摘要
目的探讨膀胱癌行经尿道膀胱肿瘤电切术(TURBT)后行吉西他滨膀胱热灌注治疗的临床疗效。方法选择2015年2月~2017年2月我院收治的膀胱尿路上皮细胞癌患者60例,随机分为两组,各30例:观察组行45℃吉西他滨热灌注治疗,对照组行吉西他滨常规膀胱灌注治疗。两组治疗持续时间和化疗方案一致。比较两组患者治疗前后血清可溶性细胞间黏附分子-1(sICAM-1)、血清前梯度蛋白2(AGR2)水平,远期生存率、复发及不良反应情况。结果灌注治疗后两组患者sICAM-1和AGR2水平均较灌注前显著下降(P<0.05),且观察组sICAM-1和AGR2水平低于对照组(P<0.05)。观察组2年总复发率和非原位复发率分别为13.33%和3.33%,低于对照组的36.67%和26.67%(P均<0.05);观察组2年无复发生存期平均(22.43±3.41)个月,较对照组(19.04±3.12)个月延长(P<0.05)。两组不良反应率比较无统计学差异(P>0.05)。结论吉西他滨膀胱热灌注治疗可有效降低膀胱癌患者血清sICAM-1和AGR2水平,预后好,能降低TURBT术后复发率,延长生存期,且安全性与常规灌注治疗相近,其治疗膀胱癌的临床前景可期。
Objective To study the effect of gemcitabine hyperthermic intravesical chemotherapy(HIVEC)on the levels of serum soluble intercellular adhesion molecule 1(sICAM-1)and anterior gradient-2(AGR2),the recurrence rate and the prognosis in the patients with bladder uroepithelium cell cancer after TURBT.Methods A random study was performed in 60 cases suffered bladder uroepithelium cell carcinoma from February 2015 to February 2017.The intravesical hyperthermic instillation of gemcitabine at 45℃was carried out in the observation group(n=30),and the routine intravesical chemotherapy of gemcitabine was performed in the control group(n=30).The chemotherapy regimen,dosage and duration were same in both groups.The serum levels of sICAM-1 and AGR2,long term survival rate,recurrence rate and adverse reactions were compared between the two groups.Results The levels of sICAM-1 and AGR2 was decreased significantly in both groups after the perfusion than those before the perfusion(P<0.05),and both sICAM-1 and AGR2 was lower in the observation group than those in the control group(P<0.05).The total recurrence rate and non-in situ recurrence rate was 13.33%and 3.33%respectively in the observation group,and both were lower than 36.67%and 26.67%respectively in the control group(P<0.05).The 2-year recurrence-free survival period of the observation group was(22.43±3.41)months,and was longer than(19.04±3.12)months of the control group(P<0.05).There was no statistical difference in the adverse reaction rate between the two group(P>0.05).Conclusion HIVEC of gemcitabine can effectively reduce the serum levels of sICAM-1 and AGR2,decrease the recurrence rate,prolong the survival period and achieve the reliable safety consistent with the conventional perfusion for bladder cancer patients after TURBT,and it has got a good prognosis and a promising clinical prospect.
作者
吴荣鑫
胡明进
孟元
俞宇宙
章培
谢成亮
WU Rong-xin;HU Ming-jin;MENG Yuan;YU Yu-zhou;ZHANG Pei;XIE Cheng-liang(Department of Urology, Lishui Branch, Zhongda Hospital Affiliated to Southeast University, Nanjing 211200, Jiangsu, China)
出处
《中国现代手术学杂志》
2020年第1期60-64,共5页
Chinese Journal of Modern Operative Surgery
基金
南京市医学科技发展项目:YKK15204。
关键词
膀胱肿瘤
经尿道膀胱肿瘤电切术
热灌注治疗
吉西他滨
预后
bladder neoplasms
transurethral resection of bladder tumor(TURBT)
hyperthermic perfusion
gemctitabine
prognosis
