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Objectives. The most common subtype of renal cell carcinoma, clear cell renal cell carcinoma (ccRCC), has a high heterogeneity and aggressive nature. The basement membrane (BM) is known to play a vital role in tumor metastasis. BM-related genes remain untested in ccRCC, however, in terms of their prognostic significance. Methods. BM-related genes were gleaned from the most recent cutting-edge research. The RNA-seq and clinical data of the ccRCC were obtained from TCGA and GEO databases, respectively. The multigene signature was constructed using the univariate Cox regression and the LASSO regression algorithm. Then, clinical features and prognostic signatures were combined to form a nomogram to predict individual survival probabilities. Using functional enrichment analysis and immune-correlation analysis, we investigated potential enrichment pathways and immunological characteristics associated with BM-related-gene signature. Results. In this study, we built a model of 20 BM-related genes and classified them as high-risk or low-risk, with each having its anticipated risk profile. Patients in the high-risk group showed significantly reduced OS compared with patients in the low-risk group in the TCGA cohort, as was confirmed by the testing dataset. Functional analysis showed that the BM-based model was linked to cell-substrate adhesion and tumor-related signaling pathways. Comparative analysis of immune cell infiltration degrees and immune checkpoints reveals a central role for BM-related genes in controlling the interplay between the immune interaction and the tumor microenvironment of ccRCC. Conclusions. We combined clinical characteristics known to predict the prognosis of ccRCC patients to create a gene signature associated with BM. Our findings may also be useful for forecasting how well immunotherapies would work against ccRCC. Targeting BM may be a therapeutic alternative for ccRCC, but the underlying mechanism still needs further exploration.

Background. Cell division cycle associated 3 (CDCA3) mediates the ubiquitination WEE1 kinase at G2/M phase. However, its contribution to cancer immunity remains uncertain. Methods. We first evaluated the effect of CDCA3 on the prognosis of patients with renal cell carcinoma (RCC). The results of bioinformatics analysis were verified by the tissue microarray, immunofluorescence (IF) staining, CCK-8 assay, colony formation, cell cycle, and Western blot. Results. Bioinformatics analysis predicated CDCA3 was an independent predictor of poor prognosis in RCC and was associated with poor TNM stage and grade. CDCA3 was related to the infiltration of CD8+ T cells and Tregs. Tissue microarray demonstrated that CDCA3 was strongly associated with poor prognosis and positively relevant to CD8+ T infiltration. In vitro experiments showed that exgenomic interference of CDCA3 could attenuate cellular proliferation, arrest cell cycle, and blockade accumulation of CDK4, Bub3, and Cdc20 in mitosis process. Conclusion. CDCA3 presents as a good biomarker candidate to predict the prognosis of RCC patients and potentiates the immune tumor microenvironment (TME) of RCC.

Background: 30% of patients with hypokalemia develop ventricular tachycardia or ventricular fibrillation. Through clinical observation, we found that there are more patients with hypokalemia after surgical treatment of urinary calculi; as far as we know, there is no study on the changes of serum potassium after intracavitary treatment of urinary calculi. Objective: The change of electrolyte level through intracavitary treatment of urinary calculi (including URSL, PCNL, FURS combined with double endoscopy). To analyze the risk factors of hypokalemia and to provide evidence-based medical evidence for peri-operative management of intracavitary treatment of urinary calculi. Methods: 585 patients with urolithiasis (including URSL, MPCNL, FURS) from January 2020 to August 2021 were collected and analyzed. The relationship between age, sex, basic diseases, clinical manifestations, mode of operation, operation time, urinary leukocyte, urine culture, serum creatinine, electrolyte, location and size of urinary calculi and serum potassium were analyzed, and the independent risk factors were analyzed. Results: Among the 228 eligible patients, the proportion of women with HK was 63% higher than that of 37% in NG group, 3% in diabetic patients with HK, lower than that in NG group, 14.1% white blood cells in urine of HK (188.5 / ul) was higher than that of NG (96.4 / ul), and the serum creatinine (76mmol/L) before HK was lower than that of NG (85mmol/L). There was no significant difference between the two groups in age, BMI, basic diseases complicated with hypertension and coronary heart disease, clinical manifestations of low back pain and fever, positive urine culture before operation, anti-infection, blood magnesium, blood sodium, blood glucose, stone size, urine red blood cell count and operation time. Compared with men, women had diabetes. The OR values of ureteroscopy and flexible ureteroscope relative to percutaneous nephroscope and urinary leukocyte ≥ 120 / uL were 2.325, 7.793, 3.993, 2.09, respectively. Conclusion: Female, diabetes, ureteroscope, flexible ureteroscope and urinary calculi with elevated white blood cells may develop hypokalemia during the peri-operative period, so we should pay attention to blood potassium supplement.

Background: Sarcomatoid renal cell carcinoma (sRCC) is aggressive and with a poor prognosis. The therapeutic strategy of sRCC is unclear. We aim to evaluate the effectiveness of chemotherapy on sRCC and investigate the potential remedy to fight the sRCC. Methods: Patient information was derived from US Surveillance, Epidemiology, and End Results (SEER) database, and the demographic and clinical characteristics as variables were adopted. We apply log-rank to generate Kaplan–Meier survival curve. We established a nomogram by Cox proportional hazard model and apply the concordance index (C-index) and receiver-operating characteristic (ROC) to verify the quality of the model. Results: 809 patients were collected from SEER database. There are six independent prognostic factors, including age, sex, T stage, N stage, surgery, chemotherapy, that were employed to establish a prognostic model. The C-index of the model was 0.696. Tissue microarray (TMA) results suggested that programmed cell death ligand 1(PD-L1) was highly expressed in sRCC patients. Conclusions: Patients who have metastatic disease in sRCC can benefit from chemotherapy and surgery. Immunotherapy is promising to treat sRCC and should lunch a clinical trial at the current stage.

Objectives: To use bibliometric analysis to articles regarding RCC treating by ICIs, extended analysis effect, and safety of enrolled paper to interpret the current situation and future trend of clinical trials. Methods: We searched in the WoSCC Database on May 30, 2021. Articles were ranked in descending order based on their total citations. Also, we investigated the uncovered trials registered in ClinicalTrials.gov to analyze the trend of the future of ICI treatment. Results: The top 30 most cited articles were identified and analyzed. The most productive year was 2020, with 12 articles published. The USA and Memorial Sloan Kettering Cancer Center were the most effective country and institutions. The 15 journals contributed to these articles, and the top five keywords were survival, therapy, nivolumab, everolimus, and immunotherapy. The 13 original articles registered on ClinicalTrials.gov: monotherapy was 38.5% and combined therapy was 61.5%. The ORR of monotherapy and combined therapy was 24.05% vs 49.03% (P< 0.001). The mPFS of monotherapy was shorter than combined therapy (4.01 mo vs 14.51 mo, P< 0.001). The incidence of grade 3/4 adverse events in single-agent was significantly lower than combined therapy (19.76% vs 59.38%, P< 0.001). 91 grey data were extracted from ClinicalTrials.gov, which included single-agent (11%) and combination therapy (89%). Conclusions: Although the side effect is unfavorable, the combined therapy will replace the single-agent ICI treatment in the future clinical trial design. The effect of treatment based on PD-1, PD-L1, and CTLA-4 has almost reached the bottleneck, the scientist should focus on new targets of checkpoints in clinical research.

Background To investigate the expression of miR-125b and vitamin D receptor (VDR) in renal cell carcinoma (RCC) and assess the possible association between them. Then, to elucidate whether miR-125b can regulate the expression of VDR and affect proliferation and metastasis in RCC. Methods The expression of miR-125b was detected by quantitative real-time polymerase chain reaction (RT-PCR) in RCC cell lines. MiR-125b mimic and inhibitor were employed to measure the function and behavior of miR-125b in RCC cell lines. The relationship between miR-125 and VDR was verified using luciferase assays, and their expression was also examined in primary tumor and normal peritumoral kidney tissues in 20 clear cell RCC (ccRCC) samples. Results Overexpression of miR-125b promoted migration and invasion and reduced cell apoptosis in ACHN cells, while inhibition of miR-125b suppressed migration and invasion and induced cell apoptosis in 786-O cells. Overexpression of miR-125b decreased VDR expression via targeting VDR. Expression of miR-125b mRNA was significantly higher in ccRCC tissues than in normal adjacent tissues, and the expression of miR-125b mRNA negatively correlated with that of VDR (r=-0.444, p=0.04). Conclusion Overexpression of miR-125b decreased the expression of VDR and the promoted migration and invasion of RCC cells; in addition, there was a negative correlation between miR-125b and VDR expression in ccRCC.