吉西他滨联合顺铂新辅助化疗对肌层浸润性膀胱癌的疗效及免疫功能的影响  

Efficacy and immunological effects of neoadjuvant chemotherapy with gemcitabine and cisplatin for muscle-invasive bladder cancer

作　　者：高智强 陈涛 刘磊[1] 孙春山 冀易隆 唐浩 GAO Zhiqiang;CHEN Tao;LIU Lei;SUN Chunshan;JI Yiong;TANG Hao(Department of Urology,People's Hospital of Henan University of Chinese Medicine,People's Hospital of Zhengzhou,Zhengzhou,Henan 450053,China)

机构地区：[1]河南中医药大学人民医院郑州人民医院泌尿外科,河南郑州450053

出　　处：《中国临床研究》2025年第4期578-581,587,共5页Chinese Journal of Clinical Research

摘　　要：目的 探讨吉西他滨联合顺铂(GC)新辅助化疗在肌层浸润性膀胱癌(MIBC)患者术前化疗中的疗效及其对免疫功能的影响。方法 回顾性选取在郑州人民医院接受新辅助化疗的65例MIBC患者,根据术前化疗方案的不同分为接受GC化疗方案33例(GC组)和接受甲氨蝶呤+长春新碱+多柔比星+顺铂(MVAC)化疗方案32例(MVAC组)。比较两组化疗后的临床疗效、不良反应的发生情况、外周血中CD3^(+)、CD4^(+)、CD8^(+)T淋巴细胞百分比及CD4^(+)/CD8^(+)、Th1/Th2、Th17/Treg的比值。结果 GC组患者的治疗有效率为87.88%,显著高于MVAC组(65.62%),差异有统计学意义(χ^(2)=4.532,P<0.05)。两组间不良反应发生率差异无统计学意义(P>0.05)。化疗后,GC组患者的中CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)、Th1、Th17、Th1/Th2、Th17/Treg高于MVAC组,而CD8^(+)、Th2、Treg低于MVAC组(P<0.05)。结论 MIBC患者术前接受GC新辅助化疗的近期疗效较好,能够在一定程度上改善机体免疫功能。Objective To investigate the efficacy of neoadjuvant chemotherapy with gemcitabine and cisplatin(GC)in patients with muscle-invasive bladder cancer(MIBC),and its impact on immune function.Methods A retrospective analysis was conducted on 65 patients with MIBC who received neoadjuvant chemotherapy at Peoples Hospital of Zhengzhou.Patients were divided into two groups based on their chemotherapy regimen:33 cases received gemcitabine and cisplatin(GC group),while 32 cases received methotrexate,vincristine,doxorubicin,and cisplatin(MVAC)(MVAC group).Clinical efficacy,incidence of adverse reactions,and immune function indicators including CD3+,CD4^(+),CD8^(+)T lymphocyte percentages,and ratios of CD4^(+)/CD8^(+),helper T cell(Th)1/Th2,Th17/regulatory T cell(Treg)were compared between the two groups.Results The treatment efficacy rate in the GC group was 87.88%,significantly higher than that in the MVAC group(65.62%),with a statistically significant difference(χ2=4.532,P<0.05).No significant difference in the incidence of adverse reactions was observed between the two groups(P>0.05).After chemotherapy,the GC group had higher levels of CD3+,CD4^(+)cells,CD4^(+)/CD8^(+)ratio,Th1,Th17,Th1/Th2,and Th17/Treg compared to the MVAC group,while CD8^(+)cells,Th2,and Treg levels were lower in the GC group(P<0.05).Conclusion Neoadjuvant chemotherapy with GC in MIBC patients demonstrates better short-term efficacy and may improve immune function to a certain extent.

关 键 词：肌层浸润性膀胱癌 吉西他滨 顺铂 疗效 免疫功能 

分 类 号：R737.14[医药卫生—肿瘤]