经尿道膀胱肿瘤等离子电切术联合吉西他滨膀胱灌注化疗对浅表性膀胱癌的临床疗效  

Clinical efficacy of transurethral plasmakinetic resection of bladder tumor combined with gemcitabine intravesical chemotherapy for superficial bladder cancer

作　　者：石阳 黄刘虎 SHI Yang;HUANG Liuhu(Department of Urology,Rugao People's Hospital,Nantong 226500,China)

机构地区：[1]如皋市人民医院泌尿外科,江苏南通226500

出　　处：《中国肿瘤外科杂志》2024年第5期475-479,共5页Chinese Journal of Surgical Oncology

基　　金：江苏省重点研发计划(社会发展)(BE2021651)。

摘　　要：目的评估经尿道膀胱肿瘤等离子电切术联合吉西他滨膀胱灌注化疗对浅表性膀胱癌患者的临床疗效。方法选取如皋市人民医院2019年1月至2023年3月收治的浅表性膀胱癌患者87例,随机分为治疗组和对照组。治疗组(44例)接受经尿道膀胱肿瘤等离子电切术后进行吉西他滨膀胱灌注化疗,对照组(43例)仅接受经尿道膀胱肿瘤电切术。两组患者性别组成、年龄、病理分级、分期和基础疾病等相比,差异无统计学意义(P>0.05)。比较两组治疗效果、复发情况、治疗前后的肿瘤标志物和血清标志物水平,并记录不良反应发生情况。结果所有手术均一次成功,肿瘤最大径0.5~3.0 cm,平均直径为1.6 cm。手术时间平均为23 min,出血量均<10 mL;治疗组在术后3、6、12个月的复发率均低于对照组,全部缓解和部分缓解率高于对照组,但差异无统计学意义(P>0.05);治疗组在治疗后的尿液肿瘤标志物(CYFR21-1、NMP22、BTA)均显著低于治疗前,与对照组相比改善更为显著(P<0.05);治疗组的VEGFC和VEGFA水平在治疗后也显著降低,相比对照组降幅更大(P<0.05);治疗组的不良反应发生率显著低于对照组(P<0.05)。结论经尿道膀胱肿瘤等离子电切术联合吉西他滨膀胱灌注化疗可以降低患者肿瘤标志物水平,并预防不良反应的发生。Objective To evaluate the clinical efficacy of transurethral plasmakinetic resection of bladder tumor combined with gemcitabine intravesical chemotherapy for patients with superficial bladder cancer.Methods A total of 87 patients with superficial bladder cancer admitted to Rugao People's Hospital from January 2019 to March 2023 were randomly divided into a treatment group and a control group.The treatment group(44 patients)received gemcitabine bladder perfusion chemotherapy after transurethral plasmakinetic resection of bladder tumor,while the control group(43 patients)only underwent transurethral resection of the bladder tumor.There was no statistically significant difference between the two groups in terms of gender composition,age,pathological grading,staging,and underlying diseases(P>0.05).The treatment effect,recurrence situations,and levels of tumor markers and serum markers before and after treatment were compared between the two groups,and the occurrence of adverse reactions was recorded.Results All the surgeries were successful at one time,and the tumor size was between 0.5-3.0 cm,and the average diameter was 1.6 cm.The average operation time was 23 min,and the blood loss was less than 10 mL.The recurrence rates in the treatment group at 3,6,and 12 months post-surgery were lower than those in the control group,and the rates of complete and partial remission were higher than those in the control group,but the differences were not statistically significant(P>0.05).Similarly,urinary tumor markers(CYFR21-1,NMP22,BTA)in the treatment group were significantly lower than those before treatment,and the improvement was more significant than those in the control group(P<0.05).Additionally,levels of VEGFC and VEGFA in the treatment group were also significantly reduced post-treatment,and the incidence of adverse reactions in the treatment group was significantly lower than those in the control group(P<0.05).Conclusions Transurethral plasmakinetic resection of bladder tumor combined with gemcitabine intravesical che

关 键 词：浅表性膀胱癌 经尿道膀胱肿瘤等离子电切术 吉西他滨 复发率 

分 类 号：R737.14[医药卫生—肿瘤]