非肌层浸润性膀胱癌经尿道膀胱肿瘤等离子电切术后吉西他滨膀胱灌注化疗的效果分析

Analysis of the Effect of Bladder Infusion Chemotherapy with Gemcitabine for Non-muscular Invasive Bladder Cancer after Transurethral Resection of Bladder Tumor with Plasmakinetic

目的:探讨非肌层浸润性膀胱癌(NMIBC)行经尿道膀胱肿瘤等离子电切术(PKRBT)后吉西他滨膀胱灌注化疗的临床效果。方法:纳入苏州大学附属张家港医院2017年1月-2019年10月泌尿外科收治的NMIBC患者136例,按照随机数字表法分成对照组(n=68)与研究组(n=68),均行PKRBT术,术后分别给予表柔比星、吉西他滨膀胱灌注化疗,患者随访至2021年10月,观察两组术后复发率,比较两组术后不良反应发生率、血清肿瘤标志物及生存质量变化。结果:对照组与研究组患者1年内复发率(11.76%vs 4.41%)比较,差异无统计学意义(P>0.05),但2年内复发率研究组明显低于对照组(8.82%vs 25.00%)(P<0.05);且研究组总复发率为13.24%,明显低于对照组的36.76%,差异有统计学意义(P<0.05)。术后6个月,研究组血清癌胚抗原(CEA)、血管内皮生长因子(VEGF)、可溶性细胞间黏附分子-1(sICAM-1)水平均明显低于对照组,差异有统计学意义(P<0.05);术后6个月,研究组膀胱刺激征(2.94%)及血尿(2.94%)的发生率均明显低于对照组(14.71%、13.24%),不良反应总发生率为8.82%,明显低于对照组的30.88%,差异有统计学意义(P<0.05);术后6个月,研究组生存质量测定量表简表(QOL-BREF)评分明显高于对照组(P<0.05)。结论:非肌层浸润性膀胱癌PKRBT术后吉西他滨灌注化疗可抑制肿瘤细胞生长,降低术后肿瘤复发率,减少膀胱刺激征及血尿不良反应发生,提升患者生活质量。

Objective:To investigate the clinical effects of Gemcitabine bladder infusion chemotherapy after transurethral resection of bladder tumor with plasmakinetic(PKRBT)for non-muscular invasive bladder cancer(NMIBC).Method:A total of 136 patients with NMIBC who were admitted to the Urology Department of Zhangjiagang Hospital Affiliated to Suzhou University from January 2017 to October 2019 were randomly divided into the control group(n=68)and the study group(n=68),both underwent transurethral resection of bladder tumor with plasmakinetic(PKRBT)surgery,and were given Epirubicin and Gemcitabine bladder infusion chemotherapy respectively after surgery.The patients were followed up to October 2021,the postoperative recurrence rate of the two groups,and the adverse reaction rate,serum tumor markers and quality of life changes between the two groups after operation were compared.Result:There was no significant difference in the recurrence rate(11.76%vs 4.41%)between the control group and the study group within 1 year(P>0.05).However,the recurrence rate within 2 years in the study group was significantly lower than that in the control group(8.82%vs 25.00%)(P<0.05),and the total recurrence rate in the study group was 13.24%,which was significantly lower than 36.76%in the control group,the difference was statistically significant(P<0.05).Six months after the operation,the levels of serum carcinoembryonic antigen(CEA),vascular endothelial growth factor(VEGF)and soluble intercellular adhesion molecule-1(sICAM-1)in the study group were significantly lower than those in the control group,the differences were statistically significant(P<0.05).Six months after surgery,the incidence rates of bladder irritation sign(2.94%)and hematuria(2.94%)in the study group were significantly lower than those of the control group(14.71%and 13.24%),and the total incidence of adverse reactions(8.82%)was significantly lower than 30.88%in the control group,the differences were statistically significant(P<0.05).The quality of life measurement scale brief version(QOL-BREF)score in the study group 6 months after surgery was significantly higher than that of the control group(P<0.05).Conclusion:Gemcitabine infusion chemotherapy after PKRBT of non-muscular invasive bladder cancer can inhibit tumor cell growth,reduce postoperative tumor recurrence rate,and reduce bladder irritation and hematuria,and improve the quality of life of patients.