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Recurrent renal cell carcinoma(reRCC) is associated with poor prognosis and the underlying mechanism is not yet clear. A comprehensive understanding of tumor microenvironment (TME) of reRCC may aid in designing effective anticancer therapies, including immunotherapies. Single-cell transcriptomics holds great promise for investigating the TME, however, this technique has not been used in reRCC. Here, we aimed to explore the difference in the TME and gene expression pattern between primary RCC (pRCC) and reRCC at single-cell level.We performed single-cell RNA sequencing analyses of 32,073 cells from 2 pRCC, 2 reRCC, and 3 adjacent normal kidney samples. 41 pairs of pRCC and reRCC samples were collected as a validation cohort to assess differences observed in single-cell sequencing. The prognostic significance of related cells and markers were studied in 47 RCC patients underwent immunotherapy. The function of related cells and markers were validated via in vitro and in vivo experiments.reRCC had reduced CD8We delineated the heterogeneity of reRCC and highlighted an innovative mechanism that CAFs acted as a suppressor of CD8

To study the characteristics of histopathologic features of small renal carcinoma.This retrospective study collected the data of renal cell carcinoma from the patients who underwent surgery from January 2002 to June 2012. They were all preoperatively diagnosed as renal cancer by CT scan, and pathologically diagnosed as renal cell carcinoma after surgery with the diameter ≤ 4 cm. We recorded and analyzed the tumor size, histologic subtype, Fuhrman grading, TNM stage, the existence of tumor vascular invasion, sarcomatoid differentiation, and whether it was multifocal, and then grouped them for comparison.A total of 1 276 patients were included in the study and were analyzed, of whom 306 (24.0%) had small renal cell carcinoma less than 2.0 cm, 526 (41.2%) 2.0-3.0 cm, and 444 (34.8%) bigger than 3.0 cm. Of all the subjects, 1 158 (90.7%) suffered from clear cell carcinoma, 49 (3.8%) papillary carcinoma, 32 (2.5%) chromophobe cell carcinoma, whose distribution was not related with tumor size. Of the ≤ 2.0 cm and2.0 cm groups, Furmann grades of G3/4 were 15 (4.9%), 98 (10.1%), respectively (P=0.007). T3a + stage and above were 1 (0.3%), and 32 (3.3%), respectively (P=0.004). Synchronous distant metastases occurred in 6 patients, all in group2.0 cm. Tumor sarcomatoid differentiation (0.3% vs. 0.9%), vascular invasion (0.6% vs. 2.1%) and multifocal (1.3% vs. 2.7%) had no significant difference between the two groups.Small renal cell carcinoma with diameter over 2.0 cm are more aggressive, suggesting that renal cancer bigger than 2.0 cm in diameter should not select a non-surgical treatment.

To investigate the pathological feature, therapy and prognosis of bilateral sporadic renal cell carcinoma.The data of 59 bilateral sporadic renal cell carcinoma patients diagnosed from Apr. 1986 to Dec. 2009 were collected. We retrospectively analyzed the treatment, pathological features, long term survival and prognosis factors of the disease.We found 59 patients with bilateral sporadic renal cell carcinoma (RCC) in the database diagnosed from Apr. 1986 to Dec. 2009. The median age was 56 years. Of all the cases, 37 were bilateral synchronous sporadic renal cell carcinoma and 22 bilateral metachronous sporadic renal cell carcinoma. Forty-three patients underwent bilateral surgeries, 11 unilateral surgery, and 5 no treatment. There were 122 masses in the 59 patients and 109 masses had pathological reports. All the 59 cases were RCC, and clear cell carcinomas was the main subtype (96.6%). The median follow-up time was 62.1 months (range 4-277 months). Thirty-nine patients (66.1%) survived without tumor recurrence, 4 survived with tumors recurrence, and 16 (27.1%) died. Kaplan-Meier curve revealed that the 3-year and 5-year overall survival rates were 83.5% and 81.1%, respectively; the 3-year and 5-year cancer special survival rates were 73.1% and 64.8%, respectively. The disease-free survival rates of bilateral synchronous and bilateral metachronous RCC were similar. Multivariate regression suggested that post-operative application of interferon-α and bilateral surgeries were related with a better prognosis.The main subtype of bilateral sporadic renal cell carcinoma was clear cell carcinoma (96.6%). Bilateral synchronous and bilateral metachronous RCC both had a long time disease-free survival. Interferon-α application after surgery and bilateral surgeries were related with a better prognosis.

To analyse the predictive factors for worse pathological outcome (muscle invasive pT2+, non-organ-confined pT3+ or N+ and histological Grade 3) of upper tract urothelial carcinoma (UTUC) in a Chinese population from a nationwide high-volume centre in China.Predictors were studied by retrospectively reviewing the clinicopathological data of 729 consecutive patients with UTUC treated in our centre from January 2002 to December 2010. Univariate and multivariate logistic regression analyses were used.There were more female patients (56.4%) than males and more tumours were located in the ureter (52.7%) than in the pelvis. In multivariate analysis, male gender (hazard ratio [HR] 1.898, P = 0.001), sessile architecture (HR 3.249, P0.001), high grade (HR 5.007, P0.001), ipsilateral hydronephrosis (HR 4.768, P0.001), renal pelvis location (HR 2.620, P0.001) and tumour without multifocality (HR 1.639, P = 0.028) were predictive factors for muscle-invasive UTUC. Male gender (HR 2.132, P0.001), renal pelvis location (HR 3.466, P0.001), tumour without multifocality (HR 2.532, P = 0.001), sessile tumour architecture (HR 3.274, P0.001), and high grade (HR 3.019, P0.001) were predictive factors for non-organ-confined disease. Chronological old age (HR 1.047, P0.001), sessile tumour architecture (HR 25.192, P0.001), ipsilateral hydronephrosis (HR 1.689, P = 0.024), and positive urinary cytology (HR 1.997, P = 0.006) were predictive factors for histological Grade 3 UTUC.There was a predominance of female patients and ureteric tumours in UTUCs of this Chinese population. Male gender, sessile architecture, tumour location, tumour without multifocality, high histological grade and preoperative ipsilateral hydronephrosis were independent predictive factors for worse pathological outcome of UTUCs.

To analyze the clinicopathologic features of 10 Chinese prostate adenocarcinoma patients under 50 years.Between January 2007 and April 2012, 10 cases of prostate adenocarcinoma patients under 50 years (age: 36-49) were diagnosed at our institution through prostate biopsy. The indications of biopsy were abnormal digital rectal examination (7 cases) and/or a total prostate specific antigen (PSA) over 4.0 μg/L (4 cases). The clinicopathological data of these patients were reviewed. The results of biopsy were 1 case with Gleason score (GS) 6, 4 cases with GS 7 and 5 cases with GS 9. In the study, 7 patients were diagnosed with cT4. Lymph node metastasis and bone metastasis were found in 5 and 4 cases, respectively. The treatments were hormonal therapy in 5 cases, radical prostatectomy in 2 cases and combination therapy in 3 cases.During the follow-up, 6 patients were in progression within 3 to 7 months, 1 patient died after 3 years, and 4 patients were lost of the follow-up.These findings suggest that the Chinese prostate adenocarcinoma patients with age under 50 years are likely to have more aggressive tumor and combination therapy might be appropriate.

To investigate and analyze the treatment and Long-term follow-up results of adult Wilms' tumor.Medical records for diagnosed Wilms' tumor in patients aged more than 15 years from Jan. 1970 to Dec. 2011 were reviewed retrospectively. The clinical presentations, stages, operative details, pathologic findings, adjuvant therapies and outcomes were analyzed. All the patients received regular follow-up, and particular attention was paid to the median follow-up period and tumor specific survival time.The records revealed the 10 patients with a median age of 33.5 year. Male and female were each 5. Left was 4 and right was 6. In the study, 80% of the patients had clinical presentations, and 30% of the patients presented with abdominal mass, and 30% of the patients had distant metastasis at the time of diagnosis. The number of the patients with tumor stages I,II, III, and IV were 2, 1, 4, and 3. One patient just underwent fine needle biopsy due to advanced tumor stage, and the others underwent surgical operations. The range of the follow-up time was 12 to 187 months, and the median follow-up period was 20 months. One patient lost the follow up , 5 patients died, 2 patients survived with tumor recurrence, and 2 patients survived without tumor recurrence. The median survival period was 42 months, and one patient lost the follow-up.The Long-term follow-up data demonstrated the poor prognosis of adult Wilms' tumor. Early tumor stage and the combination of operation, radiotherapy and chemotherapy are key factors to improve the outcomes.

To evaluate the prognostic factors of ureter transitional cell carcinoma (TCC).Between January 2001 and December 2005 133 TCC patients were treated. And the data was retrospectively analyzed.A mean age of the 133 patients was 68 years (range 43 - 87 years) at diagnosis. Altogether the non-invasive ureter TCC was found in 42 patients (31.6%) and the invasive ureter TCC in 91 patients (68.4%). Invasive ureter TCC growth was more common in distally located tumors (82.5%) compared to mid (62.5%) and proximal ureter (47.1%). Tumor stage, grade and location of the tumor were all correlated with disease specific survival in a univariate analysis. In a multivariate Cox analysis, tumor stage and grade were significantly associated with disease specific survival.More invasive tumors are found in ureter than in bladder. Ureter cancer is more frequently found in the distal part. Distally located ureteral tumors are more likely invading into the muscular cell layers compared to proximally located tumors. Tumor stage and grade are still the more important prognostic factors for ureter TCC.

To investigate the prognosis of surgical treatment for renal cell carcinoma with renal vein or inferior vena cava tumor thrombus.Between August 1994 and July 2004, 33 patients with renal cell carcinoma with renal vein or inferior vena cava tumor thrombus underwent radical nephrectomy and thrombectomy. The study population included 26 male and 7 female. The median age was 60 years (20 - 82). Level of tumor thrombus was renal vein in 15 patients, infrahepatic (level I) in 9, intrahepatic (level II) in 5, suprahepatic (level III) in 1, and right atrial extension (level IV) in 3. Survival analysis was made with Kaplan-Meier method.Twenty-nine patients can be followed up. Fourteen patients were lost with a mean survival time of (16.4 +/- 2.9) months (1 - 42 months). Fifteen patients were survival with a mean follow-up of (17.3 +/- 4.6) months (3 - 67 months). One patient was lost on the second postoperative day. Three patients can not be followed up. The 5-year Kaplan-Meier survival rate was 16%. The mean survival time of patients with renal vein involvement [(49.9 +/- 9.8) months] versus level I [(16.7 +/- 1.9) months] was significantly different (P0.05).Radical nephrectomy plus thrombectomy is a valuable method for the treatment of renal cell carcinoma with renal vein or inferior vena cava involvement. Patients with renal vein tumor thrombus appear to have better survival compared to patients with inferior vena cava tumor thrombus.

Background To compare the efficacy of sorafenib and sunitinib with regard to overall survival (OS) and progression free survival (PFS) in Chinese patients with metastatic renal cell carcinoma (mRCC). Methods A multicenter, retrospective study was performed to elucidate the relationship between clinical variables and prognosis comparing sorafenib and sunitinib as first-line treatment agents in Chinese patients with mRCC. Between September 2006 and December 2014, 845 patients received either sorafenib (400 mg bid; n = 483) or sunitinib (50 mg q.d; n = 362). The primary end point was OS and PFS. Results The percentage of patients with low and moderate risk according to Memorial Sloan-Kettering Cancer Centre (MSKCC) score was significantly higher in sunitinib group, and that with high risk was significantly higher in sorafenib group (15.1 vs. 5.2%; p