吉西他滨膀胱灌注对非肌层浸润性膀胱癌TURBT术后复发及免疫功能的影响  

Effects of Gemcitabine Intravesical Instillation on Recurrence and Immune Function of Non-muscle Invasive Bladder Cancer after TURBT

作　　者：熊毅 XIONG Yi(Ruijin People's Hospital,Ruijin Jiangxi 342500,China)

机构地区：[1]瑞金市人民医院,江西瑞金342500

出　　处：《药品评价》2023年第3期321-324,共4页Drug Evaluation

摘　　要：目的探讨非肌层浸润性膀胱癌患者经尿道膀胱肿瘤电切术(TURBT)术后采取吉西他滨膀胱灌注对免疫功能的影响及术后复发风险,旨在为提高非肌层浸润性膀胱癌患者TURBT术后整体获益水平。方法按随机数字表法将2018年1月至2021年12月期间瑞金市人民医院收入的60例非肌层浸润性膀胱癌患者随机分为两组,对照组(30例,TURBT术后给予表柔比星膀胱灌注),研究组(30例,TURBT术后联合吉西他滨灌注),对比两组血清指标[血清重组人Dickkopf蛋白1(DKK1)、可溶性血管细胞黏附分子-1(sVCAM-1)、血管内皮因子(VEGF)],免疫功能[淋巴细胞CD3^(+)、自然杀伤细胞(NK细胞)、CD4^(+)/CD8^(+)]及免疫球蛋白(IgA、IgG、IgM),不良反应及复发率。结果治疗前,两组血清DKK1、sVCAM-1、VEGF表达对比无差异(P>0.05);治疗结束时,研究组血清DKK1、sVCAM-1、VEGF表达低于对照组(P<0.05)。治疗前,两组血清IgA、IgG、IgM、CD3^(+)、CD8^(+)、CD4^(+)/CD8^(+)表达对比无差异(P>0.05);治疗结束时,研究组上述IgA、IgG、IgM、CD3^(+)、CD4^(+)/CD8^(+)高于对照组,CD8^(+)表达低于对照(P<0.05)。两组患者不良反应总发生率对比差异无统计学意义(χ^(2)=2.78,P=0.095);复发率对比差异无统计学意义(χ^(2)=0.27,P=0.605)。结论非肌层浸润性膀胱癌患者TURBT术后联合吉西他滨膀胱灌注对增强机体免疫功能,降低复发风险均有一定成效,且安全性理想,建议在临床非肌层浸润性膀胱癌患者术后联合治疗中开展。Objective To explore the effect of gemcitabine bladder perfusion on immune function and postoperative recurrence risk after electroresection of bladder tumor(TURBT)in patients with non-muscle invasive bladder cancer,aiming to improve the overall benefit level of TURBT in patients with non-muscle invasive bladder cancer.Methods 60 patients with non muscle invasive bladder cancer admitted to Ruijin People's Hospital from January 2018 to December 2021 were randomly divided into two groups by random number table method.The control group(30 cases,intravesical instillation of epirubicin after TURBT surgery),the study group(30 cases,combined with gemcitabine intravesical instillation after TURBT)and the serum indicators[serum recombinant human Dickkopf protein 1(DKK1),soluble vascular cell adhesion molecule-1(sVCAM-1),vascular endothelial factor(VEGF)],immune function[lymphocytes CD3^(+),natural killer cells(NK cells),CD4^(+)/CD8^(+)]and immunoglobulins(IgA,IgG,IgM),adverse reactions and recurrence rate of the two groups were compared.Results Before treatment,there was no difference in the expression of serum DKK1,sVCAM-1 and VEGF between the two groups(P>0.05).At the end of treatment,the expression of DKK1,sVCAM-1 and VEGF in serum of the study group was lower than that of the control group(P<0.05).Before treatment,there was no difference in the expression of serum IgA,IgG,IgM,CD3^(+),CD8^(+),CD4^(+)/CD8^(+)between the two groups(P>0.05);at the end of treatment,the expression of above IgA,IgG,IgM,CD3^(+),CD4^(+)/CD8^(+)in the study group was higher than that in the control group,and the expression of CD8^(+)was lower than that in the control group(P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(χ^(2)=2.78,P=0.095);there was no significant difference in recurrence rate between the two groups(χ^(2)=0.27,P=0.605).Conclusion The combination of TURBT and bladder infusion of gemcitabine in patients with non-muscle invasive bladder cancer has certain effects on

关 键 词：膀胱肿瘤 投药 膀胱内 非肌层浸润性膀胱癌 吉西他滨 膀胱切除术 免疫功能 复发风险 不良反应 

分 类 号：R737.14[医药卫生—肿瘤]