultured with lymphocytes was there an increase in IL-12 production, suggesting the involvement of a paracrine feedback loop requiring both monocytes and lymphocytes. These data suggest that retinoids can induce Th1 cytokines from normal and CTCL PBMC and that this induction may be mediated through IL-12 production.

[The relationship between expression of extracellular matrix and clinical pathology of primary lung carcinoma]

OBJECTIVE

To study the relationship between expression of laminin (LN), fibronectin (FN), collagen IV (Col. IV) and clinical pathology of primary lung cancer.

METHODS

LSAB method was used to detect the expression of LN, FN and Col. IV in 184 cases of lung carcinoma.

RESULTS

Expression of LN and Col. IV in well and moderately differentiated pulmonary squamous cell carcinoma were both higher than that in poorly differentiated cases (P < 0.01), and marked difference was found between lymph node positive and negative cases (P < 0.05). Obvious difference in the expression of LN and Col. IV was found between the patient groups with squamous cell carcinoma who died within 1/2 year and those surviving more than 5 years (P < 0.01), as was the difference in expression of FN (P < 0.05). Obvious difference in the expression of FN and Col. IV was found between patients groups with adenocarcinoma who died within 1/2 year and those surviving more than 5 years (P < 0.05, 0.01).

CONCLUSIONS

The expression of LN and Col. IV correlated with histological grading and lymph node metastasis of pulmonary squamous cell carcinoma; LN, FN, Col. IV can also be regarded as a parameter for evaluating prognosis of pulmonary squamous cell carcinoma. The expression of FN and Col. IV can be regarded as a parameter for evaluating the prognosis of pulmonary adenocarcinoma.

Adrenal sparing surgery for renal cell carcinoma

OBJECTIVE

To investigate the feasibility of adrenal sparing surgery for selected renal cell carcinoma (RCC), since the necessity of routine adrenalectomy during radical nephrectomy for RCC has been challenged in recent years.

METHODS

178 patients underwent perifascial nephrectomy in a 16-year period. Of these patients, 96 had ipsilateral adrenal gland preserved during nephrectomy and 82 underwent concomitant adrenalectomy. 75 excised adrenal specimens were examined pathologically. Disease specific survival rates were assessed according to the pathological stage of the tumors.

RESULTS

Of the 75 patients, 53 presented a macroscopically normal adrenal gland without pathohistological changes. The other 22 patients were suspected to have adrenal metastasis intraoperatively, while only 5 of them were confirmed to have adrenal involvement by histopathology. Two patients in the adrenal gland preservation group developed ipsilateral adrenal recurrence and synchronous or metachronous contralateral adrenal metastasis during follow-up, although both were documented to have a normal-appearing adrenal gland intraoperatively. Five patients with adrenal metastasis and 2 patients with adrenal recurrence had large renal tumors. The survival difference among subgroups of patients undergoing adrenalectomy or with adrenal gland left in situ was not statistically significant.

CONCLUSION

Adrenal sparing surgery could be done for patients with small renal tumors along with macroscopically normal ipsilateral adrenal glands.