吉西他滨膀胱灌注在膀胱癌患者中的疗效观察及对生存期的影响研究  

Effect of Gemcitabine Intravesical Instillation in Patients with Bladder Cancer and Its Influence on Survival

作　　者：夏浩然 梁朝朝[1,2,3] 杨诚 陈佳[1,2,3] XIA Haoran;LIANG Chaozhao;YANG Cheng;CHEN Jia(Department of Urology,the First Affiliated Hospital of Anhui Medical University,Hefei,Anhui,230032,China;Institute of Urology,Anhui Medical University,Hefei,Anhui,230032,China;Anhui Province Key Laboratory of Genitourinary Diseases,Anhui Medical University,Hefei,Anhui,230032,China)

机构地区：[1]安徽医科大学第一附属医院泌尿外科,安徽合肥230032 [2]安徽医科大学泌尿外科研究所,安徽合肥230032 [3]泌尿生殖系统疾病安徽省重点实验室,安徽合肥230032

出　　处：《肿瘤药学》2019年第5期789-792,共4页Anti-Tumor Pharmacy

基　　金：安徽省自然科学基金(编号:1708085QH203)

摘　　要：目的考察吉西他滨膀胱灌注在膀胱癌患者中的疗效及其对生存期的影响。方法选取2015年8月-2017年8月医院收治的膀胱癌患者110例作为研究对象,平均分为对照组和观察组,各55例。对照组患者采用30 mg吡柔比星+50 mL 5%葡萄糖溶液进行膀胱灌注,观察组患者采用1000 mg吉西他滨+50 mL生理盐水进行膀胱灌注,均为每周1次,连续治疗8次,此后每个月治疗1次,连续治疗1年,每3个月复查一次膀胱镜和常规检查。随访2年,详细记录患者的复发时间、复发进展时间和不良反应发生情况。治疗前和治疗后3个月,取两组患者的尿样本,采用酶联免疫吸附试剂盒检测核基质蛋白22(NMP-22)、膀胱特异性核蛋白4(BLCA-4)、白细胞介素-8(IL-8)的表达水平。结果两组患者1年复发率和2年累积复发率均无显著差异(P>0.05);观察组患者无复发生存时间明显长于对照组(P<0.05)。治疗后3个月,两组患者尿液肿瘤标志物含量均较治疗前明显降低(P<0.05);观察组患者尿液NMP-22含量低于对照组,但差异无统计学意义(P>0.05);观察组患者尿液BLCA-4、IL-8含量显著低于对照组(P<0.05)。两组患者化疗期间均出现不同程度的尿频、尿急、尿痛和血尿等膀胱刺激症状,对照组不良反应总发生率为23.36%,观察组为26.85%,差异无统计学意义(P>0.05)。结论膀胱癌患者采用吉西他滨进行膀胱灌注,可有效控制病情进展,且安全性较高,值得临床推广。Objective To investigate the efficacy of gemcitabine intravesical instillation in patients with bladder cancer and its effect on survival.Methods A total of 110 patients with bladder cancer admitted to our hospital between August 2015 and August 2017 were selected as the study subjects.They were randomly divided into control group and observation group,55 in each group.The control group was treated with 30 mg pirarubicin+50 mL 5%glucose solution for bladder perfusion,while the observation group was treated with 1000 mg gemcitabine+50 mL saline for intravesical drugs.Perfusion chemotherapy was given once a week for 8 consecutive times,thereafter,once a month for one year.Cystoscopy and routine examination were repeated every 3 months.All patients were followed up for two years.During the follow-up period,the recurrence time,recurrence progression time and adverse reactions were recorded in detail.Urine samples were taken from patients before treatment and at 3 months after treatment.The expression levels of nuclear matrix protein 22(NMP-22),bladder cancer specific nuclear matrix protein 4(BLCA-4),interleukin-8(IL-8)were detected by ELISA kit.Results Compared with the control group,there was no significant difference in 1-year recurrence rate and 2-year cumulative recurrence rate in the observation group(P>0.05).But the non-recurrence survival time of the observation group was significantly longer than that of the control group(P<0.05).Compared with before treatment, the urinary tumor markers in the control group and the observation group were significantly lowered after treatment(P<0.05). Compared with the control group, the urine NMP-22 level was decreased in the observation group, but there was no significantdifference (P>0.05). The levels of BLCA-4 and IL-8 were significantly lower in the observation group than in the control group (P<0.05).During chemotherapy, all patients in the two groups had bladder irritation symptoms such as frequency, urgency, pain and hematuria of differentdegrees. The incidence of adve

关 键 词：吉西他滨 非肌层浸润性膀胱癌 疗效观察 生存期 

分 类 号：R737.14[医药卫生—肿瘤]