铜绿假单胞菌注射液膀胱灌注治疗在膀胱尿路上皮癌手术患者中的应用效果

Application effect of Pseudomonas aeruginosa injection bladder perfusion treatment in patients with bladder urothelial carcinoma undergoing surgery

目的探讨铜绿假单胞菌注射液膀胱灌注治疗在膀胱尿路上皮癌手术患者中的应用效果。方法将78例行经尿道膀胱肿瘤电切术(TURBT)的膀胱尿路上皮癌患者采用随机数字表法分为对照组和观察组,每组39例,观察组患者术后采用铜绿假单胞菌注射液膀胱灌注治疗,对照组患者术后采用吉西他滨膀胱灌注治疗。比较两组患者的血清学指标[肿瘤坏死因子-α(TNF-α)、γ干扰素(IFN-γ)、血管内皮生长因子(VEGF)、白细胞介素-2(IL-2)]、生活质量[卡氏功能状态(KPS)评分]、不良反应发生情况及肿瘤复发情况。结果治疗后6、12个月,两组患者TNF-α、IFN-γ、IL-2水平均高于本组治疗前,VEGF水平均低于本组治疗前,观察组患者TNF-α、IFN-γ、IL-2水平均高于对照组,VEGF水平均低于对照组,差异均有统计学意义(P﹤0.05)。治疗后12、24个月,两组患者KPS评分均高于本组治疗前,观察组患者KPS评分均高于对照组,差异均有统计学意义(P﹤0.05)。两组患者各不良反应发生率比较,差异均无统计学意义(P﹥0.05)。治疗后24个月,观察组患者的肿瘤复发率为5.13%,低于对照组患者的20.51%,差异有统计学意义(P﹤0.05)。结论铜绿假单胞菌注射液膀胱灌注治疗应用于膀胱尿路上皮癌手术患者,能降低肿瘤复发率,有效抑制VEGF表达,增强肿瘤细胞清除能力,提高生活质量,且不会增加不良反应。

Objective To investigate the application effect of Pseudomonas aeruginosa injection bladder perfusion treatment in patients with bladder urothelial carcinoma undergoing surgery.Method A total of 78 patients with bladder urothelial carcinoma who underwent transurethral resection of bladder tumor(TURBT)were divided into control group and observation group by random number table method,with 39 cases in each group.The observation group were treated with Pseudomonas aeruginosa injection bladder perfusion and the control group were treated with gemcitabine bladder perfusion after surgery.The serum indexes[tumor necrosis factor-α(TNF-α),interferon-γ(IFN-γ),vascular endothelial growth factor(VEGF),interleukin-2(IL-2)],quality of life[Karnofsky performance status(KPS)score],incidence of adverse reactions and tumor recurrence were compared between the two groups.Result At 6 months and 12 months after treatment,the levels of TNF-α,IFN-γand IL-2 in two groups were higher than those before treatment,the levels of VEGF were lower than those before treatment,the levels of TNF-α,IFN-γand IL-2 in observation group were higher than those in control group,the levels of VEGF were lower than those in control group,and the differences were statistically significant(P<0.05).At 12 and 24 months after treatment,the KPS scores in two groups were higher than those before treatment,the KPS scores in observation group were higher than those in control group,and the differences were statistically significant(P<0.05).There were no significant differences in the incidence of adverse reactions between the two groups(P>0.05).At 24 months after treament,the tumor recurrence rate of observation group was 5.13%,which was lower than 20.51%of control group,and the difference was statistically significant(P<0.05).Conclusion The application of Pseudomonas aeruginosa injection for bladder perfusion treatment in patients with bladder urothelial carcinoma undergoing surgery can reduce tumor recurrence rate,effectively inhibit VEGF expression,enhance tumor cell clearance ability,improve quality of life,and do not increase adverse reactions.