经尿道膀胱肿瘤电切术联合吡柔比星膀胱灌注化疗在浅表性膀胱癌患者中的应用效果

Effect of transurethral resection of bladder tumor combined with perfusion chemotherapy of pirarubicin in patients with superficial bladder cancer

目的探讨经尿道膀胱肿瘤电切术联合吡柔比星膀胱灌注化疗在浅表性膀胱癌患者中的应用效果。方法根据手术方式的不同将90例浅表性膀胱癌分为对照组(n=45)和观察组(n=45),对照组患者采取经尿道膀胱肿瘤电切术治疗,观察组患者采取经尿道膀胱肿瘤电切术联合吡柔比星膀胱灌注化疗。比较两组患者的肿瘤标志物[血管内皮生长因子(VEGF)、成纤维细胞生长因子(FGF)、基质金属蛋白酶9(MMP9)、基质金属蛋白酶2(MMP2)]水平、生活质量[健康调查简表(SF-36)]、并发症发生情况及肿瘤复发情况。结果治疗后1周,两组患者血清VEGF、FGF、MMP9、MMP2水平均低于本组治疗前,且观察组患者血清VEGF、FGF、MMP9、MMP2水平均低于对照组,差异均有统计学意义(P﹤0.05)。治疗后1个月,两组患者SF-36量表各维度评分均高于本组治疗前,且观察组患者SF-36量表各维度评分均高于对照组,差异均有统计学意义(P﹤0.05)。对照组患者的并发症总发生率为8.89%,与观察组患者的6.67%比较,差异无统计学意义(P﹥0.05)。随访6个月,对照组患者的复发率为4.44%,与观察组患者的2.22%比较,差异无统计学意义(P﹥0.05);随访1年,观察组患者的1年复发率为4.44%,低于对照组患者的17.78%,差异有统计学意义(P﹤0.05)。结论经尿道膀胱肿瘤电切术联合吡柔比星膀胱灌注化疗治疗浅表性膀胱癌,能够降低血清因子水平,提高患者生活质量,降低术后复发率,且无明显不良反应。

Objective To investigate the effect of transurethral resection of bladder tumor combined with perfusion chemotherapy of pirarubicin in patients with superficial bladder cancer.Method A total of 90 cases of superficial bladder cancer were divided into control group(n=45)and observation group(n=45)according to different surgical methods.Patients in the control group were treated with transurethral resection of bladder tumor,and patients in the observation group were treated with transurethral resection of bladder tumor combined with pirarubicin bladder perfusion chemotherapy.The levels of tumor markers[vascular endothelial growth factor(VEGF),fibroblast growth factor(FGF),matrix metalloproteinase 9(MMP9),matrix metalloproteinase 2(MMP2)],quality of life[the MOS 36-item short form health survey(SF-36)],complications and tumor recurrence were compared between the two groups.Result One month after the treatment,the levels of serum VEGF,FGF,MMP9,and MMP2 in the two groups were lower than those before the treatment,and the levels of serum VEGF,FGF,MMP9,and MMP2 in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).One month after the treatment,the scores of each dimension of the SF-36 scale in the two groups were higher than those before treatment,and the scores in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).The total incidence of complications in the control group was 8.89%,compared with 6.67%in the observation group,the difference was not statistically significant(P>0.05).During the six-month follow-up,the recurrence rate in the control group was 4.44%,compared with 2.22%in the observation group,the difference was not statistically significant(P>0.05).During the one-year follow-up,the one-year recurrence rate in the observation group was 4.44%,which was lower than 17.78%in the control group,and the difference was statistically significant(P<0.05).Conclusion Transurethral resection of bladder tumor combined with pirarubicin bladder perfusion chemotherapy in the treatment of superficial bladder cancer could reduce the level of serum tumor markers,improve the quality of life,and reduce postoperative recurrence rate without obvious adverse events.