树突状细胞治疗联合膀胱灌注表柔比星在TURBT术后的应用研究

Clinical effectiveness of dendritic cells therapy combined with intravesical perfusion of epirubicin on bladder cancer after TURBT

目的经尿道膀胱肿瘤切除术(TURBT)后,评价树突状细胞治疗联合膀胱灌注表柔比星(EPI)在预防复发中的疗效。方法选取我院2005年1月至2008年8月行TURBT的患者106例,随机分为两组,A组行树突状细胞治疗联合膀胱灌注EPI,B组仅行膀胱灌注EPI,所有患者随访2年,观察比较两组患者T淋巴细胞亚群变化、肿瘤复发率及不良反应。结果 A组患者树突状细胞治疗后CD3+、CD4+、CD4+/CD8+比值升高,与治疗前相比差异有统计学意义(P<0.05),与同期B组患者相比差异亦有统计学意义(P<0.05)。A、B组患者2年复发率分别为10%、25.8%,差异有统计学意义(P<0.05)。A组3例患者在树突状细胞治疗后出现轻微皮肤炎症反应。结论与单纯膀胱灌注EPI相比,树突状细胞治疗联合膀胱灌注EPI能有效降低膀胱癌术后2年复发率,树突状细胞生物免疫治疗联合膀胱灌注化疗药物为膀胱癌术后辅助治疗的发展提供了新的思路,开拓了新的空间。

Objective：To evaluate the effectiveness of intra-dermal injection of dendritic cells combined with intra-vesical perfusion of epirubicin（EPI） on preventing recurrence of bladder cancer after TURBT.Methods：106 bladder cancer patients were randomly divided into two groups after TURBT,group A was treated with intradermal injection of dendritic cells combined with intravesical perfusion of EPI,while group B was treated only with intra-vesical perfusion of EPI.All patients were followed up for at least 2 years.T-lymphocyte subsets,tumor recurrence rates and adverse reactions of patients were observed and compared.Results：CD3＋,CD4＋ and CD4＋/CD8＋ of group A increased after dendritic cells therapy.Compared with that before the therapy and that of group B,the differences were significant（P0.05）.2-year recurrence rates of group A and group B were 10% and 25.8%,respectively.The difference was significant（P0.05）.3 patients of group A developed modent dermal inflammation after dendritic cells therapy.Conclusions：Compared with simple intra-vesical perfusion of EPI,DC therapy combined with intravesical perfusion of EPI can effectively reduce 2-year recurrence rate of bladder cancer after TURBT.Therefore,DC immune therapy combined with intra-vesical chemotherapy provides a new way for the adjuvant treatment of bladder cancer.