首页膀胱肿瘤治疗及预后证据详情

Safety and Efficacy of Transurethral Resection of Bladder Tumour Comparing Spinal Anaesthesia to Spinal Anaesthesia with an Obturator Nerve Block: A Systematic Review and Meta-Analysis

原文: 2021 年 发布于 European Urology 100 卷 第 3 期 377-385 浏览量:212次

作者: Krishan A. Bruce A. Khashaba S. Abouelela M. Ehsanullah S. A.

作者单位: Department of Urology, Aarhus University Hospital, Aarhus University, Aarhus, Denmark. Department of Clinical Medicine, Aarhus University, Aarhus, Denmark. Department of Public Health, Research Unit for Epidemiology, Aarhus University, Aarhus, Denmark.

归属分类: 膀胱肿瘤治疗及预后证据

DOI: 10.1111/bju.15723

关键词: Administration Intravesical Antibiotics Antineoplastic/administration & dosage/*therapeutic use BCG Vaccine Carcinoma Transitional Cell/*drug therapy Humans Mitomycin/administration & dosage/*therapeutic use Randomized Controlled Trials as Topic Treatment Outcome Urinary Bladder Neoplasms/*drug therapy

文献简介

Bladder cancer (BLC) is a recurrent high-risk malignancy typified by an inherent localised chronic inflammation. IL-23-receptor (IL-23R), as a positive regulator in the priming of T helper-17 cells, is regarded a principal coordinator of inflammation-propelled neoplasia. In this article, we indented firstly to scrutinise the influence of rs10889677`A/C` SNP located in IL-23R-gene on BLC development and progression among Egyptians. Findings revealed that the rs10889677`C` allele was significantly associated with the increased BLC risk and its higher frequencies were plainly noticeable in high-grade and invasive tumours when applied the dominant/homozygous/allelic genetic models. Under the same genetic models, elevated serum levels of IL-23R protein in BLC patients were pertinently correlated with the rs10889677`A/C` polymorphism. As a corollary, the frequent up-regulation of IL-23R exerts a subsequent activation of the IL-23/17 inflammatory axis. That is experienced as a drastic increase in IL-23 and IL17 levels under the dominant/homozygous/heterozygous/recessive models. Second, study further described how the rs10889677 variant confers its pro-tumoural influences on IL-23R-bearing immune cells, involving tumour-associated macrophages (TAMs), natural killers (NKs) and CD4(+) T-helper cells. When the dominant model was adopted, it was observed that patients bearing the rs10889677 `C` allele had lower counts of IL-23R-positive CD56(+)NKs and CD4(+) T-cells, in tandem with higher levels of IL-23R-positive CD14(+) TAMs compared with those with rs10889677 `A` allele. To entrench the idea, we did a meta-analysis on BLC patients from three different ethnicities (Asian, Caucasians and African). We observed that rs10889677`SNP` is significantly correlated with increased risk of BLCs in the overall population using over-dominant model. Consequently, authors suggested that the rs10889677 variant could be directly implicated in developing inflammatory environment more prone to generating malignancy.

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