TURBT联合吉西他滨膀胱灌注治疗非肌层浸润性膀胱癌的效果观察  

Observation on the Effect of TURBT Combined with Gemcitabine Bladder Perfusion in the Treatment of Non-Muscle Invasive Bladder Cancer

作　　者：丁鹏照 黄勇 DING Pengzhao;HUANG Yong(Affiliated Cancer Hospital of Guizhou Medical University,Guiyang 550000,China;不详)

机构地区：[1]贵州医科大学附属肿瘤医院,贵州贵阳550000

出　　处：《中外医学研究》2024年第27期37-41,共5页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:探讨经尿道膀胱肿瘤切除术(TURBT)联合吉西他滨膀胱灌注治疗在非肌层浸润性膀胱癌(NMIBC)患者中的应用价值。方法:选取2018年4月—2022年4月贵州医科大学附属肿瘤医院收治的86例NMIBC患者作为研究对象,对其临床资料进行回顾性分析。所有患者均接受TURBT治疗,根据用药方案差异性将其分为A组(吉西他滨膀胱灌注治疗)与B组(吡柔比星膀胱灌注治疗),每组各43例。比较两组手术相关情况、血清肿瘤标志物[癌胚抗原(CEA)、癌抗原199(CA199)、细胞角蛋白(CK19)]变化、T淋巴细胞亚群水平、不良反应、术后肿瘤复发情况。结果:A组CEA、CA199、CK19水平低于B组,CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平高于B组,膀胱刺激征与胃肠道反应发生率低于B组,差异有统计学意义(P<0.05)。两组手术用时、住院时间、导尿管留置时间、术中出血量、血尿与膀胱炎的发生率、术后复发率比较,差异无统计学意义(P>0.05)。结论:在NMIBC患者的治疗中,TURBT联合吉西他滨膀胱灌注治疗具有较好的疗效,能够改善血清肿瘤标志物水平,并保护患者的免疫功能,且用药期间的不良反应较少。Objective:To investigate the clinical value of transurethral resection of bladder tumor(TURBT)combined with gemcitabine intravesical perfusion in patients with non-muscular invasive bladder cancer(NMIBC).Method:Eighty-six NMIBC patients admitted to the Affiliated Cancer Hospital of Guizhou Medical University between April 2018 and April 2022 were selected as the study objects and the clinical data were retrospectively analysed.All cases were treated with TURBT,and the patients were divided into group A and group B according to the variability of the medication regimen,with 43 cases in each group.The patients of group A were treated with gemcitabine intravesical perfusion,the patients of group B were treated with bladder infusion of pirarubicin.Surgery-related conditions,changes in serum tumour markers[carcinoembryonic antigen(CEA),cancer antigen 199(CA199),cytokeratin(CK19)],levels of T-lymphocyte subpopulations,adverse reactions and postoperative tumour recurrence were compared between the two groups.Result:The levels of CEA,CA199,and CK19 in group A were lower than those in group B,and the difference was statistically significant(P>0.05).The levels of CD3^(+),CD4^(+),and CD4^(+)/CD8^(+)in group A were higher than those in group B,and the difference was statistically significant(P>0.05).The incidence of bladder irritation signs and gastrointestinal reactions in group A were lower than those in group B,and the difference was statistically significant(P>0.05).There was no significant difference in operation time,hospital stay,catheter indwelling time,intraoperative blood loss,incidence of hematuria and cystitis,and postoperative recurrence between the two groups(P>0.05).Conclusion:In the treatment of NMIBC patients,TURBT combined with gemcitabine bladder perfusion therapy has a good effect,can improve the serum tumour marker levels,and protect the immune function of patients.What's more,there are fewer adverse reactions during the treatment.

关 键 词：非肌层浸润性膀胱癌 吉西他滨 膀胱灌注 经尿道膀胱肿瘤切除术 

分 类 号：R737.14[医药卫生—肿瘤]