吉西他滨联合丝裂霉素C膀胱灌注对膀胱癌患者经尿道膀胱肿瘤电切术后复发的影响

Effect of gemcitabine combined with mitomycin C on the recurrence of bladder cancer after transurethral resection for bladder tumor

目的 研究吉西他滨联合丝裂霉素C膀胱灌注对膀胱癌患者经尿道膀胱肿瘤电切术(TURBT)后复发的影响。方法 将本院收治的进行TURBT的膀胱癌患者109例,根据术后膀胱灌注方案将其分为对照组(膀胱内灌注吉西他滨1 000 mg)和试验组(膀胱内灌注吉西他滨1 000 mg联合丝裂霉素C 20 mg)。比较2组术前、术后血管生成因子水平、生活质量评分;比较2组术后复发情况及药物不良反应发生情况。结果 对照组51例,试验组58例。对照组和试验组术后血清血管内皮生长因子(VEGF)分别为(113.14±13.72)和(81.15±10.21)pg·mL^(-1),促血管生成素-1(Ang-1)分别为(0.39±0.05)和(0.28±0.04)ng·mL^(-1),碱性成纤维细胞生长因子(bFGF)水平分别为(72.25±9.17)和(55.24±8.10)mg·L^(-1),癌症生命质量测定共性量表(FACT-G)分别为(62.65±10.35)和(70.32±11.84)分,膀胱癌特异性量表(BSS)分别为(28.17±6.38)和(34.01±6.59)分,膀胱癌治疗功能评价系统(FACT-BL)评分分别为(90.82±11.92)和(104.33±12.37)分,差异均有统计学意义(均P<0.05)。对照组2年复发率为34.04%,试验组为15.69%,差异有统计学意义(P<0.05)。2组无复发生存Kaplan-Meier曲线比较,差异有统计学意义(P<0.05)。对照组药物不良反应发生率为36.17%,试验组为37.25%,差异无统计学意义(P>0.05)。结论 膀胱癌患者TURBT术后采用吉西他滨联合丝裂霉素C膀胱灌注可抑制血管生成、改善患者生活质量、降低复发率,且不会明显增加药物不良反应发生率。

Objective To investigate the effect of gemcitabine combined with mitomycin C on the recurrence of bladder cancer after transurethra resection (TURBT) in patients with bladder tumor.Methods One hundred and nine patients with bladder cancer admitted to our hospita(all with TURBT during hospitalization),were divided into control group(intravesical gemcitabine infusion) and treatment group (intravesica gemcitabine infusion combined with mitomycin C) according to the postoperative bladder perfusion regimen.The angiogenic factor levels and quality of life scores before and after operation were compared between the two groups.Postoperative recurrence and adverse drug reactions were compared between the two groups.Results There were 51 patients in control group,58 patients in treatment group.The serum levels o vascular endothelial growth factor (VEGF) in control group and treatment group were (113.14±13.72) and(81.15±10.21) pg·mL^(-1),Ang-1 were (0.39±0.05) and (0.28±0.04) ng·mL^(-1),basic fibroblast growth factor (b FGF) levels were (72.25±9.17) and (55.24±8.10) mg·L^(-1),cancer quality of life measurement common scale (FACT-G) were (62.65±10.35) and (70.32±11.84) points,the Bladder Cancer Specificity Scale(BSS) were (28.17±6.38) and (34.01±6.59) points,the Bladder cancer Therapeutic Function Evaluation System(FACT-BL) were (90.82±11.92) and (104.33±12.37) points.The differences were statistically significant (all P<0.05).The 2-year recurrence rate was 34.04%in control group and 15.69%in treatment group,the difference was statistically significant (P<0.05).The Kaplan-Meier curve of relapse-free survival between the two groups showed significant difference (P<0.05).The incidence of total adverse drug reactions was 36.17%in control group and 37.25%in treatment group,with no statistical significance (P>0.05).Conclusion Postoperative bladder infusion of gemcitabine combined with mitomycin C can inhibit angiogenesis,improve the quality of life and reduce the recurrence rate of patients with bladder cancer without significantly increase the incidence of adverse drug reactions.