Purpose: The present study aimed at determining the expression of carbonic anhydrase IX (CAIX) in tissue and serum of patients with clear cell renal cell carcinoma (ccRCC) and its relationship with clinical-pathological parameters; assessing CAIX as a marker of progression and survival; and studying the relationship of CAIX concentration in serum before and after surgical intervention.Materials and Methods: Immunohistochemistry was used to assess the expression of CAIX in tumor and adjacent healthy renal tissues. The concentration of CAIX in serum was determined using commercial enzyme-linked immunosorbent assay before and 24 hours after radical nephrectomy in 60 patients diagnosed with ccRCC. SPSS ver. 28.0.1.0 was used for descriptive and inferential statistical analysis and graphics. A significance level of 0.05 was considered for all statistical tests performed.Results: CAIX expression was positive in 59 of the 60 samples of tumor renal tissue, and negative in the 60 samples of healthy renal tissues. Median serum CAIX concentration was higher before nephrectomy (178.25 pg/mL) than after it (59.30 pg/mL), with a high correlation between pre-and postsurgical measurements (r=0.891). Significant differences were found in CAIX concentration according to the following variables: TNM, tumor stage, Fuhrman nuclear grade, progression, and death. Serum CAIX concentration before nephrectomy correlated with disease progression and overall survival, with a hazard ratio of 4.849 for CAIX values greater than 169.95 pg/mL.Conclusion: CAIX expression in tumor renal tissue was specific, but not clinically useful as a prognostic marker. Measurements of CAIX in serum obtained pre- and postsurgical interventions showed good prognostic potential, correlating with clinical-pathological parameters and estimating the risk of progression. Presurgical intervention serum CAIX concentrations higher than 169.95 pg/mL indicated an almost 5-fold increased risk of death.
Background: Higher education training in Medicine has considerably evolved in recent years. One of its main goals has been to ensure the training of students as future adequately qualified general practitioners (GPs). Tools need to be developed to evaluate and improve the teaching of Urology at the undergraduate level. Our objective is to identify the knowledge and skills needed in Urology for the real clinical practice of GPs. Methods: An anonymous self-administered survey was carried out among GPs of Primary Care and Emergencies which sought to evaluate urological knowledge and necessary urological skills. The results of the survey were exported and descriptive statistics were performed using IBM SPSS Statistics version 19.0. Results and limitations: A total of 127 answers were obtained, in which ‘Urological infections’, ‘Renal colic’, ‘PSA levels and screening for prostate cancer’, ‘Benign prostatic hyperplasia’, ‘Hematuria’, ‘Scrotal pain’, ‘Prostate cancer diagnosis’, ‘Bladder cancer diagnosis’, ‘Urinary incontinence’, and ‘Erectile dysfunction’ were rated as Very high or High formative requirements (>75%). Regarding urological skills, ‘Abdominal examination’, ‘Interpretation of urinalysis’, ‘Digital rectal examination’, ‘Genital examination’, and ‘Transurethral catheterization’ were assessed as needing Very high or High training in more than 80% of the surveys. The relevance of urological pathology in clinical practice was viewed as Very high or High in more than 80% of the responses. Conclusions: This study has shown helpful results to establish a differentiated prioritization of urological knowledge and skills in Primary Care and Emergencies. Efforts should be aimed at optimizing the teaching in Urology within the Degree of Medicine which consistently ensures patients’ proper care by future GPs.
Purpose: Clear cell renal cell carcinoma (ccRCC) is the most common histological subtype of renal carcinoma, accounting for 75%–80% of cases. Vascular endothelial growth factor (VEGF), which promotes angiogenesis via its membrane receptors (VEGFRs), and E-cadherin, which decreases in expression during invasion and metastasis, are both implicated in ccRCC pathogenesis. We analyzed the relationship between these proteins and ccRCC lesions to assess their usefulness as prognostic markers.Materials and Methods: Renal tumor tissue samples from nephrectomies of 69 patients were analyzed using immunohistochemical techniques to evaluate the expression of the aforementioned proteins. These findings were then compared with established prognostic scales. Statistical analysis was performed using SPSS Statistics ver. 29.0.1.0.Results: VEGF intensity was significantly correlated with tumor size (T; p=0.002), stage (p<0.001), and metastasis (M; p=0.049) according to the TNM classification. VEGFR3 expression correlated positively with tumor size (T; p=0.046) and stage (p=0.040). E-cadherin expression correlated negatively with tumor size (p=0.047). In relation to prognostic scales, VEGF expression correlated with the UCLA Integrated Staging System score (p=0.009), while E-cadherin correlated with the stage, size, grade and necrosis (SSIGN) score (p=0.044). For both overall and disease-free survival, significant differences were observed between the moderate (2++) and intense (3+++) VEGFR3 intensity groups (p=0.009 for both).Conclusion: VEGF may have prognostic value due to its association with tumor size, stage, metastasis, and the UCLA Integrated Staging System score. Similarly, VEGFR3 shows prognostic potential based on its correlations with tumor size, stage, and its relation to overall and disease-free survival. E-cadherin also demonstrates prognostic significance through its association with tumor size and the SSIGN score.
Angiología es una revista científica bimensual editada desde 1949. Está dedicada al estudio de las enfermedades vasculares, incluyendo todos los aspectos de la medicina vascular, el diagnóstico no invasivo, el tratamiento quirúrgico tradicional arterial y venoso, así como el mínimamente invasivo y/o endovascular.