Accuracy of an urine-based liquid biopsy genetic test in detecting renal pelvic cancer.

e16500 Background: Renal pelvis cancer is accounting for about two-thirds of upper tract urinary carcinoma. Lesions in renal pelvis often lead to a differential diagnosis that requires ureteroscopic biopsy. Besides causing discomfort and pain, ureteroscopy prior to surgery increases risk of tumor implantation and recurrence. Although urine cytology and FISH were applied, more effective non-invasive diagnostic method is imperative for diagnosis of renal pelvic cancer. Methods: A total of 141 patients with one or more lesions in renal pelvis detected by ultrasound were enrolled. 50-ml first-void urine sample was collection before ureteroscopic biopsy and was analysis by Genetron uro-18 genes panel, by which mutations in 17 genes and methylation status of ONECUT2 were analysis using high-throughput sequencing. If mutations and/or ONECUT2 methylation were detected in urine sediment DNA, the patients were considered as high risk of renal pelvis cancer. The results of the urine-based liquid biopsy genetic test were compared with pathology report and urine FISH results of urinary cells. Results: According to pathological analysis with ureteroscopic biopsy, 42 out of 141 patients (29.7%) were diagnosis with renal pelvic cancer: 13 low-grade, 24 high-grade, 5 equivocal. For 33 renal pelvic cancer patients with FISH testing result of urinary cells, only 54.5% (18/33) samples were positive. By Genetron uro-18 genes test, 95 patients (67.4%) were classified as high risk and 46 (32.6%) patients were low risk. The overall specificity was 88.0% (88/95) and overall sensitivity was 92.9% (39/42), which is significant higher than FISH test of urinary cells. Conclusions: With high specificity and sensitivity, Genetron uro-18 genes test could be incorporated in renal pelvic cancer diagnosis, especially for patients with a ultrasound detectable lesions. Ureteroscopy prior to surgery could be reduced, which may lead to decrease risk of tumor implantation and recurrence.

Chinese Herb Resveratrol Inhibits Renal Pelvic Cancer Cell Proliferation via Regulating miR-30a-5p

Renal pelvis cancer (RPC) is rare with unclear pathogenesis. Resveratrol (RSV) also plays a beneficial role in preventing chronic diseases related to inflammation. But its effect on RPC cells has not been reported. RPC cells were cultured and treated with resveratrol for 48 hours followed by analysis of cell proliferation, apoptosis and cell cycle, and miR-30a-5p expression. The expression of miR-30a-5p effects proliferation, apoptosis and cell cycle was also assessed. After treatment, RPC cells showed upregulated miR-30a-5p, decreased cell survival and enhanced cell apoptosis rate compared with abnormal cell cycle (P < 0.05), and the effect was more significant with the increase in concentration (P < 0.05). The miR-30a-5p target gene is AVEN. miR-30a-5p downregulation can reverse its effect on RPC cells (P < 0.05). Resveratrol treatment on RPC cells can upregulate miR-30a-5p, inhibite cell proliferation, promotes apoptosis, and changes cell cycle.

A Case of Renal Pelvic Cancer with a Complete Duplication of the Renal Pelvis and Ureter

This paper describes a case of renal pelvic cancer with a complete duplication of the renal pelvis and ureter, which is substantially rare. A 76-year-old man was referred to the hospital because of gross hematuria for 2 years. A tumor was detected in the upper right kidney using enhanced computed tomography and magnetic resonance imaging scan, and the downstream ureter was suspected to open into the prostate. Retrograde ureteroscopy via the ectopic ureter orifice showed a hemorrhagic papillary tumor consistent with imaging findings. Laparoscopic radical nephroureterectomy was performed and the prostate was preserved because the tumor was only in the renal pelvis. Histopathological examination showed the tumor as a high-grade urothelial carcinoma. There was no sign of recurrence at one and a half years after operation. Ureteroscopy was effective in detecting an upper urinary tract tumor, even via ectopic ureter orifice, and preserving the prostate was possible.