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Wu KY, Cheong IS, Lai JN, Hu CY, Hung KC, Chen YT, Chiu LT, Tsai HT, Jou YC, Tzai TS, Tsai YS. Risk of secondary primary malignancies in survivors of upper tract urothelial carcinoma: A nationwide population-based analysis. Cancer Epidemiol 2024; 89:102536. [PMID: 38281454 DOI: 10.1016/j.canep.2024.102536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 01/16/2024] [Accepted: 01/19/2024] [Indexed: 01/30/2024]
Abstract
BACKGROUND To investigate the cancer types and risk factors of secondary primary malignancy (SPM) in patients with upper tract urothelial carcinoma (UTUC) in Taiwan. METHODS Using National Health Insurance Research Dataset and catastrophic illness registry, we enrolled newly diagnosed UTUC patients from 2000 to 2013. Those without catastrophic illness registration were excluded from the study. The cancer types and hazard ratios (HRs) of subsequent SPMs were calculated according to the antecedent malignancy. We analyzed the risk factors for developing SPMs using multivariate Cox proportional hazard models. RESULTS A total of 9050 UTUC patients were registered and 2187 (24.2%) patients developed SPMs during the study period. As compared with primary UTUC, the relative risk ratios of SPM was 2.5 folds and 18% higher in those with antecedent non-UC malignancy and with bladder cancer history, respectively. Totally, 387 (37.8%) of 1022 UTUC patients with antecedent non-UC malignancy developed subsequent SPM after UTUC diagnosis. The antecedent and subsequent cancer types are similar and kidney cancer is most common, followed by hepatoma. Multivariate analysis showed that a history of antecedent non-UC malignancy is the most unfavorable factor for SPM development (HR, 2.50; 95% CI, 2.23-2.81), followed by liver disease, male gender, antecedent bladder cancer history, age ≥ 75 years, and chronic kidney disease. CONCLUSIONS Our study, conducted in Taiwan and involving 9050 UTUC patients, meticulously examined the types of SPM and the associated risk factors. Our research unearthed several pivotal discoveries: a preceding history of non-UC malignancies emerged as the single most influential factor contributing to the occurrence of subsequent cancers, followed by liver disease, male gender, antecedent bladder cancer history, age ≥75 years, and chronic kidney disease. Futhermore, kidney cancer emerged as the predominant subsequent malignancy, closely trailed by hepatoma..
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Affiliation(s)
- Kuan-Yu Wu
- Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704, Taiwan
| | - Ian-Seng Cheong
- Department of Urology, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi 600, Taiwan
| | - Jung-Nien Lai
- School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung 404, Taiwan; Department of Chinese Medicine, China Medical University Hospital, Taichung 404, Taiwan
| | - Che-Yuan Hu
- Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704, Taiwan
| | - Kuo-Chuan Hung
- Department of Anesthesiology, Chi Mei Medical Center, No.901, ChungHwa Road, Yung Kung Dist, Tainan 710, Taiwan; Department of Health and Nutrition, Chia Nan University of Pharmacy and Science, Tainan 717, Taiwan
| | - Yi-Ting Chen
- Department of Anesthesiology, Chia-Yi Chang Gung Memorial Hospital, Chia-Yi 613, Taiwan
| | - Lu-Ting Chiu
- Management office for Health Data, China Medical University Hospital, Taichung 404, Taiwan
| | - Hsin-Tzu Tsai
- Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704, Taiwan
| | - Yeong-Chin Jou
- Division of Urology, Department of Surgery, St Martin De Porres Hospital, Chia-Yi 600, Taiwan
| | - Tzong-Shin Tzai
- Department of Urology, An Nan Hospital, China Medical University, Tainan 709, Taiwan.
| | - Yuh-Shyan Tsai
- Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704, Taiwan.
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Kikuchi E, Ng CF, Kitamura H, Ku JH, Lee LS, Lin TP, Ng JYS, Nishiyama H, Poon DMC, Kanesvaran R, Seo HK, Spiteri C, Tan EM, Tsai YS, Tran B. Controversies in terminology associated with management of BCG-unresponsive NMIBC in Asia-Pacific. Int J Urol 2024; 31:32-38. [PMID: 37795933 DOI: 10.1111/iju.15298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 09/06/2023] [Indexed: 10/06/2023]
Abstract
OBJECTIVES Examine the understanding of terminologies and management patterns of bacillus Calmette-Guérin (BCG)-unresponsive nonmuscle invasive bladder cancer (NMIBC) in six territories in Asia-Pacific. METHODS This study involved two phases: (1) a survey with 32 urologists and 7 medical oncologists (MOs) and (2) a factorial experiment and in-depth interviews with 23 urologists and 2 MOs. All clinicians had ≥8 years' experience managing NMIBC patients in Australia, Hong Kong, Japan, South Korea, Singapore, and Taiwan. Data from Phase 1 were summarized using descriptive statistics; content and thematic analyses applied in Phase 2. RESULTS In phase 1, 35% of clinicians defined BCG-unresponsive as BCG-refractory, -relapse and -resistant, 6% defined it as BCG-refractory and -relapse; 22% classified BCG-failure as BCG-refractory, -relapse, -resistant, and when muscle-invasive bladder cancer is detected. If eligible and willing, 50% (interquartile range [IQR], 50%-80%) of BCG-unresponsive patients would undergo radical cystectomy (RC), and 50% (IQR 20%-50%) of RC-eligible patients would receive bladder-sparing treatment or surveillance. In phase 2, we found that 32%, 88%, and 48% of clinicians, respectively, used "BCG-unresponsive," "BCG-refractory," and "BCG-relapse" in clinical practice but with no consistent interpretation of the terms. Compared with EAU definitions, 8%-60% of clinicians appropriately classified 9 tumor types that are persistent or recurrent after adequate BCG. Fifty percent of clinicians mentioned a lack of bladder-preserving treatment that outperforms RC in quality of life as a reason to retreat BCG-unresponsive patients with BCG. CONCLUSIONS Our study revealed varied understanding and application of BCG-unresponsive terminologies in practice. There is a need for a uniform and simple definition of BCG-unresponsive disease in Asia-Pacific.
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Affiliation(s)
- Eiji Kikuchi
- Department of Urology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Chi-Fai Ng
- Department of Surgery, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | | | - Ja Hyeon Ku
- Department of Urology, Seoul National University, Seoul, South Korea
| | - Lui Shiong Lee
- Department of Urology, Seng Kang General Hospital, Singapore, Singapore
| | - Tzu-Ping Lin
- Department of Urology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Junice Yi Siu Ng
- Health Economics and Outcomes Research, IQVIA Asia-Pacific, Singapore, Singapore
| | | | - Darren Ming-Chun Poon
- Comprehensive Oncology Center, Hong Kong Sanatorium & Hospital, Hong Kong, Hong Kong
| | - Ravindran Kanesvaran
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - Ho Kyung Seo
- Department of Urology, National Cancer Center, Goyang-si, South Korea
| | - Carmel Spiteri
- Market Access Asia Pacific, MSD Macquarie Park, NSW, Macquarie Park, Australia
| | - Ee Min Tan
- Health Economics and Outcomes Research, IQVIA Asia-Pacific, Singapore, Singapore
| | - Yuh-Shyan Tsai
- Department of Urology, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Ben Tran
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia
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Ku JH, Lee LS, Lin TP, Kikuchi E, Kitamura H, Ng CF, Ng JYS, Poon DMC, Kanesvaran R, Seo HK, Spiteri C, Tan EM, Tran B, Tsai YS, Nishiyama H. Risk stratification and management of non-muscle-invasive bladder cancer: A physician survey in six Asia-Pacific territories. Int J Urol 2024; 31:64-71. [PMID: 37800879 DOI: 10.1111/iju.15309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 09/13/2023] [Indexed: 10/07/2023]
Abstract
OBJECTIVES Multiple clinical practice guidelines, conflicting evidence, and physician perceptions result in variations in risk stratification among patients with non-muscle-invasive bladder cancer (NMIBC). This study aims to describe the extent of this variation and its impact on management approaches in the Asia-Pacific region. METHODS We conducted a cross-sectional survey involving 32 urologists and seven medical oncologists with ≥8 years of experience managing early-stage bladder cancer patients across Australia, Hong Kong, Japan, South Korea, Singapore, and Taiwan. The physicians completed an anonymous questionnaire that assessed their risk stratification and respective management approaches, based on 19 NMIBC characteristics. For each NMIBC characteristic, they were required to select one risk group, and their most preferred management approach. RESULTS Our results demonstrated a higher consensus on risk classification versus management approaches. More than 50% of the respondents agreed on the risk classification of all NMIBC characteristics, but 42% or fewer chose the same treatment option as their preferred choice for all but two characteristics-existence of variant histology (55%) and persistent high-grade T1 disease on repeat resection (52%). Across territories, there was the greatest variation in preferred treatment options (i.e., no treatment, intravesical chemotherapy, or Bacillus Calmette-Guérin [BCG] treatment) for intermediate-risk patients and the highest consensus on the treatment of very high-risk patients, namely radical cystectomy. CONCLUSIONS Our study revealed considerable variation in risk stratification and management of NMIBC in the region. It is critical to develop practical algorithms to facilitate the recognition of NMIBC and standardize the treatment of NMIBC patients.
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Affiliation(s)
- Ja Hyeon Ku
- Seoul National University, Seoul, South Korea
| | | | - Tzu-Ping Lin
- Taipei Veterans General Hospital, Taipei, Taiwan
| | - Eiji Kikuchi
- St Marianna University School of Medicine, Kawasaki, Japan
| | | | - Chi-Fai Ng
- The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | | | | | | | | | | | - Ee Min Tan
- IQVIA Asia-Pacific, Singapore, Singapore
| | - Ben Tran
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
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Hu CY, Hung CF, Chen PC, Hsu JY, Wang CT, Lai MD, Tsai YS, Shiau AL, Shieh GS, Wu CL. Oct4 and Hypoxia Dual-Regulated Oncolytic Adenovirus Armed with shRNA-Targeting Dendritic Cell Immunoreceptor Exerts Potent Antitumor Activity against Bladder Cancer. Biomedicines 2023; 11:2598. [PMID: 37892972 PMCID: PMC10604824 DOI: 10.3390/biomedicines11102598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 09/12/2023] [Accepted: 09/20/2023] [Indexed: 10/29/2023] Open
Abstract
Immunotherapy has emerged as a promising modality for cancer treatment. Dendritic cell immunoreceptor (DCIR), a C-type lectin receptor, is expressed mainly by dendritic cells (DCs) and mediates inhibitory intracellular signaling. Inhibition of DCIR activation may enhance antitumor activity. DCIR is encoded by CLEC4A in humans and by Clec4a2 in mice. Gene gun-mediated delivery of short hairpin RNA (shRNA) targeting Clec4a2 into mice bearing bladder tumors reduces DCIR expression in DCs, inhibiting tumor growth and inducing CD8+ T cell immune responses. Various oncolytic adenoviruses have been developed in clinical trials. Previously, we have developed Ad.LCY, an oncolytic adenovirus regulated by Oct4 and hypoxia, and demonstrated its antitumor efficacy. Here, we generated a Clec4a2 shRNA-expressing oncolytic adenovirus derived from Ad.LCY, designated Ad.shDCIR, aimed at inducing more robust antitumor immune responses. Our results show that treatment with Ad.shDCIR reduced Clec4a expression in DCs in cell culture. Furthermore, Ad.shDCIR exerted cytolytic effects solely on MBT-2 bladder cancer cells but not on normal NIH 3T3 mouse fibroblasts, confirming the tumor selectivity of Ad.shDCIR. Compared to Ad.LCY, Ad.shDCIR induced higher cytotoxic T lymphocyte (CTL) activity in MBT-2 tumor-bearing immunocompetent mice. In addition, Ad.shDCIR and Ad.LCY exhibited similar antitumor effects on inhibiting tumor growth. Notably, Ad.shDCIR was superior to Ad.LCY in prolonging the survival of tumor-bearing mice. In conclusion, Ad.shDCIR may be further explored as a combination therapy of virotherapy and immunotherapy for bladder cancer and likely other types of cancer.
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Affiliation(s)
- Che-Yuan Hu
- Department of Urology, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan (Y.-S.T.)
| | - Chi-Feng Hung
- Department of Urology, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi City 60002, Taiwan
| | - Pi-Che Chen
- Department of Urology, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi City 60002, Taiwan
| | - Jia-Yu Hsu
- Department of Biochemistry and Molecular Biology, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan (M.-D.L.)
| | - Chung-Teng Wang
- Department of Microbiology and Immunology, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan (A.-L.S.)
| | - Ming-Derg Lai
- Department of Biochemistry and Molecular Biology, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan (M.-D.L.)
| | - Yuh-Shyan Tsai
- Department of Urology, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan (Y.-S.T.)
| | - Ai-Li Shiau
- Department of Microbiology and Immunology, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan (A.-L.S.)
- Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi City 60002, Taiwan
| | - Gia-Shing Shieh
- Department of Urology, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan (Y.-S.T.)
- Department of Urology, Tainan Hospital, Ministry of Health and Welfare, Executive Yuan, Tainan 70043, Taiwan
| | - Chao-Liang Wu
- Department of Biochemistry and Molecular Biology, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan (M.-D.L.)
- Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi City 60002, Taiwan
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Chou LP, Hsu CW, Yang SF, Lee CT, Ou YC, Lin KC, Hu CY, Jou YC, Tsai YS, Chow NH. Clinicopathologic Analysis of Micropapillary Urothelial Carcinoma of the Upper Urinary Tract: Implications for HER2-Targeted Therapy. Clin Genitourin Cancer 2023; 21:508.e1-508.e10. [PMID: 37183125 DOI: 10.1016/j.clgc.2023.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 04/10/2023] [Accepted: 04/10/2023] [Indexed: 05/16/2023]
Abstract
Introduction/Background To determine the clinical significance of micropapillary urothelial carcinoma (MPUC) of the upper urinary tract (UTUC) and a potential therapeutic strategy. Patients and Methods A retrospective cohort study was conducted to examine the incidence of micropapillary UTUC from 2010 to 2018 and its clinicopathological characteristics. Clinical outcomes and cancer-specific survival (CSS) were compared between MPUC and conventional UTUC matched by stage within a 6-month variation of receiving surgery. Results A total of 24 MPUC cases were identified out of 901 cases (2.7%) of urothelial carcinoma (UC) of the renal pelvis and ureter. MPUC was significantly smaller (<3 cm) and associated with nodal metastasis compared with conventional UTUC (P = .017 & 0.021, respectively); however, no significant difference was observed for lymphovascular invasion, distant metastasis, or CSS (P > 0.50, respectively) compared with match controls. Six MPUC patients (25%) developed metastasis to the liver, lymph nodes, and lung during follow-up. Patients with HER2-positive MPUC (3 of 4) had a significantly higher risk of metastasis compared with HER2-negative MPUC (3 of 20; P = 0.035). Conclusions MPUC is an aggressive variant of UTUC and usually presents as a small locally advanced disease. HER2 immunohistochemistry may identify the subset of patients with micropapillary UTUC that are candidates for targeted therapy.
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Affiliation(s)
- Lien-Ping Chou
- Department of Urology, Ditmanson Medical Foundation Chiayi Christian Hospital, Chiayi City, Taiwan
| | - Che-Wei Hsu
- Department of Pathology, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Sheau-Fang Yang
- Department of Pathology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Pathology, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chung-Ta Lee
- Department of Pathology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yin-Chien Ou
- Department of Urology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Kun-Che Lin
- Department of Urology, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Che-Yuan Hu
- Department of Urology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yeong-Chin Jou
- Division of Urology, Department of Surgery, St Martin De Porres Hospital, Chia-Yi City, Taiwan.
| | - Yuh-Shyan Tsai
- Department of Urology, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
| | - Nan-Haw Chow
- Department of Pathology, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
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Hu CY, Su BH, Lee YC, Wang CT, Yang ML, Shen WT, Fu JT, Chen SY, Huang WY, Ou CH, Tsai YS, Kuo FC, Shiau AL, Shieh GS, Wu CL. Interruption of the long non-coding RNA HOTAIR signaling axis ameliorates chemotherapy-induced cachexia in bladder cancer. J Biomed Sci 2022; 29:104. [PMID: 36471329 PMCID: PMC9724340 DOI: 10.1186/s12929-022-00887-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 11/22/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Cisplatin-based chemotherapy is the first line of treatment for bladder cancer. However, cisplatin induces muscle wasting associated with NF-κB and cancer cachexia. HOTAIR, an oncogenic long non-coding RNA (lncRNA), promotes cancer progression in different cancers. Crosstalk between HOTAIR and NF-κB is documented. Prothymosin α (ProT) plays important roles in cancer progression and inflammation. However, the potential link between HOTAIR, ProT, and cisplatin-induced cancer cachexia remains unexplored. Here, we investigated the contribution of HOTAIR in cisplatin-induced cancer cachexia and dissected the potential signaling cascade involving the epidermal growth factor receptor (EGFR), ProT, NF-κB, and HOTAIR. MATERIALS AND METHODS Expression of ProT and HOTAIR transcripts and their correlations in tumor tissues of bladder cancer patients and bladder cancer cell lines were determined by RT-qPCR. Next, levels of phospho-EGFR, EGFR, phospho-NF-κB, and NF-κB were examined by immunoblot analysis in human bladder cancer cells treated with cisplatin. Expression of HOTAIR in cisplatin-treated cells was also assessed by RT-qPCR. Pharmacological inhibitors and overexpression and knockdown approaches were exploited to decipher the signaling pathway. The murine C2C12 myoblasts were used as an in vitro muscle atrophy model. The syngeneic murine MBT-2 bladder tumor was used to investigate the role of mouse Hotair in cisplatin-induced cancer cachexia. RESULTS Expression of ProT and HOTAIR was higher in bladder tumors than in normal adjacent tissues. There were positive correlations between ProT and HOTAIR expression in clinical bladder tumors and bladder cancer cell lines. Cisplatin treatment increased EGFR and NF-κB activation and upregulated ProT and HOTAIR expression in bladder cancer cells. ProT overexpression increased, whereas ProT knockdown decreased, HOTAIR expression. Notably, cisplatin-induced HOTAIR upregulation was abrogated by EGFR inhibitors or ProT knockdown. ProT-induced HOTAIR overexpression was diminished by NF-κB inhibitors. HOTAIR overexpression enhanced, whereas its knockdown reduced, cell proliferation, cachexia-associated pro-inflammatory cytokine expression, and muscle atrophy. Cachexia-associated symptoms were ameliorated in mice bearing Hotair-knockdown bladder tumors undergoing cisplatin treatment. CONCLUSIONS We demonstrate for the first time a critical role for HOTAIR and identify the involvement of the EGFR-ProT-NF-κB-HOTAIR signaling axis in cisplatin-induced cachexia in bladder cancer and likely other cancers. Our findings also provide therapeutic targets for this disease.
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Affiliation(s)
- Che-Yuan Hu
- grid.64523.360000 0004 0532 3255Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan ,grid.64523.360000 0004 0532 3255Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138, Sheng Li Road, Tainan, 704302 Taiwan
| | - Bing-Hua Su
- grid.412896.00000 0000 9337 0481School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Ya-Che Lee
- grid.413878.10000 0004 0572 9327Department of Urology, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi, Taiwan
| | - Chung-Teng Wang
- grid.64523.360000 0004 0532 3255Department of Microbiology and Immunology, College of Medicine, National Cheng Kung University, 1 University Road, Tainan, 701401 Taiwan
| | - Mei-Lin Yang
- grid.64523.360000 0004 0532 3255Department of Microbiology and Immunology, College of Medicine, National Cheng Kung University, 1 University Road, Tainan, 701401 Taiwan ,grid.413878.10000 0004 0572 9327Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi, Taiwan
| | - Wan-Ting Shen
- grid.64523.360000 0004 0532 3255Department of Biochemistry and Molecular Biology, College of Medicine, National Cheng Kung University, 1 University Road, Tainan, 701401 Taiwan
| | - Jing-Ting Fu
- grid.64523.360000 0004 0532 3255Department of Biochemistry and Molecular Biology, College of Medicine, National Cheng Kung University, 1 University Road, Tainan, 701401 Taiwan
| | - Shih-Yao Chen
- grid.411636.70000 0004 0634 2167Department of Nursing, College of Nursing, Chung Hwa University of Medical Technology, Tainan, Taiwan
| | - Wei-Yun Huang
- grid.64523.360000 0004 0532 3255Department of Microbiology and Immunology, College of Medicine, National Cheng Kung University, 1 University Road, Tainan, 701401 Taiwan
| | - Chien-Hui Ou
- grid.64523.360000 0004 0532 3255Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138, Sheng Li Road, Tainan, 704302 Taiwan
| | - Yuh-Shyan Tsai
- grid.64523.360000 0004 0532 3255Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138, Sheng Li Road, Tainan, 704302 Taiwan
| | - Feng-Chih Kuo
- grid.260565.20000 0004 0634 0356Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Ai-Li Shiau
- grid.64523.360000 0004 0532 3255Department of Microbiology and Immunology, College of Medicine, National Cheng Kung University, 1 University Road, Tainan, 701401 Taiwan ,grid.413878.10000 0004 0572 9327Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi, Taiwan
| | - Gia-Shing Shieh
- grid.64523.360000 0004 0532 3255Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138, Sheng Li Road, Tainan, 704302 Taiwan ,grid.454740.6Department of Urology, Tainan Hospital, Ministry of Health and Welfare, Executive Yuan, Tainan, Taiwan
| | - Chao-Liang Wu
- grid.413878.10000 0004 0572 9327Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi, Taiwan ,grid.64523.360000 0004 0532 3255Department of Biochemistry and Molecular Biology, College of Medicine, National Cheng Kung University, 1 University Road, Tainan, 701401 Taiwan
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Tsai YS, Wu TY, Ou CH, Cheng HL, Tzai TS, Yang WH, Wang JD. Dynamic changes of quality of life in muscle-invasive bladder cancer survivors. BMC Urol 2022; 22:126. [PMID: 35987634 PMCID: PMC9392945 DOI: 10.1186/s12894-022-01084-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 07/29/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
To explore the dynamic changes and effects of radical cystectomy on quality of life in muscle-invasive bladder cancer survivors.
Methods
Patients with muscle-invasive bladder cancer were randomly recruited in this study. We used the World Health Organization Quality of Life-Brief questionnaire to assess consecutive patients’ quality of life. We applied kernel smoothing to illustrate the dynamic changes of the domain and item scores after treatment. Mixed-effects models were constructed to determine the effects of radical cystectomy on the scores of each item and domain of the World Health Organization Quality of Life-Brief questionnaire after controlling demographic and clinical factors.
Results
We collected 397 repeated measurements of the World Health Organization Quality of Life-Brief questionnaire from 109 muscle-invasive bladder cancer patients. Forty-two of them received radical cystectomy. Patients with radical cystectomy exhibited higher levels of education, less co-morbidities (i.e., diabetes and heart diseases), but were associated with more malignancies. Construction of mixed-effects models showed patients with radical cystectomy and those with bladder sparing had similar scores in the three main domains and their items, except that of certain items of physical domain. By applying kernel smoothing method, we found that stage III–IV patients consistently showed higher scores on sleep and rest after radical cystectomy for more than 5 years. In contrast, stage II patients receiving radical cystectomy did not show a higher score on the “sleep and rest” item compared with those with bladder sparing operation.
Conclusions
Radical cystectomy may result in sound sleep and rest, especially in those with stage III–IV bladder cancer.
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Tsai YS, Wu TY, Jou YC, Tzai TS, Wang JD. Determinants and Dynamic Changes of Generic Quality of Life in Human Bladder Cancer Patients. J Clin Med 2021; 10:jcm10235472. [PMID: 34884174 PMCID: PMC8658139 DOI: 10.3390/jcm10235472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 11/15/2021] [Accepted: 11/17/2021] [Indexed: 11/24/2022] Open
Abstract
We measured and determined the factors associated with long-term generic quality-of-life (QOL) changes in human bladder cancer patients. We utilized the World Health Organization QOL-Brief questionnaire to assess consecutive patients’ QOL at outpatient clinics of our hospital. A mixed-effects model was constructed to investigate the determinants of QOL changes according to each domain and individual item after controlling for demographic and clinical factors, as well as the effect of radical cystectomy. We also applied a kernel smoothing method to describe the long-term dynamic changes after the first definite treatment. In total, 1185 repeated measurements were collected from 343 bladder cancer patients. The mixed-effects models demonstrated that marital status, monthly income, and comorbidity with heart disease and diabetes were significant determinants among all the study participants. Regardless of the urinary diversion type, radical cystectomy contributed to lower scores for all four domains, mainly from 4–5 years after cystectomy, which declined significantly in patients who were older than 60 years. As for non-muscle-invasive bladder cancer (NMIBC) patients with preserved bladders, tumor recurrence was a major predictor for lower scores for sexual activity in the social domain. In summary, generic QOL can be independently influenced by many factors, not only cystectomy and tumor recurrence, which should be discussed with patients before treatment.
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Affiliation(s)
- Yuh-Shyan Tsai
- Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704, Taiwan
- Correspondence: ; Tel.: +886-6-2353535-5251; Fax: +886-6-2383678
| | - Tzu-Yi Wu
- Department of Occupational Therapy, Asia University, Taichung 413, Taiwan;
| | - Yeong-Chin Jou
- Department of Urology, Ditmanson Medical Foundation, Chiayi Christian Hospital, Chia-Yi 60002, Taiwan;
- Department of Food Nutrition and Health Biotechnology, Asia University, Taichung 413, Taiwan
| | - Tzong-Shin Tzai
- Department of Urology, Tainan Municipal An-Nan Hospital, Tainan 709, Taiwan;
| | - Jung-Der Wang
- Departments of Internal Medicine and Occupational and Environmental Medicine, National Cheng Kung University Hospital, Tainan 704, Taiwan;
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan
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9
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Hsu LN, Tsai YS, Tong YC. Low-pressure hydrodistension induces bladder glomerulations in female patients with interstitial cystitis/bladder pain syndrome. Neurourol Urodyn 2021; 41:296-305. [PMID: 34633704 DOI: 10.1002/nau.24818] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Revised: 08/04/2021] [Accepted: 09/16/2021] [Indexed: 11/11/2022]
Abstract
AIMS The role of hydrodistension in the diagnosis of interstitial cystitis/bladder pain syndrome (IC/BPS) is controversial. This study evaluated the effect of low-pressure hydrodistension on glomerulation formation in female patients diagnosed with the disease. METHODS Sixty female patients with the clinical diagnosis of IC/BPS and 30 female controls without the disease underwent cystoscopy and hydrodistension. Cold-cup biopsy was taken from bladder posterior wall at sites with normal cystoscopic appearance before hydrodistension in the IC/BPS group. The tissue samples were processed for histology study. Low-pressure (40 cmH2 O) hydrodistension for 2 min was performed and the appearance of glomerulations was compared between the two groups. High-pressure (80 cmH2 O) hydrodistension for 8 min was then performed as a therapeutic measure for the IC/BPS patients. Further changes to the degree of glomerulations were recorded. RESULTS Histology showed pathological changes in the normal-appearing IC/BPS bladder mucosa including urothelium denudation, inflammatory cell infiltration, stromal edema, fibrosis, and vascular congestion. Low-pressure hydrodistension induced significant glomerulation formation in the patient group (percentage of patients with Grades 0-4: 0%, 8.3%, 40%, 35%, 10%, respectively) while none in the controls. High-pressure hydrodistension further increased the glomerulation grading in the IC/BPS patients. CONCLUSIONS Structural changes are present in prehydrodistension IC/BPS bladder wall, which may not be macroscopically detectable. Hydrodistension at low pressure is adequate to disrupt the integrity of such diseased mucosa and offers a more discriminative test in the diagnosis of IC/BPS.
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Affiliation(s)
- Lin-Nei Hsu
- Department of Urology, An Nan Hospital, China Medical University, Tainan City, Taiwan, ROC
| | - Yuh-Shyan Tsai
- Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan City, Taiwan
| | - Yat-Ching Tong
- Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan City, Taiwan
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10
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Wang YW, Song HL, Chiang CY, Song HF, Chang HY, Chu CA, Tuan YL, Tsai KH, Ou YC, Chow NH, Tsai YS. The significance of SMARCB1 in the pathogenesis of renal cell carcinoma with rhabdoid features. Transl Oncol 2021; 14:101175. [PMID: 34243015 PMCID: PMC8273225 DOI: 10.1016/j.tranon.2021.101175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 06/23/2021] [Accepted: 07/04/2021] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Renal cell carcinoma with rhabdoid features (RCC-RF) is an aggressive histologic variant in the adults and is usually unresponsive to standard chemotherapy. METHODS Expression of SMARCB1/INI1 was examined in primary RCC-RF (n = 5). Stable INI1 with/without prostaglandin E2 receptor 1 (EP1) knockdown cell lines were created in the ACHN and 786-O RCC cell lines and measured for epidermal growth factor receptor (EGFR)-related signaling pathways. Chemosensitivity to targeted drugs in vitro was tested after knocking down of INI1 in both cell lines. The outcome of co-targeting of INI1 and EP1 in RCC was examined using a tumorigenicity assay. RESULTS Expression of INI1 was markedly reduced at both transcriptional and translational levels in primary RCC-RF. Immunohistochemical expression of INI1 protein was lost in the nuclei of rhabdoid cells compared with conventional RCC (n = 8). Using two cell lines with different genetic background, we showed that knocking down of INI1 activates the EGFR signaling with up-regulated AKT and ERK pathways and sensitizes cancer cells to Erlotinib treatment in vitro. However, cell-line dependent effects were also demonstrated with reference to impact of INI1 or EP1 on cell growth, migration and response to Gefitinib or Everolimus treatment in vitro. CONCLUSION Inactivation of INI1 may play a role in the pathogenesis of RCC-RF. Erlotinib is recommended in the management of patients with INI1-related RCC.
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Affiliation(s)
- Yi-Wen Wang
- Departments of Pathology, College of Medicine, National Cheng Kung University, Tainan, TAIWAN
| | - Hsiang-Lin Song
- Department of Pathology, National Cheng Kung University Hospital, Tainan, TAIWAN
| | - Cheng-Yao Chiang
- Departments of Pathology, College of Medicine, National Cheng Kung University, Tainan, TAIWAN
| | - Hong-Fang Song
- Institute of Molecular Medicine, College of Medicine, National Cheng Kung University, Tainan, TAIWAN
| | - Hong-Yi Chang
- Department of Biotechnology and Food Technology, College of Engineering, Southern Taiwan University of Science and Technology, Tainan, TAIWAN
| | - Chien-An Chu
- Departments of Pathology, College of Medicine, National Cheng Kung University, Tainan, TAIWAN
| | - Yih-Lin Tuan
- Institute of Molecular Medicine, College of Medicine, National Cheng Kung University, Tainan, TAIWAN
| | - Kun-Hao Tsai
- Institute of Molecular Medicine, College of Medicine, National Cheng Kung University, Tainan, TAIWAN
| | - Yin-Chien Ou
- Departments of Urology, College of Medicine, National Cheng Kung University, Tainan, TAIWAN
| | - Nan-Haw Chow
- Departments of Pathology, College of Medicine, National Cheng Kung University, Tainan, TAIWAN; Department of Pathology, National Cheng Kung University Hospital, Tainan, TAIWAN; Institute of Molecular Medicine, College of Medicine, National Cheng Kung University, Tainan, TAIWAN.
| | - Yuh-Shyan Tsai
- Departments of Urology, College of Medicine, National Cheng Kung University, Tainan, TAIWAN.
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11
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Cheng HL, Chou LP, Tsai HW, Lee CT, Wang YW, Chung-Liang H, Ou JH, Tsai YS, Chow NH. Urothelial carcinoma with trophoblastic differentiation: Reappraisal of the clinical implication and immunohistochemically features. Urol Oncol 2021; 39:732.e17-732.e23. [PMID: 33773916 DOI: 10.1016/j.urolonc.2021.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 02/21/2021] [Accepted: 03/08/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE To investigate the clinical implications of identifying urothelial carcinoma (UC) with trophoblastic differentiation (UCTD). MATERIALS AND METHODS A prospective cohort study was performed from 2010 to 2016 to examine the incidence of UCTD in urinary tract cancer and association with clinicopathological indicators and patient outcome. RESULTS UCTD was detected in 47 of 859 (5.5%) cases of UC of the bladder and 65 of 635 (10.2%) cases in the upper urinary tract. UCTD of the bladder was significantly associated with non-papillary, multiple, larger size ( > 3 cm), muscle invasion, and nodal metastasis (P ≤ 0.0001, respectively). A higher risk of recurrence (P = 0.005), progression (P < 0.0001), and patient death (P < 0.0001) was observed for UCTD than those with traditional, high-grade UC of the bladder. Among four patterns of expression, focal expression of β-human chorionic gonadotropin was frequently detected in papillary tumor (P < 0.005) and UCs of smaller than 3 cm (P = 0.03). Significant indicators in predicting poor disease-specific overall survival in multivariate statistical model were tumor staging (P = 0.001), followed by non-focal β-hCG expression (P = 0.049). CONCLUSION UCTD is more often identified in the upper urinary tract than in the bladder. UCTD of the bladder was significantly associated with higher risk of recurrence, progression, and patient death. Expression of β-hCG in non-focal patterns predicts a worse prognosis for patients with UCTD and deserves an individualized treatment planning.
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Affiliation(s)
- Hong-Ling Cheng
- Departments of Urology, College of Medicine, National Cheng Kung University, Tainan, TW
| | - Lien-Ping Chou
- Department of Urology, National Cheng Kung University Hospital, Tainan, TW
| | - Hung-Wen Tsai
- Departments of Pathology, College of Medicine, National Cheng Kung University, Tainan, TW
| | - Chung-Ta Lee
- Departments of Pathology, College of Medicine, National Cheng Kung University, Tainan, TW
| | - Yi-Wen Wang
- Departments of Pathology, College of Medicine, National Cheng Kung University, Tainan, TW
| | - Ho Chung-Liang
- Departments of Pathology, College of Medicine, National Cheng Kung University, Tainan, TW; Institute of Basic Medical Sciences, College of Medicine, National Cheng Kung University, Tainan, TW
| | - Jiann-Hui Ou
- Departments of Urology, College of Medicine, National Cheng Kung University, Tainan, TW
| | - Yuh-Shyan Tsai
- Departments of Urology, College of Medicine, National Cheng Kung University, Tainan, TW.
| | - Nan-Haw Chow
- Departments of Pathology, College of Medicine, National Cheng Kung University, Tainan, TW; Institute of Basic Medical Sciences, College of Medicine, National Cheng Kung University, Tainan, TW.
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12
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Shen CY, Chow NH, Tsai YS. Seminal Vesicle Schwannoma: Transrectal and Intraoperative Sonographic Findings. J Med Ultrasound 2021; 29:123-125. [PMID: 34377645 PMCID: PMC8330677 DOI: 10.4103/jmu.jmu_68_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 06/14/2020] [Accepted: 07/01/2020] [Indexed: 11/11/2022] Open
Abstract
Schwannomas, namely neurilemmomas, are benign nerve sheath tumors and comprise the myelin sheaths around the peripheral nerves. Schwannomas commonly occur in the head and neck, or extremities, less found in the mediastinum and retroperitoneum, and rarely in the pelvis. We report a 40-year-old male presenting with an 18-month history of nocturia and urinary frequency. Transrectal ultrasound revealed a well-defined, 2.81 cm × 3.77 cm in size, homogeneous, hypoechoic mass in the tail of the left seminal vesicle, compatible with the finding of a well-demarcated mass at the left seminal vesicle with homogeneous contrast enhancement on computed tomography. He underwent laparoscopic excision of the mass via da Vinci robotic surgical system. Intraoperative sonography showed that the mass exhibited the majority of hypoechoic density with some hyperechoic spots inside. Pathology reveals schwannoma. Both of erectile and ejaculatory functions were claimed postoperatively. Our case report highlights the potential of either intraoperative or preoperative sonography in the assessment of the seminal vesicle schwannoma.
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Affiliation(s)
- Chih-Yu Shen
- Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Nan-Haw Chow
- Department of Pathology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yuh-Shyan Tsai
- Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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13
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Hsu LN, Tsai YS, Tsai HT, Su WP, Tong YC. Study on the pathophysiological mechanism responsible for lower urinary tract symptoms associated with prostate cancer using an animal model. Low Urin Tract Symptoms 2021; 13:390-399. [PMID: 33410260 DOI: 10.1111/luts.12370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 11/24/2020] [Accepted: 11/29/2020] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To investigate the pathophysiological mechanism leading to lower urinary tract symptoms in prostate cancer (PCa) by using an animal model. METHODS An orthotopic PCa model in mice was established by injection of human DU145 cells into the prostate gland lateral lobe of NOD.CB17-Prkdcscid /NcrCrlBltw (NOD-SCID) mice. Cancer growth was quantified by a luciferase-based in vivo imaging system (IVIS) serially every 7 days. Comparisons were made for urodynamic parameters, bladder histology, and biological markers until the sixth week. Bladder wall structural changes were assessed by the bladder wall thickness and degree of fibrosis. Biomarker expressions in bladder tissue including muscarinic acetylcholine receptor 2 (M2 ), transient receptor potential cation channel subfamily V member 4 (TRPV4), BCL2-associated X protein (Bax), and caspase3 were evaluated by immunohistochemical staining and immunofluorescence confocal laser scanning microscopy. RESULTS DU145 cell growth in the prostate was successfully monitored by a luciferase-based IVIS. after orthotopic injection. Using our injection technique, no anatomical obstruction of the bladder outlet and urethra was noted up to 6 weeks after injection. The presence of PCa induced changes in urinary bladder histology, biomarkers, and urodynamic parameters. Cystometry showed features of detrusor overactivity with increased voiding frequency and high-amplitude voiding contractions from the fourth week onward. Histological analyses 4 weeks after DU145 injection demonstrated detrusor thickening and bladder wall fibrosis. Immunohistochemistry showed increased expressions of bladder M2 , TRPV4, Bax, and caspase3 in the PCa mice as early as in the first or second week. CONCLUSIONS PCa can induce bladder microenvironment changes involving neural receptors and biological mediators leading to histological and functional alterations even in the absence of overt anatomical obstruction.
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Affiliation(s)
- Lin-Nei Hsu
- Department of Urology, An Nan Hospital, China Medical University, Tainan City, Taiwan (ROC).,Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan City, Taiwan (ROC)
| | - Yuh-Shyan Tsai
- Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan City, Taiwan (ROC)
| | - Hsin-Tzu Tsai
- Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan City, Taiwan (ROC)
| | - Wen-Pin Su
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan City, Taiwan (ROC).,Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan City, Taiwan (ROC)
| | - Yat-Ching Tong
- Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan City, Taiwan (ROC)
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14
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Kao YL, Ou CH, Lin SH, Chang SM, Wang JD, Tsai YS. Dynamic Changes of Generic Quality of Life after Different Treatments for Localized Prostate Cancer. J Clin Med 2021; 10:jcm10010158. [PMID: 33466363 PMCID: PMC7795146 DOI: 10.3390/jcm10010158] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 12/29/2020] [Accepted: 12/30/2020] [Indexed: 11/24/2022] Open
Abstract
Generic quality of life (QoL) is an important issue in decision making related to the primary treatment of localized prostate cancer (PC). This study assessed the dynamic changes of QoL in patients with localized PC under different treatment modalities. From 2013 to 2018, we prospectively assessed QoL scores in patients with localized PC under unitary treatment using the World Health Organization Quality of Life (WHOQOL) BREF version. The trajectories of the QoL scores after different treatments were estimated using a kernel-smoothing method. Dynamic changes in the major determinants were analyzed using a mixed effects model. The clinical features of the participants in our institute were compared with PC patients in Taiwan’s cancer registry. A total of 196 patients were enrolled with 491 repeated assessments. The participants shared similar clinical characteristics with the PC patients in Taiwan as a whole. Patients with lower household incomes showed statistically significant lower scores on all four domains and related facets, while PC survivors with comorbidities of anxiety and/or diabetes appeared to be affected on the physical domain and related facets. After controlling for these determinants, patients under active surveillance or observation demonstrated significantly higher QoL scores in the physical and social domains, as well as several facets belonging to these domains, in mixed models compared with patients undergoing radical prostatectomy or radiotherapy within the first year. The generic QoL scores were higher within the first year in patients receiving active surveillance or observation after controlling other significant factors. The difference diminished after one year of post management. More studies are needed to corroborate our findings.
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Affiliation(s)
- Yao-Lin Kao
- Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704, Taiwan; (Y.-L.K.); (C.-H.O.)
| | - Chien-Hui Ou
- Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704, Taiwan; (Y.-L.K.); (C.-H.O.)
| | - Sheng-Hsiang Lin
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan 704, Taiwan;
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan 704, Taiwan;
- Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704, Taiwan
| | - Sheng-Mao Chang
- Department of Statistics, National Cheng Kung University, Tainan 701, Taiwan;
| | - Jung-Der Wang
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan 704, Taiwan;
| | - Yuh-Shyan Tsai
- Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704, Taiwan; (Y.-L.K.); (C.-H.O.)
- Correspondence: ; Tel.: +886-6-235-3535 (ext. 5251); Fax: +886-6-238-3678
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15
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Chen CH, Grollman AP, Huang CY, Shun CT, Sidorenko VS, Hashimoto K, Moriya M, Turesky RJ, Yun BH, Tsai K, Wu S, Chuang PY, Tang CH, Yang WH, Tzai TS, Tsai YS, Dickman KG, Pu YS. Additive Effects of Arsenic and Aristolochic Acid in Chemical Carcinogenesis of Upper Urinary Tract Urothelium. Cancer Epidemiol Biomarkers Prev 2020; 30:317-325. [PMID: 33277322 DOI: 10.1158/1055-9965.epi-20-1090] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 09/21/2020] [Accepted: 12/01/2020] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Aristolochic acids (AA) and arsenic are chemical carcinogens associated with urothelial carcinogenesis. Here we investigate the combined effects of AA and arsenic toward the risk of developing upper tract urothelial carcinoma (UTUC). METHODS Hospital-based (n = 89) and population-based (2,921 cases and 11,684 controls) Taiwanese UTUC cohorts were used to investigate the association between exposure to AA and/or arsenic and the risk of developing UTUC. In the hospital cohort, AA exposure was evaluated by measuring aristolactam-DNA adducts in the renal cortex and by identifying A>T TP53 mutations in tumors. In the population cohort, AA exposure was determined from prescription health insurance records. Arsenic levels were graded from 0 to 3 based on concentrations in well water and the presence of arseniasis-related diseases. RESULTS In the hospital cohort, 43, 26, and 20 patients resided in grade 0, 1+2, and 3 arseniasis-endemic areas, respectively. Aristolactam-DNA adducts were present in >90% of these patients, indicating widespread AA exposure. A>T mutations in TP53 were detected in 28%, 44%, and 22% of patients residing in grade 0, 1+2, and 3 arseniasis-endemic areas, respectively. Population studies revealed that individuals who consumed more AA-containing herbs had a higher risk of developing UTUC in both arseniasis-endemic and nonendemic areas. Logistic regression showed an additive effect of AA and arsenic exposure on the risk of developing UTUC. CONCLUSIONS Exposure to both AA and arsenic acts additively to increase the UTUC risk in Taiwan. IMPACT This is the first study to investigate the combined effect of AA and arsenic exposure on UTUC.
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Affiliation(s)
- Chung-Hsin Chen
- Department of Urology, National Taiwan University Hospital, Taipei, Taiwan
| | - Arthur P Grollman
- Department of Pharmacological Sciences, Stony Brook University, Stony Brook, New York.,Department of Medicine, Stony Brook University, Stony Brook, New York
| | - Chao-Yuan Huang
- Department of Urology, National Taiwan University Hospital, Taipei, Taiwan
| | - Chia-Tung Shun
- Department of Forensic Medicine and Pathology, National Taiwan University Hospital, Taipei, Taiwan
| | - Viktoriya S Sidorenko
- Department of Pharmacological Sciences, Stony Brook University, Stony Brook, New York
| | - Keiji Hashimoto
- Department of Pharmacological Sciences, Stony Brook University, Stony Brook, New York
| | - Masaaki Moriya
- Department of Pharmacological Sciences, Stony Brook University, Stony Brook, New York
| | - Robert J Turesky
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota.,Department of Medicinal Chemistry, University of Minnesota, Minneapolis, Minnesota
| | - Byeong Hwa Yun
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota.,Department of Medicinal Chemistry, University of Minnesota, Minneapolis, Minnesota
| | - Karen Tsai
- School of Medicine, Stony Brook University, Stony Brook, New York
| | - Stephanie Wu
- School of Medicine, Stony Brook University, Stony Brook, New York
| | - Po-Ya Chuang
- School of Health Care Administration, Taipei Medical University, Taipei, Taiwan
| | - Chao-Hsiun Tang
- School of Health Care Administration, Taipei Medical University, Taipei, Taiwan
| | - Wen-Horng Yang
- Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Tzong-Shin Tzai
- Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yuh-Shyan Tsai
- Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
| | - Kathleen G Dickman
- Department of Pharmacological Sciences, Stony Brook University, Stony Brook, New York. .,Department of Medicine, Stony Brook University, Stony Brook, New York
| | - Yeong-Shiau Pu
- Department of Urology, National Taiwan University Hospital, Taipei, Taiwan.
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16
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Cheong IS, Tsai YS, Kang CH, Jou YC, Chen PC, Lin CT. Needle Tip Culture after Prostate Biopsy: A Tool for Early Detection for Antibiotics Selection in Cases of Post-Biopsy Infection. Urol J 2020; 18:307-313. [PMID: 32869256 DOI: 10.22037/uj.v16i7.5912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
PURPOSE To investigate biopsy needle tip culture after prostate biopsies for bacteria prediction and antibiotics selection. MATERIALS AND METHODS From May 2017 to April 2019, 121 patients who underwent a prostate biopsy were enrolled. All biopsy needle tips were sent for aerobic and anaerobic culture. Patients were divided into positive and negative culture groups. Perioperative data were recorded and compared between the two groups. The culture time and susceptibility of febrile patients were analyzed. Blood cultures were conducted for all patients who experienced fever after biopsy. The time and results of the needle and blood cultures were recoded for descriptive analysis. RESULTS There were 59 (48.8%) positive needle cultures. Other than fever (p = 0.023), there were no statistical significances in clinical data between the two groups. Fever occurred in eight patients, and seven febrile patients had positive needle cultures, six of whom had positive blood cultures. These six needle and blood cultures were consistent with the susceptibility test results. As compared to the waiting time for blood cultures, target antibiotics were administered at an average of 48.0 h earlier based on needle cultures. None of the patients with positive anaerobic cultures developed a fever, while all eight febrile patients had negative anaerobic cultures. CONCLUSION Fevers developed at statistically significant higher rate among those who had positive needle cultures. Needle and blood cultures were consistent with the susceptibility test results. Needle cultures can help us administer target antibiotics earlier to febrile patients without the need to wait for blood cultures.
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Affiliation(s)
- Ian Seng Cheong
- Department of Urology, Ditmanson Medical Foundation Chia-Yi Christian Hospital, 539 Chung-Hsiao Road, Chiayi City, Taiwan.
| | - Yuh-Shyan Tsai
- Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Shengli Road, Tainan City, Taiwan.
| | - Chun-Hsiung Kang
- Department of Urology, Ditmanson Medical Foundation Chia-Yi Christian Hospital, 539 Chung-Hsiao Road, Chiayi City, Taiwan.
| | - Yeong-Chin Jou
- Department of Urology, Ditmanson Medical Foundation Chia-Yi Christian Hospital, 539 Chung-Hsiao Road, Chiayi City, Taiwan.
| | - Pi-Che Chen
- Department of Urology, Ditmanson Medical Foundation Chia-Yi Christian Hospital, 539 Chung-Hsiao Road, Chiayi City, Taiwan.
| | - Chang-Te Lin
- Department of Urology, Ditmanson Medical Foundation Chia-Yi Christian Hospital, 539 Chung-Hsiao Road, Chiayi City, Taiwan.
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17
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Sun CY, Huang CC, Tsai YS, Chang YT, Ou CH, Su WC, Fan SY, Wang ST, Yang DC, Huang CC, Chang CM. Clinical Frailty Scale in Predicting Postoperative Outcomes in Older Patients Undergoing Curative Surgery for Urologic Malignancies: A Prospective Observational Cohort Study. Urology 2020; 144:38-45. [PMID: 32711011 DOI: 10.1016/j.urology.2020.06.069] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 06/07/2020] [Accepted: 06/28/2020] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To examine the utility of the Clinical Frailty Scale (CFS) in predicting outcomes in older adults with urologic malignancies undergoing curative surgeries. METHODS This prospective observational cohort study was conducted in a university-based tertiary medical center. Patients aged 75 years or older who were scheduled to undergo curative surgery for a urologic malignancy from January 2017 to December 2017 were recruited. Patients were grouped according to the CFS scores. The primary postoperative outcome measures were a major complication within 30 days and a decline in the activities of daily living (ADL) within 30 days and 90 days. Multivariable analyses and the area under the receiver operating characteristic curve were performed to investigate the association between the CFS and postoperative outcomes. RESULTS A total of 82 patients, 50% women, were enrolled with mean age 81.6 years. The CFS was significantly associated with postoperative outcomes in a dose-response relationship. When compared with those with a CFS <5, patients with CFS scores ≥5 had a 10.3-times higher risk for a major complication, 8.5-times and 21.4-times higher risk for a decline in ADL within 30 days and 90 days. The area under the receiver operating characteristic curves for the CFS to predict a major complication, the 30-day decline in ADL and the 90-day decline in ADL were 0.60, 0.73, and 0.79. CONCLUSION A higher CFS score predicted a higher risk of poor outcomes in this population. It is recommended that patients with higher CFS scores, especially above 5, are needed to receive further multidisciplinary perioperative care.
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Affiliation(s)
- Chien-Yao Sun
- Division of Geriatrics and Gerontology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chien-Cheng Huang
- Department of Emergency Medicine, Chi-Mei Medical Center, Tainan, Taiwan; Department of Senior Services, Southern Taiwan University of Science and Technology, Tainan, Taiwan; Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yuh-Shyan Tsai
- Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yu-Tzu Chang
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chien-Hui Ou
- Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Wu-Chou Su
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Sheng-Yu Fan
- Institute of Gerontology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Shan-Tair Wang
- Institute of Gerontology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Deng-Chi Yang
- Division of Geriatrics and Gerontology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Institute of Gerontology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chi-Chang Huang
- Division of Geriatrics and Gerontology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chia-Ming Chang
- Division of Geriatrics and Gerontology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Institute of Gerontology, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
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Uemura H, Ye D, Kanesvaran R, Chiong E, Lojanapiwat B, Pu YS, Rawal SK, Abdul Razack AH, Zeng H, Chung BH, Md Yusoff NA, Ohyama C, Kim CS, Leewansangtong S, Tsai YS, Liu Y, Liu W, van Kooten Losio M, Asinas-Tan M. United in Fight against prOstate cancer (UFO) registry: first results from a large, multi-centre, prospective, longitudinal cohort study of advanced prostate cancer in Asia. BJU Int 2020; 125:541-552. [PMID: 31868997 PMCID: PMC7187217 DOI: 10.1111/bju.14980] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Objectives To document the management of advanced prostate cancer including diagnosis, prognosis, treatment, and care, in real‐world practice in Asia using the United in Fight against prOstate cancer (UFO) registry. Patients and Methods We established a multi‐national, longitudinal, observational registry of patients with prostate cancer presenting to participating tertiary care hospitals in eight Asian countries. A total of 3636 eligible patients with existing or newly diagnosed high‐risk localised prostate cancer (HRL), non‐metastatic biochemically recurrent prostate cancer (M0), or metastatic prostate cancer (M1), were consecutively enrolled and are being followed‐up for 5 years. Patient history, demographic and disease characteristics, treatment and treatment decisions, were collected at first prostate cancer diagnosis and at enrolment. Patient‐reported quality of life was prospectively assessed using the European Quality of Life‐five Dimensions, five Levels (EQ‐5D‐5L) and Functional Assessment of Cancer Therapy for Prostate Cancer questionnaires. In the present study, we report the first interim analysis of 2063 patients enrolled from study start (15 September 2015) until 18 May 2017. Results Of the 2063 enrolled patients, 357 (17%), 378 (19%), and 1328 (64%) had HRL, M0 or M1 prostate cancer, respectively. The mean age at first diagnosis was similar in each group, 56% of all patients had extracapsular extension of their tumour, 28% had regional lymph node metastasis, and 53% had distant metastases. At enrolment, 62% of patients had at least one co‐morbidity (mainly cardiovascular disease or diabetes), 91.8% of M1 patients had an Eastern Cooperative Oncology Group performance score of <2 and the mean EQ‐5D‐5L visual analogue score was 74.6–79.6 across cohorts. Treatment of M1 patients was primarily with combined androgen blockade (58%) or androgen‐deprivation therapy (either orchidectomy or luteinising hormone‐releasing hormone analogues) (32%). Decisions to start therapy were mainly driven by treatment guidelines and disease progression. Decision to discontinue therapy was most often due to disease progression (hormonal drug therapy) or completion of therapy (chemotherapy). Conclusion In the UFO registry of advanced prostate cancer in Asia, regional differences exist in prostate cancer treatment patterns that will be explored more deeply during the follow‐up period; prospective follow‐up is ongoing. The UFO registry will provide valuable descriptive data on current disease characteristics and treatment landscape amongst patients with prostate cancer in Asia.
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Affiliation(s)
- Hirotsugu Uemura
- Department of Urology, Kindai University, Faculty of Medicine, Osaka-Sayama, Japan
| | - Dingwei Ye
- Fudan University Shanghai Cancer Center, Shanghai, China
| | | | - Edmund Chiong
- Department of Urology, National University Hospital, National University Health System, Singapore
| | - Bannakij Lojanapiwat
- Division of Urology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Yeong-Shiau Pu
- Department of Urology, National Taiwan University Hospital, Taipei, Taiwan
| | | | | | - Hao Zeng
- Department of Urology, West China Hospital, Sichuan University, Sichuan, China
| | - Byung Ha Chung
- Department of Urology and Urological Science Institute, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Noor Ashani Md Yusoff
- Urology Department, Institute Urology and Nephrology, Hospital Kuala Lumpur, Kuala Lumpur, Malaysia
| | - Chikara Ohyama
- Department of Urology, Hirosaki University Graduate School of Medicine, Japan
| | - Choung Soo Kim
- Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Sunai Leewansangtong
- Division of Urology, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Yuh-Shyan Tsai
- Department of Urology, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, Taiwan
| | - Yanfang Liu
- Department of Global Epidemiology, Johnson & Johnson, New Brunswick, NJ, USA
| | - Weiping Liu
- Janssen Research and Development, Shanghai, China
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Chang WH, Tsai YS, Wang JY, Chen HL, Yang WH, Lee CC. Sex hormones and oxidative stress mediated phthalate-induced effects in prostatic enlargement. Environ Int 2019; 126:184-192. [PMID: 30798199 DOI: 10.1016/j.envint.2019.02.006] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Revised: 02/01/2019] [Accepted: 02/01/2019] [Indexed: 06/09/2023]
Abstract
Prostatic enlargement might affect up to 30% of men and can cause signs and symptoms in the lower urinary tract in the elderly. Imbalanced estrogen and androgen secretions are important in prostatic physiopathology. Phthalates-environmental endocrine disruptors-affect androgen secretion and disrupt sexual organs, including testes and the prostate, but the underlying mechanisms are unclear. Using European Association of Urology (EAU) guidelines, we recruited from urology clinics in southern Taiwan 207 elderly men diagnosed with benign prostatic hyperplasia (BPH) and prostatic enlargement between 2015 and 2017. We took blood and urine samples from all patients on the same day. We used multivariate linear regression, associations, and potential interactions after we had measured and analyzed oxidative stress (OS) markers, steroidal hormones, and 11 urinary phthalate metabolites, and then we adjusted for confounders. Di(2-ethylhexyl) phthalate (DEHP) metabolite levels, particularly urinary mono-(2-ethylhexyl) phthalate, were positively associated with androgen, estrogen, hormone ratios, inducible nitric oxide synthetase (iNOS), 8-hydroxy-2'-deoxyguanosine (8-OHdG), prostate specific antigen (PSA), and prostate volume (PV) (p < 0.05). PV and PSA were positively associated with androgen, estrogen, hormone ratios and OS markers (p < 0.05). The estimated percentages of exposure to phthalates in prostatic enlargement mediated by androgen, estrogen, and OS markers ranged from 3.5% to 63.1%. Exposure to DEHP promoted the progress of BPH by increasing dihydrotestosterone (DHT), estradiol (E2), the converted enzymes aromatase and 5α reductase, and reactive oxygen species (ROS) (8-OHdG and iNOS) production. Sex hormones and OS might be important hyperplasia-promoters after a patient has been exposed to phthalates, especially to DEHP.
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Affiliation(s)
- Wei-Hsiang Chang
- Research Center of Environmental Trace Toxic Substance, National Cheng Kung University, Tainan, Taiwan
| | - Yuh-Shyan Tsai
- Department of Urology, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Jia-Yu Wang
- Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Hsiu-Ling Chen
- Research Center of Environmental Trace Toxic Substance, National Cheng Kung University, Tainan, Taiwan; Department of Food Safety/Hygiene and Risk Management, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Wen-Horng Yang
- Department of Urology, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Ching-Chang Lee
- Research Center of Environmental Trace Toxic Substance, National Cheng Kung University, Tainan, Taiwan; Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
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20
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Lin TY, Cheng IH, Ou CH, Tsai YS, Tong YC, Cheng HL, Yang WH, Lin YM, Cheng YS. Incorporating Simplified Fournier's Gangrene Severity Index with early surgical intervention can maximize survival in high-risk Fournier's gangrene patients. Int J Urol 2019; 26:737-743. [PMID: 31001902 DOI: 10.1111/iju.13989] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Accepted: 03/25/2019] [Indexed: 12/17/2022]
Abstract
OBJECTIVES To determine the optimal surgical timing in high-risk patients with Fournier's gangrene by the Simplified Fournier's Gangrene Severity Index. METHODS From 1989 to 2018, 118 male patients diagnosed with Fournier's gangrene with complete medical records were retrospectively reviewed. Patients' demographics, laboratory parameters at initial diagnosis, Fournier's Gangrene Severity Index and Simplified Fournier's Gangrene Severity Index, and the time interval from emergency room arrival to surgical intervention were collected. The Fournier's gangrene patients were categorized into low-risk (Simplified Fournier's Gangrene Severity Index ≤2) and high-risk groups (Simplified Fournier's Gangrene Severity Index >2). Differences between the variables within the two groups were analyzed. The optimal surgical timing was analyzed with the receiver operating characteristic curve in high-risk Fournier's gangrene patients. RESULTS The overall mortality of 118 Fournier's gangrene patients was 14.4%. After risk stratification with the Simplified Fournier's Gangrene Severity Index scoring system, the mortality of low-risk and high-risk Fournier's gangrene patients was 1.3% and 41.0%, respectively. In the high-risk group, the time interval from emergency room arrival to surgical intervention was the only variable with a significant difference between survivors and non-survivors (P = 0.039). The optimal surgical timing was determined at 14.35 h, which allowed the highest sensitivity (0.688) and specificity (0.762) to affect mortality. The mortality was significantly lower in high-risk Fournier's gangrene patients with early surgical intervention compared with late intervention (23.8% vs 68.8%, P = 0.007). CONCLUSIONS The Simplified Fournier's Gangrene Severity Index is a quick and reliable screening tool for first-line physicians to identify high-risk patients with Fournier's gangrene (Simplified Fournier's Gangrene Severity Index >2) who have poor survival outcomes. We recommended early surgical intervention within 14.35 h to maximize the survival of high-risk Fournier's gangrene patients.
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Affiliation(s)
- Tsung-Yen Lin
- Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - I-Hung Cheng
- Division of Urology, Department of Surgery, National Cheng Kung University Hospital, Dou-Liou Branch, College of Medicine, National Cheng Kung University, Yunlin, Taiwan
| | - Chien-Hui Ou
- Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yuh-Shyan Tsai
- Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yat-Ching Tong
- Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Hong-Lin Cheng
- Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Wen-Horng Yang
- Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yung-Ming Lin
- Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yu-Sheng Cheng
- Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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Cheong* IS, Tsai YS, Jou YC, Tsai HT, Tzai TS. MP57-13 INDOLEAMINE-2,3-DIOXYGENASE -1 EXPRESSION UPREGULATES ZEB2 EXPRESSION THOUGH MICRORNA-200C SIGNALING IN HUMAN BLADDER CANCER. J Urol 2019. [DOI: 10.1097/01.ju.0000556598.18314.ff] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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22
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Tsai YS, Jou YC, Tsai HT, Shiau AL, Wu CL, Tzai TS. Prothymosin-α enhances phosphatase and tensin homolog expression and binds with tripartite motif-containing protein 21 to regulate Kelch-like ECH-associated protein 1/nuclear factor erythroid 2-related factor 2 signaling in human bladder cancer. Cancer Sci 2019; 110:1208-1219. [PMID: 30719818 PMCID: PMC6447842 DOI: 10.1111/cas.13963] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 01/18/2019] [Accepted: 01/30/2019] [Indexed: 02/01/2023] Open
Abstract
Prothymosin‐α (PTMA) is a small, acidic protein that is usually transported into the nucleus and involves many cellular and immunological functions. Previous studies demonstrated that aberrant location of PTMA expression exists in human bladder cancer, but the role of PTMA protein expression remains elusive. In this study, we created ectopic nuclear or cytoplasmic PTMA expression in human bladder cancer cells by infecting lentiviruses carrying wild type or deleted nuclear localization signal of the PTMA gene. The in vivo tumorigenesis assay showed PTMA protein with deleted nuclear localization signal promotes J82 xenograft tumor growth in mice and shortens their survival more so than the wild type. Chromatin immunoprecipitation showed that wild‐type PTMA protein binds to the PTEN promoter and enhances phosphatase and tensin homolog (PTEN) expression. Through immunoblot proteomics and in vivo ubiquitination studies, PTMA protein can bind with tripartite motif‐containing protein 21 (TRIM21) and block its ubiquitination. Also, TRIM21 can downregulate both forms of PTMA protein. In human bladder tumors, loss of nuclear PTMA expression was an unfavorable prognostic indicator for shorter disease‐free survival (hazard ratio, 1.54; P = 0.009). Our data support that nuclear PTMA protein serves as a tumor suppressor in bladder cancer through upregulating PTEN and orchestrating TRIM21 for the regulation of Nrf2 signaling.
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Affiliation(s)
- Yuh-Shyan Tsai
- Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yeong-Chin Jou
- Department of Urology, Chia-Yi Christian Hospital, Chia-Yi, Taiwan
| | - Hsin-Tzu Tsai
- Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Ai-Li Shiau
- Department of Microbiology and Immunology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chao-Liang Wu
- Department of Biochemistry and Molecular biology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Tzong-Shin Tzai
- Department of Urology, An-Nan Hospital, China Medical University, Tainan, Taiwan
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23
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Lin SL, Lin CT, Huang WT, Jou YC, Tzai TS, Tsai YS. History of Urinary Retention Is a Risk Factor for Infection after Prostate Biopsy: A Nationwide, Population-Based Cohort Study. Surg Infect (Larchmt) 2018; 20:202-207. [PMID: 30589620 DOI: 10.1089/sur.2018.174] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND AND AIM Infection or bleeding after transrectal prostate biopsy remains a concern of both patients and urologists. We explored the risk of association of certain co-morbidities with both complications. PATIENTS AND METHODS Using the Taiwan National Health Insurance Research Database, we identified patients undergoing prostate biopsy from 2000 to 2013. We used logistic multivariable regression to search for associations between post-biopsy hospitalization and the two co-morbidities within a year after biopsy. RESULTS Among 3,601 prostate biopsies, 100 infections (3.77%) and 52 (1.44%) bleeding-related emergency room visits and hospitalizations were recorded within 30 days after biopsy. The group having the biopsy as an inpatient exhibited older age (p < 0.0001) and a higher percentage of having diabetes mellitus (p = 0.015) than patients without either complication. The logistic multivariable regression analysis showed that urinary retention, freedom from diabetes, and performance as an outpatient procedure were independent risk factors for infection-related hospitalization (odds ratios 1.81, 1.96, and 1.72; p values 0.031, 0.037, and 0.010, respectively). CONCLUSION Patients with a recent history of urinary retention have a higher probability of infection-related hospitalization after prostate biopsy.
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Affiliation(s)
- Shu-Ling Lin
- 1 Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan City, Taiwan
| | - Chang-Te Lin
- 2 Department of Urology and Chia-Yi Christian Hospital, Chia-Yi City, Taiwan
| | - Wan-Ting Huang
- 3 Department of Medical Research, Chia-Yi Christian Hospital, Chia-Yi City, Taiwan
| | - Yeong-Chin Jou
- 2 Department of Urology and Chia-Yi Christian Hospital, Chia-Yi City, Taiwan
| | - Tzong-Shin Tzai
- 4 Department of Urology, Tainan Municipal An-Nan Hospital, China Medical University, Tainan City
| | - Yuh-Shyan Tsai
- 1 Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan City, Taiwan
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24
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Wang CR, Tsai YS, Ma IC. Macrophage activation syndrome with lung involvement complicating adult-onset Still's disease. Neth J Med 2018; 76:442-444. [PMID: 30569890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Adult-onset Still's disease (AOSD) can progress into macrophage activation syndrome (MAS), which may be fatal. We report on a 19-year-old Han Chinese female, who presented with MAS-related pulmonary parenchymal involvement complicating AOSD, and further associated with disseminated intravascular coagulation and generalized tonic-clonic seizure. She was managed by high-dose corticosteroids and pulse cyclophosphamide therapy with a complete recovery of disease activity.
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Affiliation(s)
- C R Wang
- Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan
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25
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Chan MWY, Hsieh HY, Jou YC, Tung CL, Tsai YS, Wang YH, Chi CL, Lin RI, Hung SK, Chuang YM, Wu SF, Li C, Shen CH, Hsu CD. Abstract 5339: Epigenetic silencing of ANGPTL4 in tumor tissues and its overexpression in the urothelial carcinoma microenvironment. Cancer Res 2018. [DOI: 10.1158/1538-7445.am2018-5339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Urothelial carcinoma (UC) carcinogenesis has been hypothesized to occur through epigenetic repression of tumor suppressor genes (TSGs). By qRT-PCR array, we found that one potential TSG, ANGPTL4, was expressed at very low levels in all UC cell lines we examined. Previous studies had demonstrated that ANGPTL4 is highly expressed in some cancers, but downregulated, by DNA methylation, in others. Consequently, due to these seemingly conflicting functions in distinct cancers, the precise role of ANGPTL4 in the etiology of UC remains unclear. In this study, using methylation-specific PCR and bisulfite pyrosequencing, we show that ANGPTL4 is transcriptionally repressed by promoter hypermethylation in UC cell lines and primary tumor samples, as compared to adjacent noncancerous bladder urothelium. Functional studies further demonstrated that ectopic expression of ANGPTL4 potently suppressed UC cell proliferation, monolayer colony formation in vitro, and invasion, migration, and xenograft formation in vivo. As ANGPTL4 is a secreted factor, we therefore examined the circulating ANGPTL4 (cir-ANGPTL4) level in UC patients. Surprisingly, cir-ANGPTL4 was significantly higher in plasma samples from UC patients than normal control, suggesting it might be secreted from other cell types. More importantly, exogenous c-terminal fragment of ANGPTL4 (cANGPTL4) could promote cell proliferation and cell migration via activation of signaling through the Erk/FAK axis. We further confirmed that mouse xenograft tumor growth could be promoted by administration of exogenous cANGPTL4. Finally, immunohistochemistry demonstrated that ANGPTL4 was downregulated in tumor cells but overexpressed in tumor-adjacent stromal tissues including muscle and macrophages of muscle-invasive UC tissue samples. In conclusion, our data supports dual roles for ANGPTL4 in urothelial carcinoma progression, either as a tumor suppressor or oncogene, in response to microenvironmental context.
Citation Format: Michael WY Chan, Hsiao-Yen Hsieh, Yeong-Chin Jou, Chun-Liang Tung, Yuh-Shyan Tsai, Yuan-Hung Wang, Chen-Lin Chi, Ru-Inn Lin, Shih-Kai Hung, Yu-Ming Chuang, Shu-Fen Wu, Chin Li, Cheng-Huang Shen, Cheng-Da Hsu. Epigenetic silencing of ANGPTL4 in tumor tissues and its overexpression in the urothelial carcinoma microenvironment [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 5339.
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Affiliation(s)
- Michael WY Chan
- 1National Chung Cheng University, Min Hsiung, Chia Yi, Taiwan
| | - Hsiao-Yen Hsieh
- 2Ditmanson Medical Foundation Chiayi Christian Hospital, Chia Yi, Taiwan
| | - Yeong-Chin Jou
- 2Ditmanson Medical Foundation Chiayi Christian Hospital, Chia Yi, Taiwan
| | - Chun-Liang Tung
- 2Ditmanson Medical Foundation Chiayi Christian Hospital, Chia Yi, Taiwan
| | - Yuh-Shyan Tsai
- 3National Cheng Kung University Hospital, Tainan, Taiwan
| | | | - Chen-Lin Chi
- 5Buddhist Dalin Tzu Chi General Hospital, Chia Yi, Taiwan
| | - Ru-Inn Lin
- 5Buddhist Dalin Tzu Chi General Hospital, Chia Yi, Taiwan
| | - Shih-Kai Hung
- 5Buddhist Dalin Tzu Chi General Hospital, Chia Yi, Taiwan
| | - Yu-Ming Chuang
- 1National Chung Cheng University, Min Hsiung, Chia Yi, Taiwan
| | - Shu-Fen Wu
- 1National Chung Cheng University, Min Hsiung, Chia Yi, Taiwan
| | - Chin Li
- 1National Chung Cheng University, Min Hsiung, Chia Yi, Taiwan
| | - Cheng-Huang Shen
- 6Ditmanson Medical Foundation Chiayi Christian Hospital, Min Hsiung, Chia Yi, Taiwan
| | - Cheng-Da Hsu
- 6Ditmanson Medical Foundation Chiayi Christian Hospital, Min Hsiung, Chia Yi, Taiwan
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Jou YC, Tsai YS, Lin CT, Tung CL, Shen CH, Tsai HT, Yang WH, Chang HI, Chen SY, Tzai TS. Foxp3 enhances HIF-1α target gene expression in human bladder cancer through decreasing its ubiquitin-proteasomal degradation. Oncotarget 2018; 7:65403-65417. [PMID: 27557492 PMCID: PMC5323164 DOI: 10.18632/oncotarget.11395] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Accepted: 08/08/2016] [Indexed: 11/29/2022] Open
Abstract
Hypoxia-inducible factor-1α (HIF-1α) can control a transcriptional factor forkhead box P3 (Foxp3) protein expression in T lymphocyte differentiation through proteasome-mediated degradation. In this study, we unveil a reverse regulatory mechanism contributing to bladder cancer progression; Foxp3 expression attenuates HIF-1α degradation. We first demonstrated that Foxp3 expression positively correlates with the metastatic potential in T24 cells and can increase the expression of HIF-1α-target genes, such as vascular endothelial growth factor (VEGF) and glucose transporter (GLUT). Foxp3 protein can bind with HIF-1α, particularly under hypoxia. In vivo ubiquination assay demonstrated that Foxp3 can decrease HIF-1α degradation in a dose-dependent manner. Knocking-down of Foxp3 expression blocks in vivo tumor growth in mice and prolongs mice's survival, which is associated with von Willebrand factor expression. Thirty-three of 145 (22.8 %) bladder tumors exhibit Foxp3 expression. Foxp3 expression is an independent predictor for disease progression in superficial bladder cancer patients (p = 0.032), associated with less number of intratumoral CD8+ lymphocyte. The metaanalysis from 2 published datasets showed Foxp3 expression is positively associated with GLUT−4, −9, and VEGF-A, B-, D expression. This reverse post-translational regulation of HIF-1α protein by Foxp3 provides a new potential target for developing new therapeutic strategy for bladder cancer.
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Affiliation(s)
- Yeong-Chin Jou
- Department of Urology, Chia-Yi Christian Hospital, Chia-Yi, Taiwan
| | - Yuh-Shyan Tsai
- Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chang-Te Lin
- Department of Urology, Chia-Yi Christian Hospital, Chia-Yi, Taiwan
| | - Chun-Liang Tung
- Department of Pathology, Chia-Yi Christian Hospital, Chia-Yi, Taiwan
| | - Cheng-Huang Shen
- Department of Urology, Chia-Yi Christian Hospital, Chia-Yi, Taiwan
| | - Hsin-Tzu Tsai
- Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Wen-Horng Yang
- Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Hung-I Chang
- Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Syue-Yi Chen
- Department of Medical Researh, Chia-Yi Christian Hospital, Chia-Yi, Taiwan
| | - Tzong-Shin Tzai
- Department of Urology, School of Medicine, China Medical University, Taichung, Taiwan.,Department of Urology, Tainan Municipal An-Nan Hospital, China Medical University, Tainan, Taiwan
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Tzai TS, Tsai YS. Small cell carcinoma of upper urinary tract: A pooled analysis of survival. Formos J Surg 2018. [DOI: 10.4103/fjs.fjs_170_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Chen MY, Chen YY, Tsai HT, Tzai TS, Chen MC, Tsai YS. Transdermal Delivery of Luteinizing Hormone-releasing Hormone with Chitosan Microneedles: A Promising Tool for Androgen Deprivation Therapy. Anticancer Res 2017; 37:6791-6797. [PMID: 29187457 DOI: 10.21873/anticanres.12139] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Revised: 10/10/2017] [Accepted: 10/12/2017] [Indexed: 11/10/2022]
Abstract
Long-term administration of luteinizing hormone-releasing hormone analogs (LHRHa) is the main type of androgen-deprivation therapy (ADT) for lethal prostate cancer. A fully insertable microneedle system, composed of embeddable chitosan microneedles and a dissolvable polyvinyl alcohol/polyvinyl pyrrolidone supporting array, was developed for sustained delivery of LHRHa to the skin. A porcine cadaver skin test showed that chitosan microneedles can be fully embedded within the skin and microneedle-created micropores reseal within 7 days. The measured LHRHa loading amount was 73.3±2.8 μg per microneedle patch. After applying goserelin-containing microneedles to mice, serum LH levels increased initially and then declined below baseline at day 7. In contrast, serum testosterone levels increased to reach a peak at day 14 and then declined to a castration level at day 21. Additionally, such a castration level was maintained for 2 weeks. Therefore, transdermal delivery of goserelin with embeddable chitosan microneedles can produce a castrated state in mice. Such a system is a promising, feasible means of delivering ADT.
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Affiliation(s)
- Ming-Yang Chen
- Department of Urology, Madou Sin-Lau Hospital, Sin-Lau Medical Foundation, the Presbyterian Church in Taiwan, Tainan, Taiwan, R.O.C
| | - Yi-Ying Chen
- Department of Chemical Engineering, National Cheng Kung University, Tainan, Taiwan, R.O.C
| | - Hsin-Tzu Tsai
- Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan, R.O.C
| | - Tzong-Shin Tzai
- Department of Urology, School of Medicine, China Medical University, Taichung, Taiwan, R.O.C.,Department of Urology, An-Nan Hospital, China Medical University, Tainan, Taiwan, R.O.C
| | - Mei-Chin Chen
- Department of Chemical Engineering, National Cheng Kung University, Tainan, Taiwan, R.O.C.
| | - Yuh-Shyan Tsai
- Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan, R.O.C.
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Chen CH, Tsai YS, Tzai TS. Significance of HER2 expression in patients with upper tract urothelial carcinoma: A meta-analysis. Urological Science 2016. [DOI: 10.1016/j.urols.2015.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Wu KY, Tsai YS, Chen CH, Chen IH, Tzai TS, Tong YC. Association of Prostate Blood Flow with Male Lower Urinary Tract Symptoms. Urol Int 2016; 97:352-357. [PMID: 27632556 DOI: 10.1159/000449233] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Accepted: 08/17/2016] [Indexed: 11/19/2022]
Abstract
PURPOSE To investigate the association of prostate blood flow (PBF) with lower urinary tract symptoms (LUTS) in aged males using Doppler spectral waveform (DSW) analysis. PATIENTS AND METHODS We performed a prospective analysis involving 133 aged males with clinical diagnosis of LUTS. DSW parameters (peak-systolic velocity (PSV), end-diastolic velocity (EDV), and resistive index (RI)) were measured at bilateral neurovascular bundles (NVB), periurethral, and capsular branches by Doppler transrectal ultrasound with the patient in the right lateral decubitus position. The associations of PBF parameters and the International Prostate Symptom Score (IPSS) were analyzed. RESULTS Overall, total IPSS scores were significantly correlated with the RI of bilateral NVB vessels (r2 = 0.03, 0.04; p = 0.04, 0.02, respectively), and PSV of left NVB vessels. PSV of bilateral NVB vessels were associated with the storage score (p = 0.022 and p = 0.016), but not with the voiding score. The sum of the frequency and urgency score was also associated with EDV of both capsular and urethral branches (p = 0.043 and p = 0.009, respectively), and PSV of NVB vessels on both sides (p = 0.045 and p = 0.019, respectively). CONCLUSIONS There is an association between PBF and LUTS, especially with storage symptoms. The findings may provide some insights in understanding the underlying pathophysiology of lower urinary tract dysfunction.
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Affiliation(s)
- Kuan-Yu Wu
- Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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Cheng CW, Tsai YS, Jou YC, Tsai HT, Yang WH, Chow NH, Tzai TS. PROGNOSTIC RELEVANCE OF RON EXPRESSION ON UPPER TRACT UROTHELIAL CARCINOMA. Urological Science 2016. [DOI: 10.1016/j.urols.2016.05.165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Kao YL, Tsai YS, Lin ZY, Ou CH, Yang WH, Chen HL, Tzai TS, Wang JD. Trend of global quality of life in localized or metastatic prostate cancer patients after treatment. Urological Science 2016. [DOI: 10.1016/j.urols.2016.05.196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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33
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Wu KY, Tsai YS, Cheng HL, Ou CH, Yang WH, Tzai TS. The role of sub-clinical prostatitis on BPH/LUTS patients. Urological Science 2016. [DOI: 10.1016/j.urols.2016.05.244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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34
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Tsai YS, Jou YC, Lin CT, Shen CH, Chen SY, Tsai HT, Yang WH, Tzai TS. FOXP3 interacts with and regulates HIF-1α-VEGF signaling in human bladder cancer. Urological Science 2016. [DOI: 10.1016/j.urols.2016.05.166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Lin TY, Ou CH, Yang WH, Tong YC, Cheng HL, Tsai YS, Cheng YS, Cheng IH, Lin YM. Early surgical intervention within 15 hours results in survival benefit in Patients with fournier's gangrene. Urological Science 2016. [DOI: 10.1016/j.urols.2016.05.116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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36
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Chang HY, Chang TC, Huang WY, Lee CT, Yen CJ, Tsai YS, Tzai TS, Chen SH, Chow NH. RON Nuclear Translocation under Hypoxia Potentiates Chemoresistance to DNA Double-Strand Break-Inducing Anticancer Drugs. Mol Cancer Ther 2016; 15:276-86. [PMID: 26772202 DOI: 10.1158/1535-7163.mct-15-0311] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Accepted: 11/27/2015] [Indexed: 11/16/2022]
Abstract
Tumor hypoxia is associated with radioresistance, chemoresistance, and metastasis, which eventually lead to cancer progression and a poor patient prognosis. RON [also known as macrophage-stimulating protein receptor (MST1R)] belongs to the c-MET [also known as hepatocyte growth factor receptor (HGFR)] receptor tyrosine kinase (RTK) superfamily. To identify the interaction partners of RON nuclear translocation in response to hypoxia, the nuclear extract of TSGH8301 bladder cancer cells was immunoprecipitated for tandem mass profiling analysis. Nuclear RON interacted with adenosine triphosphate (ATP)-dependent DNA helicase 2 (Ku70) and DNA-dependent protein kinase catalytic subunit (DNA-PKcs) to activate nonhomologous end joining (NHEJ) DNA repair. The interaction was time dependent, extending 3 to 24 hours posthypoxia or until the components had been exposed to the chemotherapeutic drugs doxorubicin and epirubicin. Stable knockdown experiments in vitro suggest the importance of RON for the chemoresistance of cancer cells under hypoxia. In addition, the tyrosine kinase domain of nuclear RON is crucial for interaction with Ku70 under hypoxia. J82 cells transfected with RON showed a survival advantage in the presence of epirubicin and hypoxia. This suggests that nuclear RON activates NHEJ repair by interacting with Ku70/DNA-PKcs and inhibiting RON activity to increase cancer cell chemosensitivity. Mol Cancer Ther; 15(2); 276-86. ©2016 AACR.
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Affiliation(s)
- Hong-Yi Chang
- Institute of Basic Medical Science, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Ting-Chia Chang
- Institute of Molecular Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Wen-Ya Huang
- Institute of Basic Medical Science, College of Medicine, National Cheng Kung University, Tainan, Taiwan. Department of Medical Laboratory Science and Biotechnology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chung-Ta Lee
- Department of Pathology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chia-Jui Yen
- Department of Internal Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yuh-Shyan Tsai
- Department of Urology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Tzong-Shin Tzai
- Department of Urology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Shu-Hui Chen
- Department of Chemistry, College of Sciences, National Cheng Kung University, Tainan, Taiwan
| | - Nan-Haw Chow
- Institute of Basic Medical Science, College of Medicine, National Cheng Kung University, Tainan, Taiwan. Institute of Molecular Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan. Department of Pathology, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
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Lee MH, Thomas JL, Chang YC, Tsai YS, Liu BD, Lin HY. Electrochemical sensing of nuclear matrix protein 22 in urine with molecularly imprinted poly(ethylene-co-vinyl alcohol) coated zinc oxide nanorod arrays for clinical studies of bladder cancer diagnosis. Biosens Bioelectron 2016; 79:789-95. [PMID: 26774095 DOI: 10.1016/j.bios.2016.01.005] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Revised: 01/01/2016] [Accepted: 01/04/2016] [Indexed: 10/22/2022]
Abstract
In 1996 and 2000, the US Food and Drug Administration (FDA) approved the use of Nuclear matrix protein 22 (NMP22) as a monitoring tool for predicting the recurrence/clearing of bladder cancer, and for screening undiagnosed individuals who have symptoms of, or are at risk for, that disease. The fabrication of electrodes for sensing NMP22 and their integration with a portable potentiostat in a homecare system may have great value. This work describes a sensing element comprised of molecularly imprinted polymers (MIPs) for the specific recognition of NMP22 target molecules. Zinc oxide (ZnO) nanorods (214 ± 45 nm in diameter and 1.08 ± 0.11 μm long) were hydrothermally grown on the sensing electrodes to increase the surface area to be coated with MIPs. A portable potentiostat was assembled and a data acquisition (DAQ) card and the Labview program were utilized to monitor electrochemical reaction to sense NMP22 in urine samples. Finally, in phase 0 clinical trials, measurements were made of samples from a few patients with bladder cancer using the NMP22 MIP-coated ZnO nanorods electrodes that were integrated into a portable potentiostat, revealing NMP 22 concentrations in the range 128 ± 19 to 588 ± 53 ng/mL.
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Affiliation(s)
- Mei-Hwa Lee
- Department of Materials Science and Engineering, I-Shou University, Kaohsiung 84001, Taiwan
| | - James L Thomas
- Department of Physics and Astronomy, University of New Mexico, Albuquerque, NM 87131, USA
| | - Yu-Chia Chang
- Department of Materials Science and Engineering, I-Shou University, Kaohsiung 84001, Taiwan
| | - Yuh-Shyan Tsai
- Department of Urology, National Cheng Kung University Hospital, Tainan 70101, Taiwan
| | - Bin-Da Liu
- Department of Electrical Engineering, National Cheng Kung University, Tainan 70101, Taiwan
| | - Hung-Yin Lin
- Department of Chemical and Materials Engineering, National University of Kaohsiung, Kaohsiung 81148, Taiwan.
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Wu KY, Tsai YS, Yang WH, Tzai TS. Analysis of prostate cancer foci in patients with transrectal 10-core systemic random biopsy—Can we predict pathological stage of prostate cancer through trus biopsy? Urological Science 2015. [DOI: 10.1016/j.urols.2015.11.098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Kao YL, Tsai YS, Ou FY, Syu YJ, Ou CH, Yang WH, Cheng HL, Tzai TS, Wang JD. Determinants of quality of life in prostate cancer patients: A single institute analysis. Urological Science 2015. [DOI: 10.1016/j.urols.2015.06.288] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Chiang CY, Pan CC, Chang HY, Lai MD, Tzai TS, Tsai YS, Ling P, Liu HS, Lee BF, Cheng HL, Ho CL, Chen SH, Chow NH. SH3BGRL3 Protein as a Potential Prognostic Biomarker for Urothelial Carcinoma: A Novel Binding Partner of Epidermal Growth Factor Receptor. Clin Cancer Res 2015; 21:5601-11. [PMID: 26286913 DOI: 10.1158/1078-0432.ccr-14-3308] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2014] [Accepted: 07/27/2015] [Indexed: 11/16/2022]
Abstract
PURPOSE Mass spectrometry-based biomarker discovery has clinical benefit. To identify novel biomarkers for urothelial carcinoma, we performed quantitative proteomics on pooled urine pairs from patients with and without urothelial carcinoma. EXPERIMENTAL DESIGN Shot-gun proteomics using liquid chromatography-tandem mass spectrometry and stable isotope dimethyl labeling identified 219 candidate proteins. The potential implication of SH3 domain binding glutamic acid-rich protein like 3 (SH3BGRL3) was examined by immunoblotting of the urine (n = 13) and urothelial tumors (n = 32). Additional immunohistochemistry was performed on bladder cancer array (n = 1145) and correlated with tumor aggressiveness. Then, biologic functions and signaling pathways of SH3BGRL3 were explored using stable cell lines. RESULTS The detectable urine SH3BGRL3 in patients with urothelial carcinoma was positively associated with higher histologic grading and muscle invasiveness of urothelial carcinoma. SH3BGRL3 is expressed in 13.9% (159/1145) of bladder cancer cohort and is positively associated with muscle invasion (P = 0.0028). SH3BGRL3 expression is associated with increased risk of progression in patients with nonmuscle-invasive bladder cancer (P = 0.032). SH3BGRL3 expression is significantly associated with a high level of epidermal growth factor receptor (EGFR) in bladder cancer (P < 0.0001). SH3BGRL3 promotes the epithelial-mesenchymal transition, cell migration, and proliferation of urothelial carcinoma in vitro. SH3BGRL3 interacts with phosphor-EGFR at Y1068, Y1086, and Y1173 through Grb2 by its proline-rich motif, and activates the Akt-associated signaling pathway. CONCLUSIONS Evaluation of SH3BGRL3 expression status or urine content may identify a subset of patients with bladder cancer who may require more intensive treatment. SH3BGRL3 deserves further investigation as a cotargeting candidate for designing EGFR-based cancer therapies. Clin Cancer Res; 21(24); 5601-11. ©2015 AACR.
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Affiliation(s)
- Cheng-Yao Chiang
- Institute of Basic Medical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chin-Chen Pan
- Department of Pathology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Hong-Yi Chang
- Institute of Basic Medical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Ming-Derg Lai
- Institute of Basic Medical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan. Department of Biochemistry and Molecular Biology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Tzong-Shin Tzai
- Department of Urology, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Yuh-Shyan Tsai
- Department of Urology, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Pin Ling
- Institute of Basic Medical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan. Department of Microbiology and Immunology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Hsiao-Sheng Liu
- Institute of Basic Medical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan. Department of Microbiology and Immunology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Bi-Fang Lee
- Department of Nuclear Medicine, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Hong-Ling Cheng
- Department of Urology, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Chung-Liang Ho
- Institute of Basic Medical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan. Department of Pathology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Shu-Hui Chen
- Department of Chemistry, College of Sciences, National Cheng Kung University, Tainan, Taiwan
| | - Nan-Haw Chow
- Institute of Basic Medical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan. Department of Pathology, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
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Lai CH, Chang CS, Liu HH, Tsai YS, Hsu FM, Yu YL, Lai CK, Gandee L, Pong RC, Hsu HW, Yu L, Saha D, Hsieh JT. Sensitization of radio-resistant prostate cancer cells with a unique cytolethal distending toxin. Oncotarget 2015; 5:5523-34. [PMID: 25015118 PMCID: PMC4170639 DOI: 10.18632/oncotarget.2133] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Cytolethal distending toxin (CDT) produced by Campylobacter jejuni is a genotoxin that induces cell-cycle arrest and apoptosis in mammalian cells. Recent studies have demonstrated that prostate cancer (PCa) cells can acquire radio-resistance when DOC-2/DAB2 interactive protein (DAB2IP) is downregulated. In this study, we showed that CDT could induce cell death in DAB2IP-deficient PCa cells. A combination of CDT and radiotherapy significantly elicited cell death in DAB2IP-deficient PCa cells by inhibiting the repair of ionizing radiation (IR)-induced DNA double-strand break (DSB) during G2/M arrest, which is triggered by ataxia telangiectasia mutated (ATM)-dependent DNA damage checkpoint responses. We also found that CDT administration significantly increased the efficacy of radiotherapy in a xenograft mouse model. These results indicate that CDT can be a potent therapeutic agent for radio-resistant PCa.
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Affiliation(s)
- Chih-Ho Lai
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, USA. School of Medicine, China Medical University, Taichung, Taiwan
| | - Chia-Shuo Chang
- School of Medicine, China Medical University, Taichung, Taiwan
| | - Hsin-Ho Liu
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Yuh-Shyan Tsai
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, USA. Department of Urology, Medical College and Hospital, National Cheng Kung University, Tainan, Taiwan
| | - Feng-Ming Hsu
- Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan. Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Yung-Luen Yu
- Graduate Institute of Cancer Biology, China Medical University, Taichung, Taiwan
| | - Cheng-Kuo Lai
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, USA. School of Medicine, China Medical University, Taichung, Taiwan
| | - Leah Gandee
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Rey-Chen Pong
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Heng-Wei Hsu
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Lan Yu
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Debabrata Saha
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Jer-Tsong Hsieh
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, USA. Graduate Institute of Cancer Biology, China Medical University, Taichung, Taiwan
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Tsai YS, Jou YC, Tsai YP, Liu BD, Lin HI, Wei CL, Chen SY, Tsai HT, Ou CH, Yang WH, Tzai TS. Development of 3-Hydroxyanthranilic acid-based Integrated Non-invasive Biosensor for Bladder Cancer Detection. Urological Science 2015. [DOI: 10.1016/j.urols.2015.06.200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Wu KY, Tsai YS, Chen IH, Lin YM, Tzai TS, Tong YC. Association of prostate blood flow with male lower urinary tract symptoms. Urological Science 2015. [DOI: 10.1016/j.urols.2015.06.170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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44
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Chen CH, Tsai YS, Tzai TS. Significance of HER2 expression in Upper Tract Urothelial Carcinoma: A meta-analysis. Urological Science 2015. [DOI: 10.1016/j.urols.2015.06.199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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45
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Tsai YS, Jou YC, Shen CH, Lin CT, Chen PC, Cheng MC. Antegrade ureteroscopic assistance during percutaneous nephrolithotomy for complete renal staghorn stone: Technique and outcomes. Urological Science 2015. [DOI: 10.1016/j.urols.2014.09.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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46
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Yeh WB, Tseng MJ, Chang NT, Wu SY, Tsai YS. Agronomically important thrips: development of species-specific primers in multiplex PCR and microarray assay using internal transcribed spacer 1 (ITS1) sequences for identification. Bull Entomol Res 2015; 105:52-59. [PMID: 25335450 DOI: 10.1017/s000748531400073x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Thrips, the sole vector of plant Tospovirus, are major pests of many agricultural crops throughout the world. Molecular approaches have been applied in recent decades to identify these minute and morphologically difficult to distinguish insects. In this study, sequences of internal transcribed spacer 1 (ITS1) region of 15 agronomically important thrips, including several virus transmission species, have been analyzed in order to design species-specific primers for multiplex PCR and probes for microarray assay. That the ITS1 sequence distances within species were smaller than those among species suggests that the ITS1 fragment can be used for thrips species identification. The specificity and stability of these primers, combined with universal paired primers, were tested and verified in multiplex PCR. Using these specific primers as probes, microarray assay showed that PCR products of all thrips species hybridized consistently to their corresponding probes, though some signals were weak. We have demonstrated that multiplex PCR using specific primers based on ITS1 sequences is a simple, reliable, and cost-effective diagnostic tool for thrips species identification. Moreover, the DNA microarray assay is expected to extend into a reliable high-throughput screening tool for the vast numbers of thrips.
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Affiliation(s)
- W B Yeh
- Department of Entomology,National Chung Hsing University,250 Kuan-Kung Rd., Taichung 40227,Taiwan
| | - M J Tseng
- Department of Entomology,National Chung Hsing University,250 Kuan-Kung Rd., Taichung 40227,Taiwan
| | - N T Chang
- Department of Plant Medicine,National Pingtung University of Science and Technology,1 Shuefu Rd., Neipu, Pingtung 91201,Taiwan
| | - S Y Wu
- Department of Entomology,National Chung Hsing University,250 Kuan-Kung Rd., Taichung 40227,Taiwan
| | - Y S Tsai
- Department of Entomology,National Chung Hsing University,250 Kuan-Kung Rd., Taichung 40227,Taiwan
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Yeh WB, Tseng MJ, Chang NT, Wu SY, Tsai YS. Development of Species-Specific Primers for Agronomical Thrips and Multiplex Assay for Quarantine Identification of Western Flower Thrips. J Econ Entomol 2014; 107:1728-1735. [PMID: 26309260 DOI: 10.1603/ec14027] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
While morphological identification of thrips species has been difficult because of their minute size and a lack of easily recognizable characteristics, molecular identification based on the development of specific molecular markers can be easily and reliably carried out. Among the known molecular markers, the nuclear internal transcribed spacer (ITS) exhibits distinguishable variations among thrips species. In this study, sequences of ITS2 region of 10 agriculturally important thrips were established to design species-specific primers for polymerase chain reaction (PCR). ITS2 sequence variations within these species were far less than those among species, indicating the suitability of this marker for species-specific primers design. These primers, though with one or two sporadically variable positions, showed a good efficacy within species. The specificity of these primers, examined on thrips species belonging to 15 genera, proved satisfactory. Furthermore, a multiplex PCR was used successfully for identifying Frankliniella occidentalis (Pergande), an insect pest monitored for quarantine purpose, and three additional thrips also commonly found in imported agricultural products and field samples, i.e., Thrips tabaci Lindeman, Thrips hawaiiensis (Morgan), and Frankliniella intonsa (Trybom). This study has demonstrated that specific primers and multiplex PCR based on ITS2 are reliable, convenient, and diagnostic tool to discriminate thrips species of quarantine and agricultural importance.
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Affiliation(s)
- W B Yeh
- Department of Entomology, National Chung Hsing University; 250 Kuan-Kung Rd., Taichung, Taiwan 40227.
| | - M J Tseng
- Department of Entomology, National Chung Hsing University; 250 Kuan-Kung Rd., Taichung, Taiwan 40227
| | - N T Chang
- Department of Plant Medicine, National Pingtung University of Science and Technology; 1 Shuefu Road, Neipu, Pingtung, Taiwan 91201
| | - S Y Wu
- Department of Entomology, National Chung Hsing University; 250 Kuan-Kung Rd., Taichung, Taiwan 40227
| | - Y S Tsai
- Department of Entomology, National Chung Hsing University; 250 Kuan-Kung Rd., Taichung, Taiwan 40227
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Tsai YS, Lai CL, Lai CH, Chang KH, Wu K, Tseng SF, Fazli L, Gleave M, Xiao G, Gandee L, Sharifi N, Moro L, Tzai TS, Hsieh JT. The role of homeostatic regulation between tumor suppressor DAB2IP and oncogenic Skp2 in prostate cancer growth. Oncotarget 2014; 5:6425-36. [PMID: 25115390 PMCID: PMC4171641 DOI: 10.18632/oncotarget.2228] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Altered DAB2IP gene expression often detected in prostate cancer (PCa) is due to epigenetic silencing. In this study, we unveil a new mechanism leading to the loss of DAB2IP protein; an oncogenic S-phase kinase-associated protein-2 (Skp2) as E3 ubiquitin ligase plays a key regulator in DAB2IP degradation. In order to unveil the role of Skp2 in the turnover of DAB2IP protein, both prostate cell lines and prostate cancer specimens with a variety of molecular and cell biologic techniques were employed. We demonstrated that DAB2IP is regulated by Skp2-mediated proteasome degradation in the prostate cell lines. Further analyses identified the N-terminal DAB2IP containing the ubiquitination site. Immunohistochemical study exhibited an inverse correlation between DAB2IP and Skp2 protein expression in the prostate cancer tissue microarray. In contrast, DAB2IP can suppressSkp2 protein expression is mediated through Akt signaling. The reciprocal regulation between DAB2IP and Skp2 can impact on the growth of PCa cells. This reciprocal regulation between DAB2IP and Skp2 protein represents a unique homeostatic balance between tumor suppressor and oncoprotein in normal prostate epithelia, which is apparently altered in cancer cells. The outcome of this study has identified new potential targets for developing new therapeutic strategy for PCa.
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Affiliation(s)
- Yuh-Shyan Tsai
- Department of Urology, Medical College and Hospital, National Cheng Kung University, Tainan, Taiwan; Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Chen-Li Lai
- Department of Urology, Medical College and Hospital, National Cheng Kung University, Tainan, Taiwan
| | - Chih-Ho Lai
- School of Medicine and Graduate Institute of Basic Medical Science, China Medical University, Taichung, Taiwan
| | - Kai-Hsiung Chang
- Department of Cancer Biology, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Kaijie Wu
- Department of Urology, The First Affiliated Hospital, Medical School of Xi'an Jiaotong University, Xi'an, China
| | - Shu-Fen Tseng
- Department of Bioengineering, University of Texas at Arlington, Arlington, TX, USA
| | - Ladan Fazli
- VancouverProstate Center, University of British Columbia, Vancouver, British Columbia, Canada
| | - Martin Gleave
- VancouverProstate Center, University of British Columbia, Vancouver, British Columbia, Canada
| | - Guanghua Xiao
- Department of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Leah Gandee
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Nima Sharifi
- Department of Cancer Biology, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Loredana Moro
- Institute of Biomembranes and Bioenergetics, National Research Council (C.N.R.), Bari, Italy
| | - Tzong-Shin Tzai
- Department of Urology, Medical College and Hospital, National Cheng Kung University, Tainan, Taiwan
| | - Jer-Tsong Hsieh
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA; Graduate Institute of Cancer Biology, China Medical University, Taichung, Taiwan
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Liu HH, Tsai YS, Lai CL, Tang CH, Lai CH, Wu HC, Hsieh JT, Yang CR. Evolving Personalized Therapy for Castration-Resistant Prostate Cancer. Biomedicine (Taipei) 2014; 4:2. [PMID: 25520915 PMCID: PMC4264971 DOI: 10.7603/s40681-014-0002-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2013] [Accepted: 12/31/2013] [Indexed: 12/21/2022] Open
Abstract
With advances in molecular biologic and genomic technology, detailed molecular mechanisms for development of castration-resistant prostate cancer (CRPC) have surfaced. Metastatic prostate cancer (PCa) no longer represents an end stage, with many emerging therapeutic agents approved as effective in prolonging survival of patients from either pre- or post-docetaxel stage. Given tumor heterogeneity in patients, a one-size-fits-all theory for curative therapy remains questionable. With the support of evidence from continuing clinical trials, each treatment modality has gradually been found suitable for selective best-fit patients: e.g., new androgen synthesis inhibitor arbiraterone, androgen receptor signaling inhibitor enzalutamide, sipuleucel-T immunotherapy, new taxane carbazitaxel, calcium-mimetic radium-223 radiopharmaceutical agent. Moreover, several emerging immunomodulating agents and circulating tumor cell enumeration and analysis showed promise in animal or early phase clinical trials. While the era of personalized therapy for CRPC patients is still in infancy, optimal therapeutic agents and their sequencing loom not far in the future.
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Affiliation(s)
- Hsin-Ho Liu
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
- Division of Urology, Department of Surgery, Taichung Tzu Chi General Hospital, Taichung, Taiwan
- Department of Bio-Industrial Mechatronics Engineering, National Taiwan University, Taipei, Taiwan
| | - Yuh-Shyan Tsai
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
- Department of Urology, Medical College and Hospital, National Cheng Kung University, Tainan, Taiwan
| | - Chen-Li Lai
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
- Department of Urology, Medical College and Hospital, National Cheng Kung University, Tainan, Taiwan
| | - Chih-Hsin Tang
- School of Medicine, China Medical University, Tainan, Taiwan
| | - Chih-Ho Lai
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
- School of Medicine, China Medical University, Tainan, Taiwan
| | - Hsi-Chin Wu
- School of Medicine, China Medical University, Tainan, Taiwan
- Department of Urology, China Medical University Hospital, Tainan, Taiwan
| | - Jer-Tsong Hsieh
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
- Graduate Institute of Cancer Biology, China Medical University, Tainan, Taiwan
| | - Che-Rei Yang
- School of Medicine, China Medical University, Tainan, Taiwan
- Department of Urology, China Medical University Hospital, Tainan, Taiwan
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50
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Chang HY, Liu HS, Lai MD, Tsai YS, Tzai TS, Cheng HL, Chow NH. Hypoxia promotes nuclear translocation and transcriptional function in the oncogenic tyrosine kinase RON. Cancer Res 2014; 74:4549-62. [PMID: 24903148 DOI: 10.1158/0008-5472.can-13-3730] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Tumor hypoxia drives metastatic progression, drug resistance, and posttreatment relapses, but how cancer cells adapt and evolve in response to hypoxic stress is not well understood. In this study, we address this question with the discovery that the receptor tyrosine kinase RON translocates into the nucleus of hypoxic cancer cells. In response to hypoxia, nuclear RON interacts with the hypoxia-inducible factor HIF-1α in a manner that relies on RON tyrosine kinase activity, binding to the c-JUN promoter and activating it. Mechanistic investigations revealed unexpectedly that nuclear RON played a more important role in activation of the c-JUN promoter than HIF-1α, leading to increased cell proliferation, survival adaptation, in vitro migration, and tumorigenicity under hypoxic conditions. Taken together, our results pointed to a novel function for RON as a transcriptional regulator that promotes the survival of cancer cells subjected to hypoxia. These results suggest novel implications for the use of small-molecule inhibitors or monoclonal antibodies targeting the RON kinase in the prevention or treatment of advanced cancer.
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Affiliation(s)
- Hong-Yi Chang
- Institute of Basic Medical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Hsiao-Sheng Liu
- Institute of Basic Medical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan. Department of Microbiology and Immunology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Ming-Derg Lai
- Institute of Basic Medical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan. Department of Biochemistry and Molecular Biology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yuh-Shyan Tsai
- Department of Urology, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Tzong-Shin Tzai
- Department of Urology, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Hong-Ling Cheng
- Department of Urology, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Nan-Haw Chow
- Institute of Basic Medical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan. Department of Pathology, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
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