动脉化疗栓塞术联合TUR-BT治疗膀胱癌及对患者免疫功能、氧化应激和术后复发的影响

Arterial chemoembolization combined with TUR-BT in the treatment of bladder cancer and its effects on immune function,oxidative stress and postoperative recurrence

目的:探究动脉化疗栓塞术联合经尿道膀胱肿瘤电切术(TUR-BT)治疗膀胱癌的疗效及患者免疫功能、氧化应激和术后复发的情况分析。方法:选取我院2011年06月至2013年06月收治的78例膀胱癌患者,依照治疗方法的不同分为对照组和观察组,每组患者39例,对照组行TUR-BT治疗,观察组行动脉化疗栓塞术联合TUR-BT治疗,对比两组手术指标、免疫功能指标(CD3^(+)、CD4^(+)、CD8^(+)及CD4+/CD8^(+))、肿瘤学指标[肿瘤特异性生长因子(TSGF)、生存素(Survivin)、T淋巴瘤侵袭转移诱导因子1(Tiam1)]、氧化应激指标[超氧化物歧化酶(SOD)、丙二醛(MDA)、谷胱甘肽过氧化物酶(GPx)及总抗氧化活性(AOA)]及患者术后随访80个月期间并发症发生率、复发率和生存率。结果:观察组手术时间、术中出血量均显著小于对照组(P<0.05)。术后3 d,对照组CD3+、CD4+水平及CD4+/CD8+值较术前显著降低,CD8+水平较术前显著升高,观察组各指标显著优于对照组。术后3 d,两组TSGF、Survivin及Tiam1水平均显著降低,且观察组更低于对照组(P<0.05)。术后3 d,两组SOD、GPx及AOA水平降低,观察组显著高于对照组(P<0.05);MDA水平显著升高,观察组显著低于对照组(P<0.05)。术后随访期间观察组患者的并发症发生率、复发率均显著低于对照组,生存率显著高于对照组(P<0.05)。结论:动脉化疗栓塞术联合TUR-BT可显著提高膀胱癌的手术治疗效果,减少肿瘤标志物水平,对于患者免疫功能和氧化应激造成的影响较小,患者并发症发生率和复发率明显降低,生存质量得到提升。

Objective:To investigate the efficacy of arterial chemoembolization combined with transurethral resection of bladder tumor(TUR-BT)in the treatment of bladder cancer and the analysis of immune function,sclerosing stress and postoperative recurrence.Methods:78 patients with bladder cancer admitted to our hospital from June 2011 to June 2013 were divided into control group and observation group according to different treatment methods,39 patients in each group.Control group was treated with TUR-BT.Observation group was treated with transcatheter arterial chemoembolization combined with TUR-BT treatment.Surgical indicators,immune function indicators(CD3^(+),CD4^(+),CD8^(+)and CD4^(+)/CD8^(+)),oncological indicators[tumor specific growth factor(TSGF),survivin,T lymphoma invasion and metastasis-inducing factor 1(Tiam1)],oxidative stress indicators[superoxide dismutase(SOD),malondialdehyde(MDA),glutathione peroxidase(GPx)and total antioxidant Activity(AOA)]and the incidence of complications,recurrence rate and survival rate during the 80-month follow-up period was compared.Results:The operation time and intraoperative blood loss were significantly lower in the observation group than in the control group(P<0.05).At 3 days after operation,CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)in the control group were significantly lower than those before surgery,and CD8^(+)was significantly higher than that before surgery.The indexes of the observation group were significantly better than the control group.At 3 days after operation,the levels of TSGF,Survivin and Tiam1 were significantly lower in the two groups,and the observation group was lower than the control group(P<0.05).At 3 days after operation,SOD,GPx and AOA were decreased in the two groups,and the observation group was significantly higher than the control group(P<0.05).MDA was significantly increased,and the observation group was significantly lower than the control group(P<0.05).The complication rate and recurrence rate of the observation group were significantly lower than those of the control group during the follow-up period.The survival rate was significantly higher than that of the control group(P<0.05).Conclusion:Arterial chemoembolization combined with TUR-BT can significantly improve the surgical treatment of bladder cancer,reduce the level of tumor markers,have less impact on immune function and oxidative stress,significantly reduce the incidence of complications and recurrence,and survive quality has improved.