等离子电切术治疗非肌层浸润性膀胱癌的效果及生存情况  

Efficacy and survival of plasma electrocision in the treatment of non-muscle invasive bladder cancer

作　　者：陈巍巍[1] 陈建华[1] CHEN Weiwei;CHEN Jianhua(Department of Urinary Surgery,Rugao Hospital of Chinese Medicine,Rugao Jiangsu 226500,China)

机构地区：[1]如皋市中医院泌尿外科,江苏如皋226500

出　　处：《临床与病理杂志》2023年第1期115-122,共8页Journal of Clinical and Pathological Research

摘　　要：目的:比较两种等离子电切术治疗非肌层浸润性膀胱癌的效果及生存情况。方法:回顾性纳入2019年1月至2020年9月于如皋市中医院就诊的63例非肌层浸润性膀胱癌患者,其中行经尿道等离子针状电极精准切除术(accurate transurethral needle-electrode resection,ATUNER)的患者入选ATUNER组(n=34),行尿道等离子环状电极切除术治疗的患者入选对照组(n=29)。分析所有患者的围手术期资料、术后排尿功能、肿瘤标志物的水平变化及术后生存情况。结果:ATUNER组的手术用时显著短于对照组(P<0.05),术中出血量显著少于对照组(P<0.05)。术后,ATUNER组的闭孔神经反射发生率显著低于对照组(P<0.05)。癌残余情况、膀胱穿孔、感染发生率差异均无统计学意义(均P>0.05)。与术前相比,术后两组患者的血管内皮生长因子(vascular endothelial growth factor,VEGF)、细胞角蛋白19片段(cytokeratin 19 fragment antigen 21-1,CYFRA21-1)、膀胱肿瘤抗原(bladder tumor antigen,BTA)、核基质蛋白22(nuclear matrix protein 22,NMP22)水平均显著下降(均P<0.05),其中ATUNER组的VEGF、BTA、NMP22水平均显著低于对照组(P<0.05)。术后对照组的2年复发率显著高于ATUNER组(P<0.05)。对照组的无复发生存期显著低于ATUNER(P=0.015)。结论:ATUNER治疗非肌层浸润性膀胱癌效果较好,手术用时短,术后并发症发生率和复发率较低,患者无复发生存期较长,值得临床推广应用。Objective: To compare the efficacy and survival of 2 plasma electrosurgery for non-muscle invasive bladder cancer.Methods: A total of 63 patients with non-muscle invasive bladder cancer who were admitted to Rugao Hospital of Chinese Medicine from January 2019 to September 2020 were enrolled retrospectively. The patients underwent accurate transurethral needle-electrode excision(ATUNER) were assigned to the ATUNER group(n=34). The patients treated with urethral plasma ring electrode excision were assigned to the controd group(n=29). The perioperative data, postoperative urinary function, changes in tumor marker levels, and postoperative survival of all patients were analyzed.Results: The operation time of the ATUNER group was significantly shorter than that of the control group(P<0.05), and the intraoperative blood loss was significantly less than that of the control group(P<0.05). After operation, the incidence of obturator nerve reflex in the ATUNER group was significantly lower than that in the control group(P<0.05). There were no significant difference in the incidence of cancer residual, bladder perforation and infection(all P>0.05). Compared with before operation, the levels of vascular endothelial growth factor(VEGF), cytokeratin 19 fragment antigen 21-1(CYFRA21-1), bladder tumor antigen(BTA), and nuclear matrix protein 22(NMP22) in the 2 groups after operation were significantly decreased(all P<0.05), and the levels of VEGF, BTA, and NMP22 in the ATUNER group were significantly lower than those in the control group(all P<0.05). After the surgery, the 2-year recurrence rate in the control group was significantly higher than that in the ATUNER group(P<0.05). The recurrence-free survival of the control group was significantly lower than that of the ATUNER group(P=0.015).Conclusion: ATUNER has good curative effect in the treatment of non-muscle invasive bladder cancer, with shorter operation time, lower postoperative complication rate and recurrence rate, and longer recurrence-free survival, which is worthy of

关 键 词：等离子电切术 非肌层浸润性膀胱癌 等离子针状电极 

分 类 号：R737.14[医药卫生—肿瘤]