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Background: Our study aims to address two pivotal questions: "What are the recent advancements in understanding the etiology of urological tumors through Mendelian Randomization?" and "How can Mendelian Randomization be more effectively applied in clinical settings to enhance patient health outcomes in the future?", Methods: In our systematic review conducted in April 2023, we utilized databases like PubMed and Web of Science to explore the influence of Mendelian Randomization in urological oncological diseases. We focused on studies published from January 2018, employing keywords related to urological tumors and Mendelian Randomization, supplemented with MeSH terms and manual reference checks. Our inclusion criteria targeted original research studies, while we excluded reports and non-relevant articles. Data extraction followed a PICO-based approach, and bias risk was independently evaluated, with discrepancies resolved through discussion. This systematic approach adhered to PRISMA guidelines for accuracy and thoroughness in reporting., Results: From the initial 457 publications, we narrowed down to 43 full-text articles after screening and quality assessments. A deeper understanding of Mendelian Randomization can help us explore risk factors with a clear causal relationship to urological tumors. This insight may pave the way for future research in early diagnosis, treatment, and management of associated diseases., Conclusion: Our review underscores the value of MR in urogenital tumor research, highlighting its efficacy in establishing causality and its potential to clarify disease mechanisms. Despite challenges like large sample sizes and variant identification, MR offers new perspectives for understanding and managing these tumors, suggesting a trend towards more inclusive and diverse research approaches.

Purpose: Targeted ferroptosis is a reliable therapy to inhibit tumor growth and enhance immunotherapy. This study generated a novel prognostic risk signature based on ferroptosis-related genes (FRGs), and explored the ability in clinic for clear cell renal cell carcinoma (ccRCC)., Materials and Methods: The expression profile of mRNA and FRGs for ccRCC patients were exacted from The Cancer Genome Atlas (TCGA) database. A ferroptosis-related prognostic risk signature was constructed based on univariable and multivariable Cox-regression analysis. Kaplan-Meier (KM) survival curves and receiver operating characteristic (ROC) curves were performed to access prognostic value of riskscore. A nomogram integrating riskscore and clinical features was established to predict overall survival (OS). Based on differentially expressed genes between high- and low-OS groups with 5-year OS, function enrichment analyses and single-sample gene set enrichment analysis (ssGSEA) were investigated to immune status., Results: A 9-FRGs prognostic risk signature was constructed based on 37 differentially expressed FRGs. ROC and KM curves showed that riskscore has excellent reliability and predictive ability; Cox regression disclosed the riskscore as an independent prognosis for ccRCC patients. Then, the C-index and calibration curve demonstrated the good performance of nomogram in training and validation cohort, and its predictive ability better than other features. Immune-related biological processes were enriched by function enrichment analysis, and the immune-related cells and functions were differential by ssGSEA between high- and low-OS groups., Conclusion: Our study identified and verified a novel 9-FRGs prognostic signature and nomogram to predict OS, providing a novel sight to explore targeted therapy of ferroptosis for ccRCC.

Purpose: In this meta-analysis, we aimed to compared efficacy and safety of supracostal and infracostal access for percutaneous nephrolithotomy (PCNL)., Materials and Methods: We included eligible studies from PubMed, EMBASE, Cochrane Library, Web of Science and China National Knowledge Infrastructure. Literature searching, quality assessment and data extraction were performed by two independent reviewers. Data were analyzed by RevMan software. Binary and continuous variables were calculated as odds ratios (OR) and mean difference (MD)., Results: Two prospective comparative studies and seven retrospective observational studies were included in the meta-analysis, which contained 1,024 cases of supracostal access and 1,249 cases of infracostal access for PCNL. The supracostal access resulted in a significant reduced mean hemoglobin (95% CI: 0.26-3.46, MD = 1.86 g/L, P = .02) and a higher incidence of hydrothorax (95% CI: 4.77-22.95: OR = 10.47, P < .00001) compared to infracostal access. However, there no difference between supracostal and infracostal access regarding additional procedures (95% CI: 0.70-1.69, OR = 1.09, P = .71), stone-free rate (95% CI: 0.80-1.72, OR = 1.18, P = .41), length of hospital stay (95% CI: -0.03-0.37, MD = 0.17 day, P = .10), and occurrence of fever (95% CI: 0.95-2.03, OR = 1.39, P = .09) and blood transfusion (95% CI: 0.45-1.70, OR = 0.88, P = .70). No publication bias was identified in the study., Conclusion: Supracostal access was effective, but not as safe as infracostal access PCNL due to a higher risk of reduced hemoglobin and hydrothorax. Therefore, infracostal access should be the preferred safe and effective approach recommended for PCNL. When a supracostal puncture is performed, essential precautions to avoid hemoglobin loss and hydrothorax should be used.

The present study aimed to investigate the gene expression changes in prostate cancer (PC) and screen the hub genes and associated pathways of PC progression. The authors employed integrated analysis of GSE46602 downloaded from the Gene Expression Omnibus and The Cancer Genome Atlas databases to identify 484 consensual differentially expressed genes (DEGs) in PC, when compared with adjacent normal tissue samples. Functional annotation and pathway analysis were performed. The protein-protein interaction (PPI) networks and module were constructed. RT-qPCR was used to validate the results in clinical PC samples. Survival analysis of hub genes was performed to explore their clinical value. GO analysis results revealed that DEGs were significantly enriched in negative regulation of nitrobenzene metabolic process, extracellular space and protein homodimerization activity. KEGG pathway analysis results revealed that DEGs were most significantly enriched in focal adhesion. The top 10 hub genes were identified to be hub genes from the PPI network, and the model revealed that these genes were enriched in various pathways, including neuroactive ligand-receptor interaction, p53 and glutathione metabolism signaling pathways. RT-qPCR results validated that expression levels of eight genes (PIK3R1, BIRC5, ITGB4, RRM2, TOP2A, ANXA1, LPAR1 and ITGB8) were consistent with the bioinformatics analysis. ITGB4 and RRM2 with genetic alterations exhibited association with a poorer survival rate, compared with those without alterations. These results revealed that PC-related genes and pathways have an important role in tumor expansion, metastasis and prognosis. In summary, these hub genes and related pathways may act as biomarkers or therapeutic targets for PC., Competing Interests: None.