Establishment Of Clinical Data And Specimen Bank Of Urological Tumors With The Preliminary Application

Objective:With the development of social and economic level,the change of environment,the change of living habits and the process of aging,the incidence of malignant tumor is increasing day by day,and has gradually become one of the main culprits endangering human life and health.The mortality rate from malignant tumors is only lower than that from cardiovascular disease.Urinary tract neoplasms are second only to calculi and prostate diseases among urinary system diseases,with high rates of prostate cancer,bladder cancer,and renal cancer.In the field of urinary system,the research on various malignant tumors has developed rapidly,from cell,molecular level to holistic clinical research,epidemiology research has developed rapidly.Great achievements have been made in the pathogenesis,diagnosis and treatment of the disease.The large amount of clinical data and tumor tissue produced in clinical work are very valuable research materials.Especially tumor tissue,it is very important for the study of molecular and cell level.It is the source of information in the study,and it is also a link with clinical diseases.Secondly,the diagnosis,treatment information and group epidemiology related information of the individual after the cancer patients are admitted to hospital can also promote the development of evidence-based medicine and diagnosis and treatment technology.The significance of this study lies in:To explore the method of constructing the clinical data and specimen tissue bank of urinary system,through the standardized case collection,sorting,collection,preservation,and efficient management,the limited clinical data and tissue resources of the tumor can be utilized efficiently.The results are applied to clinical studies,molecular biomolecular biology and histopathology.It is beneficial to increase the repeatability of research,reduce the time required for research,and strengthen the cooperation between clinical departments,laboratory and pathology departments,so as to speed up the progress of tumor-related research.This study is divided into two parts:1.Establishment of urological tumor Information specimen Bank;2.According to the Retrospective analysis of the case information collected In the above specimen information bank related to the High risk non-myometrial invasive bladder cancer,to attempt to utilize the tumor information specimen bank and to find the problem in the establishment for improving it.Methods:Part one:Establishment of urological tumor Information specimen Bank:1.standardized collection of clinical data,mainly including general information of patients,related imaging,test data,pathological data;2.the collection of specimen tissue:to formulate the operation process and operation specification of colleting the specimens.The collections operated by trained and specialized personnel according to entering the operating room.3.preservation of specimen tissue:specimens transported by 3L liquid nitrogen tank or dry ice and Stored in large storage liquid nitrogen tank or-80? ultra-low temperature refrigerator.4.Input information of specimens:the information includes basic patient information,sample storage,clinical information,specimens usage management information and Specimen scrap information.The clinical information includes Pathological data,iconographydata,laboratory data related.Specimens usage management information includes:the names and numbers of related projects,names of relevant units,users.The certificates of ethnics examination.Specimen scrap information includes:Agent,specimen number,time of abandonment,cause of abandonment.5.Establishment of case follow-up platform:according to different types of diseases such as kidney cancer,bladder cancer,prostate cancer.to choose Individualized follow-up plans for establishing information bank:recording patient's personal information,disease type,onset date,treatment and informations of postoperative regular reexamination,recurrence and metastasis,cause and date of death,etc.6.Quality control of specimens:in order to ensure the quality of collected specimens,regular sampling of tumor specimens,the preparation of paraffin sections,pathological quality detection and extraction of DNAs,testing the quality of DNA preservation.7.Informed consent and Ethics:The object of collection and use of specimens must obtained the consent of the patient and the family and the informed consent relevant should be signed.Using of specimens Should be reviewed and approved by the ethics committee.Part two,analysis of the curative effect of high risk non-myometrial invasive bladder cancer after electrosurgical resection:collect the case from the above specimen information bank:?Preoperative MRI or CT show no pelvic lymph node metastasis or distant metastasis.?Undergoing surgery of transurethral rescetion of bladder tumor(Plasma or laser method).?Postoperative pathological diagnosis confirms:non-muscular urothelial carcinoma with high risk(Tl,G3,Tis).And collect of informations on follow-up of patients for one year,to study the effect of transurethral resection of bladder tumor on patients with high risk NMIBC.Results:The process of the collecting and saving Clinical data and related specimens of patients with urological tumors has been established through one-year practicing and a complete and operable operation process of the specimen bank has been established.The clinical data of 209 patients with urological tumors were collected,Including of general information of patients,pathology,laboratory and radiography-related data.And the tumor tissues of 97 patients were collected and a few adjacent tissues were collected to form a bank.The project strengthened the communication among the pathology department,the surgery department and the central laboratory,and established the cooperation flow.It provides basic support for the study of urological tumors in our hospital.By collecting and sorting out the follow-up information of the patients whose pathology is high risk non-myometrial invasive bladder malignant tumor in the specimen database,and combining with the related literature,We analyzed the effect of bladder preserving operation and postoperative bladder perfusion therapy on high risk nmibc patients.We found that bladder preserving surgery can benefit a large proportion of high risk nmibc patients,but the rate of recurrence and progression of this pathological type of tumor is high.And the survival time was greatly reduced after the distant metastasis of the tumor was found.Secondary electrotomy and BCG instillation could significantly reduce the recurrence rate and progression rate.Early radical cystectomy can significantly reduce recurrence and 5-year mortality in the goups of recurrent patients of high-risk and very high-risk groups.This study also reflects the problems in the operation of clinical data and specimen bank,which has positive significance for the adjustment of follow-up work.Conclusion(s):The clinical data and specimen bank on the subject of urinary system have been preliminarily established in our department and we have complete the initial use of it.The establishment of the clinical data and specimen bank provides a good platform for clinical research and basic research of urological tumors in our department.