膀胱肿瘤术后吡柔比星灌注对患者部分血清肿瘤标记分子及增殖和侵袭分子mRNA的影响

Effect of Pirubicin Intravesical Infusion on Serum Tumor Markers and mRNA Contents of Proliferation and Invasion Molecules in Bladder Tumor Patients

目的:探讨吡柔比星膀胱灌注化疗对膀胱肿瘤术后患者部分血清肿瘤标记分子及增殖和侵袭分子mRNA含量的影响。方法:206例行经尿道膀胱肿瘤电切术治疗膀胱肿瘤患者均分为观察组与对照组,对照组术后采用常规治疗,观察组术后采用吡柔比星膀胱灌注规范化疗1年,对两组患者定期随访1年;治疗前和治疗结束时,分别测定2组患者血清分泌型蛋白(DKK)、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-2(MMP-2)及MMP-9水平,检测血清组蛋白-赖氨酸N-甲基转移酶(EZH2)、细胞周期素(Cyclin D1)、外泌体(exosomes)及可溶性血管黏附分子(s VCAM)mRNA含量,比较2组患者随访期间肿瘤复发率及并发症。结果:与治疗前相比,治疗结束时2组患者血清DKK、VEGF、FGF、MMP-2及MMP-9水平均显著下降,观察组下降更显著(P<0.01);2组患者血清EZH2、Cyclin D1、exosomes及s VCAM mRNA含量也均显著下降(P<0.01),且观察组下降也更显著(P<0.05或P<0.01);随访期间观察组肿瘤复发率显著低于对照组(P<0.01),但2组发症总发生率比较差异无统计学意义(P>0.05)。结论:膀胱肿瘤术后行吡柔比星膀胱灌注化疗可降低患者血清肿瘤标记分子水平及增殖和侵袭分子mRNA含量,且术后复发率低。

Objective： To investigate the effect of pirubicin intravesical infusion chemotherapy on serum tumor markers and mRNA contents of proliferation and invasion molecules in bladder tumor patients after operation. Methods： Two hundred and six cases of bladder tumor patients that received transurethral bladder tumor electrocision in our hospital were selected and randomly divided into observation group（ group OB） and control group（ group CN） with 103 cases in each group. Patients in group CN were treated with routine postoperative treatment,while those in group OB were given pirubicin intravesical infusion chemotherapy for 1 continuous year after the operation. Following-up observation was made on the 2 groups for 1 year. The serum tumor marker molecular level and molecular mRNA contents of proliferation and invasion molecules of the 2 groups were tested before and after the treatment and compared; The rates of recurrence and incidence of complications during the following-up period of2 groups were statistically analyzed. Results： The serum tumor marker molecular levels of DKK,VEGF,FGF,MMP-2 and MMP-9 of the 2 groups significantly decreased after treatment than before,and those in group OB were even obviously lower than in group CO（ P 〈0. 01）; The mRNA contents of proliferation and invasion molecular such as EZH2,Cyclin D1,exosomes and s VCAM of the 2 groups after treatment significantly decreased than before（ P 〈0. 01）,and those in group OB were even obviously lower than in group CO（ P 〈0. 05 or P〈 0. 01）; The recurrence rate of group OB was significantly lower than that of group CN during the following-up period（ P 〈0. 01）,while the total incidence of complications of the 2 groups did not differ significantly（ P〉 0. 05）. Conclusion： Intravesical instillation of pirarubicin after bladder tumor surgery can decrease serum tumor marker molecular levels and mRNA contents of proliferation and invasion molecular,and reduce postoperative recurrence rate.