光动力照射联合肿瘤电切术治疗非肌层浸润性膀胱癌的临床研究及对免疫状态的影响

Effect of photodynamic irradiation combined with electric resection for treating non-muscle invasive bladder cancer and its influence on immune function

目的探讨光动力照射联合肿瘤电切术治疗对非肌层浸润性膀胱癌(NMIBC)的临床疗效及对免疫状态的影响。方法选取2018年11月至2019年11月宜春市人民医院收治的NMIBC患者60例为研究对象,采用掷硬币法分为对照组和光动力组,每组30例。对照组予以肿瘤电切术+膀胱灌注化疗,光动力组予以光动力照射联合肿瘤电切治疗+膀胱灌注化疗。比较两组T淋巴细胞、自然杀伤细胞(NK)、血管内皮生长因子、基质金属蛋白酶-9水平,术后并发症总发生率、复发率及生活质量。结果治疗前两组CD3^(+)、CD4^(+)、CD8^(+)及NK水平比较,差异无统计学意义(P>0.05),治疗后光动力组CD3^(+)、CD4^(+)、CD8^(+)及NK均高于对照组,差异有统计学意义(P<0.05)。治疗前两组患者血管内皮生长因子和基质金属蛋白酶-9水平比较,差异无统计学意义(P>0.05);治疗后光动力血管内皮生长因子和基质金属蛋白酶水平均低于对照组,差异有统计学意义(P<0.05)。光动力组并发症总发生率和复发率低于对照组,差异有统计学意义(P<0.05)。光动力组患者治疗后生活质量各方面评分高于对照组,差异有统计学意义(P<0.05)。结论光动力照射联合肿瘤电切治疗NMIBC效果显著,可明显改善患者免疫功能,降低术后并发症发生率及复发率,提高患者生活质量,值得临床推广。

Objective To investigate the clinical effect of photodynamic irradiation combined with electric resection in the treatment of non-muscle invasive bladder cancer(NMIBC),and its influence on immune function.Methods A total of 60 patients with NMIBC admitted to Yichun People′s Hospital from November 2018 to November 2019 were selected as the research subjects.They were divided into control group and photodynamic group by coin toss method,with 30 patients in each group.The control group was treated with electric resection of tumors and bladder perfusion chemotherapy,while the photodynamic group was treated with photodynamic irradiation combined with electric resection of tumors and bladder perfusion chemotherapy.The levels of T lymphocytes,natural killer(NK)cells,vascular endothelial growth factor and matrix metalloproteinase-9,the total incidence of postoperative complications,recurrence rate and quality of life were compared between the two groups.Results Before treatment,there were no significant differences in the levels of CD3^(+),CD4^(+),CD8^(+),NK cells,vascular endothelial growth factor and matrix metalloproteinase-9 between the two groups(P>0.05).After treatment,the levels of CD3^(+),CD4^(+),CD8^(+) and NK cells in the photodynamic group were higher than those in the control group,and the differences were statistically significant(P<0.05).The levels of vascular endothelial growth factor and matrix metalloproteinase-9 were lower than those in the control group,and the differences were statistically significant(P<0.05).The incidence of complications and recurrence rate in the photodynamic group were lower than those in the control group,and the differences were statistically significant(P<0.05).The quality of life scores of patients in photodynamic group were higher than those in control group,and the differences were statistically significant(P<0.05).Conclusion Photodynamic irradiation combined with electric resection is markedly effective in the treatment of NMIBC,which can significantly improve the patients′immune function,reduce the incidence of postoperative complications and recurrence rate,and improve quality of life.Therefore,it is worthy of clinical promotion.