肌层浸润性膀胱癌新辅助化疗敏感性标志物的研究现状

Progress in research of sensitive markers to neoadjuvant chemotherapy in muscle invasive bladder cancer

膀胱癌是我国男性十大恶性肿瘤之一,其中20%~30%的患者初诊时即诊断为肌层浸润性膀胱癌(muscle-invasive bladder cancer,MIBC)。既往,根治性膀胱切除术(radical cystectomy,RC)是MIBC的一线治疗方案。现有多项研究结果表明,对于MIBC患者选择新辅助化疗联合RC,相比于仅行RC,可提高肿瘤完全反应率并延长患者总生存期,已成为治疗MIBC的1类推荐标准方案,而且有保留膀胱的可能性。多项研究结果表明,以顺铂为基础的新辅助化疗在MIBC患者中的应用越来越普遍,但仍存在化疗无效或肿瘤进展的可能,因此探讨术前新辅助化疗敏感性一直是泌尿肿瘤研究的热点,本文就膀胱尿路上皮癌新辅助化疗的敏感性问题作一综述,以期对临床工作起到指导和帮助作用。

Bladder cancer is one of the tenth most common malignant tumors in Chinese men.Almost 20%to 30%patients are diagnosed as the muscle-invasive bladder cancer(MIBC)at the first diagnosis.In the past,radical cystectomy(RC)was the first-line treatment with MIBC.The current researches'results show that,neoadjuvant chemotherapy combined with RC can improve the tumor complete response rate and prolong the overall survival of patients with MIBC,comparing with the RC alone.It has become the recommended standard first line treatment for MIBC,which has the possiblity of preserving bladder.Lots of researches indicate that the application of cisplatin-based neoadjuvant chemotherapy in patients with MIBC is becoming more and more popular.However,there is still the possibility of ineffectiveness or tumor progression.Therefore,discussions about the sensitivity of neoadjuvant chemotherapy have always been a hot spot in urological tumor research.In order to provide guidance and help for clinical work,the article reviews the sensitivity of neoadjuvant chemotherapy of bladder urothelial carcinoma.