[Clinicopathological analysis of patients with papillary renal cell carcinoma]

OBJECTIVE

To investigate the clinicopathological features,treatment and prognosis of patients with papillary renal cell carcinoma (PRCC) and PRCC-complicated with tumor thrombus.

METHODS

Single center retrospective analysis of 75 patients with PRCC treated from January 2012 to October 2017 was performed. There were 55 males and 20 females at an age range of 24-82 years. Sixteen PRCC patients were complicated with tumor thrombus. All the patients were with a surgery and had clear pathological diagnosis and detailed follow-up data. The clinicopathological features, prognosis and influencing factors of the patients with PRCC and PRCC complicated with tumor thrombus were analyzed and summarized.

RESULTS

The average age of the 75 patients was(56.05±11.59)years,the average body mass index (BMI) was (26±3) kg/m², and the average tumor maximum diameter was (5.17±3.85) cm. There were significant differences between tumor maximum diameter larger than 7 cm and less than 7 cm (69.6% vs. 94.4%, P<0.001), lymph node metastasis and no lymph node metastasis (<38% vs. 98%, P<0.001), adrenal metastasis and no adrenal metastasis (0% vs. 95.3%, P<0.001), pulmonary metastasis and no pulmonary metastasis (0% vs.90.7%, P<0.001), complicated with and without tumor thrombus (<66.4% vs. 93.5%, P<0.001) on the effect of 3-year survival rate of the PRCC patients. In this study, there were 16 patients with type 2 PRCC complicated with tumor thrombus. There were significant differences in concomitant symptoms (62.5% vs. 22.0%, P=0.005), maximum tumor diameter (68.8% vs.13.3%, P<0.001), adrenal metastasis (18.8% vs. 0.02%, P=0.029), pulmonary metastasis (18.8% vs. 0%, P=0.008), nuclear grade (P<0.001) and pathological type (100% vs. 44.1%, P<0.001) between the PRCC patients with and without tumor thrombus.

CONCLUSION

There were significant differences in tumor diameter,lymph node metastasis,adrenal metastasis, pulmonary metastasis,pathological type, nuclear grade and tumor thrombus in the effect of the 3-year survival rate of PRCC patients. PRCC patients with tumor thrombus were more commonly suffered from type 2 PRCC, for whom the tumor diameter was larger,the nuclear grade was higher,and the distance metastasis happened more easily.

[Effects of low calcium on myocardial necrosis of Keshan disease by food preference]

It was noticed that monotonous diet which imitated the composition of diet for the susceptible population of Keshan disease with a habit of food preference was prominently low in calcium and selenium. The plasma calcium ion content of rats kept on a monotonous diet was significantly lowered to merely half the content of the stock diet group with significant lowering of GSH-px activity. After peritoneal injection of furosemide, the plasma calcium ion contents of the monotonous diet group were further lowered significantly and signs of calcium deficiency, such as muscle tremor, spasm and convulsion might occur. If anoxic factor NaNO2 acted simultaneously, acute and severe myocardial necrosis developed. Morphologically, the myocardial necrosis was similar to that in Keshan disease. When monotonous diet was supplemented with only calcium, the growth state of the rats was significantly improved, and the degree of myocardial necrosis was significantly decreased. Supplement of calcium, selenium as well as vitamin E, seemed more effective. It is suggested that low selenium is the basic factor of endemic pathogenesis of Keshan disease, and low calcium intake by food preference among the susceptible population of Keshan disease plays an important role in the pathogenesis of myocardial necrosis in Keshan disease.

[Detection of CAg in CSF of 231 cerebral cysticercosis patients]

The results of detection of circulating antigen (CAg) in cerebrospinal fluids (CSF) of 231 cerebral cysticercosis patients with McAb (4F8)--based ELISA were reported and compared with the case histories, clinical manifestations and CT scans. No relationship was found between CAg detected in CSF of these cases and history of taeniasis. However, the positive rate of CAg in cerebral cysticercosis patients with subcutaneous nodules was found significantly higher than those in cases with simple cerebral cysticercosis and in cases with subcutaneous nodules disappeared after anti-Cysticercus therapy before CSF collection. The results of CAg detection in CSF were related with the CT findings as well as the stage of the disease. It is thus indicated that McAb (4F8)-based ELISA might be useful not only for diagnosis of neurocysticercosis, but also for the evaluation of efficacy of anti-Cysticercus therapy.

A MAb-based ELISA for detecting circulating antigen in CSF of patients with neurocysticercosis

A monoclonal antibody (MAb)-based enzyme-linked immunosorbent assay (ELISA) was evaluated for detecting circulating antigen (CAg) in the cerebrospinal fluid (CSF) of patients with neurocysticercosis. CAg of Cysticercus Cellulosae was detected in 95 out of 116 patients with neurocysticercosis. Of the 21 neurocysticercosis patients in whom CAg was not detected, 14 had only higher density spots, 3 had one or two lower density spots and 4 had no obvious damage in their brain Computed Tomography (CT) scans. CAg was also not detected in CSF samples of patients with other diseases of the central nervous system. These included cerebral tumor, encephalopyosis, brain trauma, viral meningitis and cerebral hemorrhage. Detecting CAg with MAb-based ELISA is better than any previously available methods for the diagnosis of active neurocysticercosis.