Nitin Abrol

Expression of CD147, BIGH3 and Stathmin and their potential role as diagnostic marker in patients with urothelial carcinoma of the bladder

BACKGROUND Urothelial carcinoma of the bladder is characterised by very high recurrence rate, followed up by cystoscopy which being invasive technique makes the need for non-invasive markers important for Transitional Cell Carcinoma (TCC) detection. CD147 is a transmembrane protein highly expressed in tumour cells which aids in tumour invasion and growth. BIGH3, an Extracellular matrix protein (ECM) which interacts with various ECM component in different tissue system and Stathmin(STMN1) is cytosolic microtubule destabilising protein also called as Oncoprotein18 due to its role in tumour promotion. So far the expression of BIGH3 and STMN1 remains undetermined in cancer subjects including TCC. We therefore studied the levels and molecular expression of these molecules in TCC patients, to evaluate their usefulness as diagnostic markers. METHODS Thirty consecutive TCC patients and two sets of control- 15 Benign prostatic hyperplasia (BPH) patient and 15 healthy were taken. Serum and urine levels of these molecules were estimated by ELISA and relative mRNA expression by Q-PCR from tumour and normal urothelium. Post-Hoc analysis and ROC curve were determined to evaluate the significance and sensitivity and specificity. RESULTS The mean concentrations of these molecules were found to be significantly increased (p<0.001) in the serum and urine of TCC patients, with varying significance in each grade for different molecules. The urinary levels of CD147 (67 pg/ml) and serum STMN1 concentration (1.38 ng/ml) showed a specific increase as compared to the controls, while BIGH3 was elevated in both serum and urine samples. Molecular (mRNA) expression was elevated in the high grade (Muscle Invasive) stage of the disease for all the molecules, with a significant 3-fold increase that correlated with disease severity being observed for STMN1. ROC analysis gave optimal combination of sensitivity and specificity for diagnosis of the disease in urine and serum sample for STMN1. CONCLUSION Of CD147, BIGH3 and STMN1, significant results were obtained for STMN1 and it could serve as the best possible diagnostic marker for TCC detection in future.

Outcomes following robotic radical nephrectomy: a single-center experience.

Objectives: Advancement in technology has led to a decrease in invasiveness for surgical management of malignant renal neoplasms. Laparoscopic radical nephrectomy is an established treatment for renal tumors. Since the introduction of robotic surgery in the realm of urology, many procedures have been done robotically. We evaluated the feasibility, safety, and oncological outcomes of robotic radical nephrectomy (RRN). Methods: We retrospectively reviewed the records of patients who underwent RRN for renal tumors at our institute from September 2007 to March 2011. Patients with standard indications for a radical nephrectomy were offered a robot-assisted procedure. Intraoperative parameters (operative time, blood loss, transfusion of blood products), postoperative parameters and complications were recorded. Results: Twenty-three patients who underwent RRN were included. Mean operative time was 132.7 min and mean blood loss 270 ml. The majority of patients were able to tolerate liquid diet, were free from drain, and were fit for discharge by postoperative day (POD) 1, POD 2 and POD 3, respectively. After the mean follow-up of 29.4 months, no patient had residual tumor, local recurrence or metastasis. Conclusion: We conclude that RRN is a feasible and safe procedure with good oncological outcome on short-term follow-up.

Cutaneous metastasis of prostate carcinoma to neck and upper chest

Prostate adenocarcinoma is the most common urologic malignant neoplasm in men. Metastasis to skin is rarely reported and usually occurs late. The incidence and appearance of cutaneous metastasis are not well established in patients with prostate adenocarcinoma and their recognition remains poor among practicing urologists. Their clinical appearance may mimic other common dermatologic disorders. Definitive diagnosis requires a high index of suspicion. Immunohistochemical staining helps in establishing the diagnosis. We report a case of prostate adenocarcinoma presenting with widespread metastasis, including those to dermis and subcutaneous tissue of neck and upper chest.

Laparoscopic Palanivelu-hydatid-system aided management of retrovesical hydatid cyst

Hydatid cysts of the retrovesical region are rare. They are often adherent to the adjacent bowel and bladder, and complete removal is associated with potential injuries. The Palanivelu hydatid system allows minimally invasive treatment of hydatid cysts with no adjacent organ injuries. We describe the laparoscopic management of a pelvic hydatid cyst using this system.

Medial thigh pain: An unusual presentation of giant calculi in sigmoid neobladder.

Calculi in a neobladder usually present with irritative lower urinary tract symptoms, flank pain, and haematuria. We report a case of giant stones in a sigmoid neobladder, who presented with medial thigh pain.

Radiological seminal vesicle stones may actually be in the ureter.

Calculi in blind-ending ureters are uncommon. We describe a rare case of calculi in the diverticulum of a blind-ending ureter associated with ipsilateral renal agenesis, which masqueraded as seminal vesicle calculi.