卡介苗联合丝裂霉素膀胱灌注对膀胱癌复发及相关细胞因子表达的影响

Effects of intravesical instillation with BCG and mitomycin on recurrence and cytokines in patients with bladder cancer

目的探讨卡介苗联合丝裂霉素膀胱灌注对膀胱癌复发及相关细胞因子表达的影响。方法膀胱癌患者56例,术后随机均分为两组:对照组仅给予卡介苗膀胱灌注;试验组采用卡介苗联合丝裂霉素膀胱灌注。比较两组血清细胞因子表达、不良反应、2年复发率及首次复发时间。结果试验组血清IL-2、TNF-α和IFN-γ水平高于对照组(P<0.05),血清IL-10水平低于对照组(P<0.05)。试验组不良反应发生率低于对照组(32.1%vs.82.1%)(P<0.05)。试验组生活质量稳定率高于对照组(82.1%vs.57.1%)(P<0.05)。试验组2年复发率低于对照组(14.3%vs.39.3%)(P<0.05);试验组首次复发时间长于对照组(P<0.05)。结论与单用卡介苗比较,卡介苗联合丝裂霉素膀胱灌注更能有效预防膀胱癌术后复发。

Objective To investigate the effects of intravesical instillation with Bacillus Calmette-Guérin（BCG）and mitomycin on the recurrence and cytokines in the patients with bladder cancer.Methods Fifty-six patients with bladder cancer after surgery were treated with intravesical instillation with BCG plus mitomycin（group A,28cases）or with BCG instillation alone（group B,28cases）.The expressions of cytokines,adverse effects,recrudescence rate in two years and the time for the first recurrence of bladder cancer were compared between two groups.Results Compared to group B,group A had higher serum levels of IL-2,TNF-αand IFN-γ（P〈0.05）,lower IL-10expression（P〈0.05）,lower incidence of adverse effects（32.1% vs.82.1%）（P〈0.05）,and higher stability rate of living quality（82.1% vs.57.1%）（P〈0.05）.The recrudescence rate in two years was lower in group A than that in group B（14.3% vs.39.3%）（P〈0.05）.The time for the first recurrence of bladder cancer was longer in group A than that in group B（P〈0.05）.Conclusion Combined with mitomycin can more effectively reduce the postoperative recurrence of bladder cancer than intravesical instillation with BCG alone.