二次电切联合吉西他滨即刻灌注治疗非肌层浸润性膀胱癌的临床效果  

Clinical effectiveness of repeat transurethral resection combined with Gemcitabine immediate intravesical instillation in treatment of non-muscular invasive bladder urothelial cancer

作　　者：梁宇[1] 沈群山[1] 张珺[1] 孟杰 李海波[1] LIANG Yu;SHEN Qunshan;ZHANG Jun(Department of Urology,the 901st Hospital of Joint Logistics Support Force of PLA,Hefei 230031,China)

机构地区：[1]中国人民解放军联勤保障部队第901医院泌尿外科

出　　处：《安徽医学》2019年第6期609-612,共4页Anhui Medical Journal

基　　金：南京军区科技创新面上项目(项目编号:MS038)

摘　　要：目的研究二次电切联合吉西他滨即刻膀胱灌注治疗非肌层浸润性膀胱癌的临床效果。方法选择2011年10月至2014年10月在中国人民解放军联勤保障部队第901医院行经尿道膀胱肿瘤切除术(TURB-t)治疗的52例非肌层浸润性膀胱癌患者,将仅行TURB-t的24例患者为对照组,TURB-t术后且行二次电切的28例患者为观察组,两组患者均使用吉西他滨即刻灌注治疗。分析两组患者肿瘤病灶残留、肿瘤的复发率及进展率情况。结果对照组患者首次TURB-t术后残留率为8.33%,观察组为14.29%,两组差异无统计学意义(χ^2=0.055,P=0.815)。对照组患者12个月内肿瘤复发率为33.33%,观察组为7.14%,两组差异有统计学意义(χ^2=4.145,P=0.042);对照组患者24个月内复发率为50.00%,观察组为17.86%,两组差异有统计学意义(χ^2=6.068,P=0.014)。对照组患者24个月内肿瘤进展率为33.33%,观察组为7.14%,两组差异有统计学意义(χ^2=4.145,P=0.042)。结论二次电切能减少肿瘤病灶残留,二次电切联合吉西他滨即刻膀胱灌注治疗能够降低非肌层浸润性膀胱癌的复发率。Objective To analyze the clinical effect of repeat transurethral resection combined with gemcitabine immediate intravesical instillation in the treatment of non-muscle invasive bladder cancer(NMIBC). Methods The clinical data of 52 patients with non-muscle invasive bladder cancer diagnosed in the 901st hospital,who underwent TURB-t from Oct.2011 to Oct.2014,were retrospectivley analysed,of which 24 patients given only TURB-t were as control group,and 28 patients who underwent repeat transurethral resection after TURB-t as observation group.All patients were treated with immediate intravesical instillation with gemcitabine.The tumor residual,tumor recurrence rate and progression rate were analyzed in two groups. Results The tumor residial rate in control and observation group was 8.33% and 14.29% respectively after first TURB-t,and the difference was not statistically significant between the two groups(χ^2 = 0.055 , P =0.815).The tumor recurrence rate was 33.33% in control group and 7.14% in observation group within 12 months,and there was a statistically significant difference between the two groups (χ^2 =4.145, P =0.042).The recurrence rate was 50.00% in control group and 17.86% in observation group within 24 months,the difference was statistically significant (χ^2 =6.068, P =0.014).The tumor progression rate of control group was 33.33% within 24 months,and 7.14% in observation group,which had significant difference (χ^2 =4.145, P = 0.042 ). Conclusions Repeat transurethral resection can reduce the residual tumor.Repeat transurethral resection combined with gemcitabine immediate intravesical instillation can reduce the tumor recurrence of NMIBC.

关 键 词：非肌层浸润性膀胱癌 二次电切 肿瘤复发 膀胱灌注 吉西他滨 

分 类 号：R737.14[医药卫生—肿瘤]