Aim of the study is to define the diagnostic accuracy of selected urinary protein biomarkers in the non-invasive detection of primary and recurrent urothelial carcinoma of the urinary bladder. The urinary levels of calprotectin, CD147, APOA4 and protein deglycase DJ-1 were examined in 255 individuals, including 60 controls with non-malignant urological disease, 61 patients with a history of urinary bladder cancer with negative cytology and negative cystoscopy and 134 patients with urinary bladder cancer. Urinary concentrations of biomarkers were determined by Enzyme-Linked Immunosorbent Assay (ELISA). During the follow-up of patients with non-muscle invasive bladder cancer (NMIBC), a group of 44 patients with cancer recurrence was compared to the group of 61 patients with a history of NMIBC but with no evidence of disease. Urinary concentrations of the evaluated markers did not reveal any significant difference between these groups. During the primary diagnosis, a group of 90 patients with primary bladder cancer and 60 subjects with benign disease were compared. Urinary levels of CD147 were not significantly higher in patients with tumors. The greatest diagnostic accuracy was observed in APOA4 (sensitivity 55.6, specificity 83.3, AUC 0.75), and lesser in calprotectin (sensitivity 39.4, specificity 87.7, AUC 0.66) and in DJ-1 (sensitivity 61.1, specificity 66.7, AUC 0.64), respectively. Apolipoprotein A4 may be used potentially as a supplemental urinary marker in the diagnosis of primary bladder cancer.
- MeSH
- Apolipoproteins A urine MeSH
- Basigin urine MeSH
- Leukocyte L1 Antigen Complex urine MeSH
- Humans MeSH
- Neoplasm Recurrence, Local MeSH
- Biomarkers, Tumor urine MeSH
- Urinary Bladder Neoplasms diagnosis urine MeSH
- Protein Deglycase DJ-1 urine MeSH
- Sensitivity and Specificity MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
OBJECTIVE: To evaluate the prognostic value of the depth of lamina propria invasion in patients with T1 bladder cancer. SUBJECTS AND METHODS: 200 patients were treated between the years 2002 and 2009. Tumours with depth of invasion above the muscularis mucosae level were categorised as pT1a and those with depth of invasion up to or beyond the muscularis mucosae as pT1b. RESULTS: Categorisation for pT1a and pT1b was performed in 176 of 200 patients (88%). In 10 patients a muscle-invasive tumour was found in re-transurethral resection samples. 131 (79%) of 166 analysed patients had pT1a tumour and 35 (21%) had pT1b tumour. During the follow-up, in 101 (61%) patients the tumour had recurred and in 27 (16.3%) the tumour had progressed. Of all the investigated parameters, T1 substaging (p < 0.0001), grade (p = 0.0003) and the number of bacillus Calmette-Guérin instillations (p = 0.0490) were significant in predicting progression. The only significant factor for disease-specific survival was T1 substaging in univariable (p = 0.0008) and multivariable (hazard ratio 4.407) analysis. T1 substaging (p = 0.0149) and tumour multiplicity (p = 0.0448) have a statistically significant prognostic value with respect to overall survival. CONCLUSIONS: Deep invasion of the lamina propria is a significant adverse prognostic factor for tumour progression, disease-specific survival and overall survival.
- MeSH
- Time Factors MeSH
- Adult MeSH
- Neoplasm Invasiveness MeSH
- Middle Aged MeSH
- Humans MeSH
- Adolescent MeSH
- Young Adult MeSH
- Urinary Bladder pathology MeSH
- Multivariate Analysis MeSH
- Urinary Bladder Neoplasms diagnosis mortality MeSH
- Prognosis MeSH
- Disease Progression MeSH
- Proportional Hazards Models MeSH
- Recurrence MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Neoplasm Staging methods MeSH
- Treatment Outcome MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Adolescent MeSH
- Young Adult MeSH
- Male MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
Mycobacterium marinum is the most frequent non-tuberculous Mycobacterium in humans. We report the first ever described case of epididymoorchitis resulting from hematogenous spread of M. marinum from hand oligoarthritis. This was initially mistaken for rheumatoid disease and methylprednisolone-induced immunosuppression led to hematogenous spread of infection to the testis and epididymis.
- MeSH
- Anti-Bacterial Agents therapeutic use MeSH
- Mycobacterium Infections, Nontuberculous diagnosis drug therapy microbiology MeSH
- Diagnostic Errors MeSH
- Epididymitis diagnosis drug therapy microbiology MeSH
- Immunosuppressive Agents adverse effects MeSH
- Arthritis, Infectious diagnosis drug therapy microbiology MeSH
- Middle Aged MeSH
- Humans MeSH
- Methylprednisolone adverse effects MeSH
- Mycobacterium marinum isolation & purification pathogenicity MeSH
- Orchitis diagnosis drug therapy microbiology MeSH
- Finger Injuries complications MeSH
- Treatment Outcome MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Publication type
- Journal Article MeSH
- Case Reports MeSH
- Research Support, Non-U.S. Gov't MeSH
- Review MeSH
Urinary incontinence has a significant impact on the quality of life. Stress urinary incontinence in men is still a common problem after surgical treatment of prostatic diseases. The management of post-prostatectomy incontinence is mostly surgical (bulking agents, bulbar slings, artificial urethral sphincter). Urgency incontinence is mostly caused by detrusor hyperactivity. Antimuscarinic agents are the best therapeutic option.
The most frequent conditions of extraurethral urinary incontinence are vesicovaginal or ureterovaginal or urethrovaginal fistulae caused by iatrogenic lesions mostly during hysterectomy or other pelvic surgery. Occlusion of the fistula is possible by the transvesical or transvaginal approach, recurrent or complex or postactinic fistula are manager by supravesical diversion of urine.
