经尿道激光切除术联合甘露聚糖肽治疗浅表性膀胱癌的效果  

Efficacy of transurethral plasmakinetic resection combined with mannatide for superficial bladder cancer

作　　者：韩成贤 徐晓妮 王珂 李兆民 郝静 HAN Cheng-xian;XU Xiao-ni;WANG Ke;LI Zhao-min;HAO Jing(Department of Urology;The Fourth Department of Orthopaedics,The First People＇s Hospital of Xian-yang,Xianyang 712000,China)

机构地区：[1]陕西省咸阳市第一人民医院泌尿外科,咸阳712000 [2]陕西省咸阳市第一人民医院骨四科,咸阳712000

出　　处：《中国肿瘤临床与康复》2018年第9期1077-1080,共4页Chinese Journal of Clinical Oncology and Rehabilitation

摘　　要：目的探讨经尿道1.9μm激光切除术联合甘露聚糖肽治疗浅表性膀胱癌的效果及对血清α型叶酸受体(α-FR)和可溶性B7-H4(s B7-H4)水平的影响。方法选取2013年1月至2015年6月间陕西省咸阳市第一人民医院收治的86例浅表性膀胱癌患者,采用随机数字表法分为观察组和对照组,每组43例。对照组患者经尿道1.9μm激光切除术,观察组患者在对照组基础上采用甘露聚糖肽治疗,比较两组患者术后复发率、不良反应发生情况、T淋巴细胞亚群含量、α-FR及s B7-H4水平。结果术后随访,对照组患者失访3例,观察组患者失访2例。术后6个月,两组患者复发率比较,差异无统计学意义(P>0.05)。术后1年和2年,观察组患者复发率均低于对照组,差异均有统计学意义(均P<0.05)。术后当天(灌注治疗前),两组患者CD4^+、CD8^+和CD4^+/CD8^+比较,差异无统计学意义(P>0.05)。术后3个月,两组患者CD4^+和CD4^+/CD8^+比较,差异均有统计学意义(均P<0.05),CD8^+无统计学意义。观察组患者并发症发生率为14.6%,与对照组的15.0%比较,差异无统计学意义(P>0.05)。术前,两组患者血清α-FR和s B7-H4水平比较,差异无统计学意义(P>0.05)。术后1周和术后3个月,两组患者均较术前降低,且观察组患者术后血清α-FR和s B7-H4水平均低于对照组,差异均有统计学意义(均P<0.05)。结论经尿道1.9μm激光切除术联合甘露聚糖肽治疗浅表性膀胱癌,可有效降低术后复发率及血清α-FR和s B7-H4水平,提高机体免疫力,有安全、有效及并发症少等特点。Objective To explore the efficacy of transurethral plasmakinetic resection combined with mannatide for superficial bladder cancer and the effect on folate receptor alpha （ct-FR） and soluble B7- H4 （sBT-H4） levels. Methods From January 2013 to June 2015, 86 patients with superficial bladder cancer treated at The First People＇s Hospital of Xianyang were selected and divided into an observation group and a control group according to the random digital table method, with 43 patients in each group. The ob- servation group was treated with mannan peptide on the basis of transurethral 1.9 μm laser resection and the control group was treated with transurethral 1.9 μm laser resection only. The recurrence rate, the incidence of adverse reaction, the content of T lymphocyte subgroup, the alpha-FR and the sB7-H4 level were com- pared between the two groups. Results During the postoperative follow-up, 3 patients were omitted in the control greoup and 2 patients were omitted in the observation group. There was no significant difference in recurrence rate between the two groups at 6 months after operation （ P 〉 0.05 ）. The recurrence rate in the observation group was significantly lower than that in the control group at l and 2 years after operation （all P 〈0. 05 ）. The day after the operation （before perfusion treatment）, there was no significant difference in CD4 ＋ and CD4＋/CD8＋ between the two groups （ P 〉 0. 05 ） and the difference was significant between the two groups at 3 months after the operation （ all P 〈 0. 05 ）, while the difference in CD8 ＋ was not significant （P 〉 0. 05 ）. The incidence of complication was 14. 6% in the observation group, compared with 15.0% in the control group （ P 〉 0. 05 ）. There was no significant difference in serum alpha-FR and sB7-H4 between the two groups （ P 〉 0. 05 ） and at 1 week and 2 weeks after the operation, serum alpha-FR and sB7-H4 sig- nificantly decreased compared with before operation with the observation group l

关 键 词：浅表性膀胱肿瘤 1.9μm激光切除术 甘露聚糖肽 α型叶酸受体 可溶性 B7-H4 

分 类 号：R737.1[医药卫生—肿瘤]