膀胱肿瘤电切+膀胱灌注与膀胱肿瘤二次电切+膀胱灌注对膀胱癌患者复发性及疾病进展的影响

Effect of bladder tumor resection+bladder perfusion and bladder tumor secondary resection+bladder perfusion on recurrence and disease progression in patients with bladder cancer

目的 通过复发率、疾病进展等方面对比分析膀胱肿瘤电切、二次电切分别联合膀胱灌注治疗膀胱癌的效果。方法 选取我院2019年3月至2020年4月期间收治的膀胱癌患者99例作为研究对象,按照是否实施二次电切将研究对象分为单次组(35例)、二次组(64例),均行经尿道膀胱肿瘤电切术(TURBT)联合膀胱灌注治疗,统计对比两组肿瘤复发与疾病进展状况、毒副反应、术后并发症以及术前、术后3个月、6个月钙黏蛋白(CDH)13甲基化率、Ki-67高表达率。结果 随访2年,单次组复发率为37.14%明显高于二次组15.63%,中位组复发生存时间短于二次组(P<0.05);两组膀胱刺激征、肉眼血尿、膀胱炎以及继发发热的发生率对比,差异无统计学意义(P>0.05);与单次组2.86%相比,二次组并发症发生率20.31%较高(P<0.05);术后3个月、术后6个月单次组CDH13甲基化率、Ki-67高表达率均高于二次组(P<0.05)。结论 膀胱肿瘤二次电切+膀胱灌注治疗膀胱癌患者,可降低复发率,延长生存时间,降低CDH13甲基化率、Ki-67高表达率,但术后并发症发生风险较高。

Objective To compare the efficacy of bladder tumor resection and secondary resection combined with blad-der perfusion in the treatment of bladder cancer by recurrence rate and disease progression.Methods A total of 99 patients with bladder cancer admitted to our hospital from March 2019 to April 2020 were selected as study subjects.The study sub-jects were divided into a single group(35 cases)and a secondary group(64 cases)according to whether secondary resec-tion was performed.Transurethral resection of bladder tumor(TURBT)combined with bladder perfusion was performed in both groups.Tumor recurrence and disease progression,side effects,postoperative complications,CDH 13 methylation rate and Ki-67 high expression rate before,3 months and 6 months after surgery were compared between the two groups.Results After 2 years of follow-up,the recurrence rate of the single group was 37.14%,which was significantly higher than that of the second group(15.63%);There was no significant difference in the incidence of bladder irritation,gross hematuria,cys-titis and secondary fever between the two groups(P>0.05).There were no significant dfferences in the incidence of blad-der irritation,gross hematuria,cystitis and secondary fever between the two groups(P>0.05).The complication rate of the secondary group was 20.31%higher than that of the single group(2.86%)(P<0.05).The methylation rate of CDH13 and the high expression rate of Ki-67 in the single group were higher than those in the second group at 3 months and 6 months after surgery(P<0.05).Conclusion The treatment of bladder cancer patients with secondary electrotomy plus bladder perfusion can reduce the recurrence rate,prolong the survival time,reduce the CDH13 methylation rate and Ki-67 high expression rate,but the risk of postoperative complications is higher.