The International Society of Urological Pathology 2012 Consensus Conference made recommendations regarding classification, prognostic factors, staging, and immunohistochemical and molecular assessment of adult renal tumors. Issues relating to prognostic factors were coordinated by a workgroup who identified tumor morphotype, sarcomatoid/rhabdoid differentiation, tumor necrosis, grading, and microvascular invasion as potential prognostic parameters. There was consensus that the main morphotypes of renal cell carcinoma (RCC) were of prognostic significance, that subtyping of papillary RCC (types 1 and 2) provided additional prognostic information, and that clear cell tubulopapillary RCC was associated with a more favorable outcome. For tumors showing sarcomatoid or rhabdoid differentiation, there was consensus that a minimum proportion of tumor was not required for diagnostic purposes. It was also agreed upon that the underlying subtype of carcinoma should be reported. For sarcomatoid carcinoma, it was further agreed upon that if the underlying carcinoma subtype was absent the tumor should be classified as a grade 4 unclassified carcinoma with a sarcomatoid component. Tumor necrosis was considered to have prognostic significance, with assessment based on macroscopic and microscopic examination of the tumor. It was recommended that for clear cell RCC the amount of necrosis should be quantified. There was consensus that nucleolar prominence defined grades 1 to 3 of clear cell and papillary RCCs, whereas extreme nuclear pleomorphism or sarcomatoid and/or rhabdoid differentiation defined grade 4 tumors. It was agreed upon that chromophobe RCC should not be graded. There was consensus that microvascular invasion should not be included as a staging criterion for RCC.

The International Society of Urological Pathology (ISUP) Grading System for Renal Cell Carcinoma and Other Prognostic Parameters

Life-threatening infectious diseases are on their way to cause a worldwide crisis, as treating them effectively is becoming increasingly difficult due to the emergence of antibiotic resistant strains. Antimicrobial peptides (AMPs) form an ancient type of innate immunity found universally in all living organisms, providing a principal first-line of defense against the invading pathogens. The unique diverse function and architecture of AMPs has attracted considerable attention by scientists, both in terms of understanding the basic biology of the innate immune system, and as a tool in the design of molecular templates for new anti-infective drugs. AMPs are gene-encoded short (<100 amino acids), amphipathic molecules with hydrophobic and cationic amino acids arranged spatially, which exhibit broad spectrum antimicrobial activity. AMPs have been the subject of natural evolution, as have the microbes, for hundreds of millions of years. Despite this long history of co-evolution, AMPs have not lost their ability to kill or inhibit the microbes totally, nor have the microbes learnt to avoid the lethal punch of AMPs. AMPs therefore have potential to provide an important breakthrough and form the basis for a new class of antibiotics. In this review, we would like to give an overview of cationic antimicrobial peptides, origin, structure, functions, and mode of action of AMPs, which are highly expressed and found in humans, as well as a brief discussion about widely abundant, well characterized AMPs in mammals, in addition to pharmaceutical aspects and the additional functions of AMPs.

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Antimicrobial peptides: key components of the innate immune system

Obesity and type 2 diabetes are becoming increasingly prevalent worldwide, and both are associated with an increased incidence and mortality from many cancers. The metabolic abnormalities associated with type 2 diabetes develop many years before the onset of diabetes and, therefore, may be contributing to cancer risk before individuals are aware that they are at risk. Multiple factors potentially contribute to the progression of cancer in obesity and type 2 diabetes, including hyperinsulinemia and insulin-like growth factor I, hyperglycemia, dyslipidemia, adipokines and cytokines, and the gut microbiome. These metabolic changes may contribute directly or indirectly to cancer progression. Intentional weight loss may protect against cancer development, and therapies for diabetes may prove to be effective adjuvant agents in reducing cancer progression. In this review we discuss the current epidemiology, basic science, and clinical data that link obesity, diabetes, and cancer and how treating obesity and type 2 diabetes could also reduce cancer risk and improve outcomes.

https://www.physiology.org/doi/pdf/10.1152/physrev.00030.2014

Obesity and Diabetes: The Increased Risk of Cancer and Cancer-Related Mortality.

Introduction The use of imaging techniques such as ultrasound (US) and computed tomography (CT) has increased the detection of asymptomatic renal cell cancer (RCC). In addition, during the last 10 years, mortality rates have stabilised and even declined in some European countries. The peak incidence of RCC occurs between 60 and 70 years of age, with a 3:2 ratio of men to women. Aetiological factors include lifestyle, such as smoking, obesity and hypertension. The most effective prophylaxis is to avoid cigarette smoking and obesity.

https://uroweb.org/wp-content/uploads/10-Renal-Cell-Carcinoma_LR1.pdf

Guidelines on Renal Cell Carcinoma

https://www.imop.gr/sites/default/files/review_anatomy22.pdf

A Critical Analysis of the Current Knowledge of Surgical Anatomy Related to Optimization of Cancer Control and Preservation of Continence and Erection in Candidates for Radical Prostatectomy

/pdf/nbr1-and-kif14-downstream-of-the-mammarian-target-of-cnvp1yt53f.pdf

NBR1 and KIF14 Downstream of the Mammarian Target of Rapamycin Pathway Predict Recurrence in Nonmuscle Invasive Low Grade Urothelial Carcinoma of the Bladder

To evaluate the diagnostic performance of MDCT with axial images and multiplanar reformatted (MPR) images from the urothelial phase of the bladder in patients with hematuria using cystoscopy as the reference standard. Our IRB for human investigation approved this study, and informed consent was waived. We included 192 patients (121 men, 71 women; age range 17–90 years; mean age ± SD: 60 ± 14 years) who underwent contrast-enhanced MDCT (scan delay: 70 s; section thickness: 2 mm) and conventional cystoscopy examination for painless gross hematuria or recurrent microscopic hematuria. Two radiologists in consensus interpreted the images for the presence or absence of bladder lesions. Using the kappa statistic, the patient-based agreement was determined between the CT and cystoscopic findings. We compared the diagnostic performance of axial images to those with coronal and sagittal reformations to detect bladder lesions. MDCT showed excellent agreement between cystoscopy–axial scans (κ = 0.896) and axial with reformatted images (κ = 0.948). The sensitivity, specificity, and accuracy of MDCT were 94%, 96%, and 95% in the axial scans and 98%, 97%, and 97% in the axial with reformatted images, respectively. All statistical parameters of diagnostic performance were similar between the axial and the reformatted images (p > .05). Axial MDCT imaging demonstrates high diagnostic performance in detecting bladder lesions, but additional reformatted images can improve diagnostic accuracy.

Urothelial-phase thin-section MDCT of the bladder in patients with hematuria: added value of multiplanar reformatted images.

Results: In total, 84 (67.7%) and 40 (32.3%) of patients had final GS of 3+4 and 4+3, respectively. A final GS of 4+3 was associated with a higher pre-biopsy level of prostate-specific antigen (p<0.001) and a higher biopsy Gleason sum (p<0.001). Also, a higher pathological T stage (p=0.005), ter- tiary Gleason pattern 5 (p<0.001), seminal vesicle invasion (p=0.008), bladder neck invasion (p=0.002), angiolymphatic invasion (p=0.008), peri- neural invasion (p=0.045), positive surgical margins (p=0.038) and larger tumor volumes (p<0.001) were associated with GS of 4+3. Conclusions: Our results demonstrated that the statistically significant differences exist between GS 3+4 and 4+3 prostate cancers. Thus, GS 7 prostate cancers may be considered heterogeneous in their biological be- haviors, and GS 7 prostate cancers with a GS of 4+3 may be considered more aggressive tumors compared to those with a GS of 3+4. (Korean

Comparative Analysis of the Clinicopathological Characteristics of Patients with Prostate Cancer with a Pathological Gleason Score 3+4 versus Gleason Score 4+3

With the emergence of microbiome as a major player in many human diseases, bacteria as therapeutics are gaining significant interest. Whole bacteria or cytotoxic or immunogenic peptides carried by them exert potent anti-tumor effects in the experimental models of cancer. The use of attenuated microorganism (s) e.g., BCG to treat human urinary bladder cancer was found to be superior compared to standard chemotherapy. While bacteria alone may not offer full therapeutic benefits, modifying them with anti-tumor agents, anti-oncogenes or immunogenic antigens, either alone or in combination, will prove to be beneficial. Vectors for delivering shRNAs that target oncogenic products, express tumor suppressor genes and immunogenic proteins have been developed. These approaches have showed promising anti-tumor activity in mouse models against various tumors. These can be potential therapeutics for humans in the future and such therapeutics may become a future alternative or adjunct regimen along with conventional chemotherapy and radiotherapy. In this review, some conceptual and practical issues on how to improve these agents for human applications are discussed. (Korean J Urol Oncol 2016;14:54-62) 󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏

http://www.kjuo.or.kr/upload/pdf/kjuo-14-2-54.pdf

Genetically Modified Bacteria as Targeted Agent for Cancer

Department of Urology, Myongji Hospital, Goyang, Functional Food Research Center, School of Life Sciences and Biotechnology, Korea University, Department of Urology, Chung-Ang University College of Medicine, Seoul, Department of Urology, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Advanced Urogenital Disease Research Center, Chung-Ang University Hospital, Seoul, Korea

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In Ho Chang

Papers

NBR1 and KIF14 Downstream of the Mammarian Target of Rapamycin Pathway Predict Recurrence in Nonmuscle Invasive Low Grade Urothelial Carcinoma of the Bladder

Urothelial-phase thin-section MDCT of the bladder in patients with hematuria: added value of multiplanar reformatted images.

Comparative Analysis of the Clinicopathological Characteristics of Patients with Prostate Cancer with a Pathological Gleason Score 3+4 versus Gleason Score 4+3

Genetically Modified Bacteria as Targeted Agent for Cancer

Modulation of Antimicrobial Peptide Human β-defensin-3 by Toll-like Receptor Ligands in Vaginal Epithelial Cells