吡柔比星膀胱灌注对浅表性膀胱癌患者血清sICAM-1、VEGF及MMP-9水平的影响

Influence of pirarubicin intravesical therapy on serum sICAM-1,VEGF and MMP-9 in patients with superficial bladder cancer

目的:探讨吡柔比星膀胱灌注对浅表性膀胱癌(SBC)患者血清可溶性细胞间粘附分子-1(sICAM-1)、血管内皮生长因子(VEGF)及基质金属蛋白酶-9(MMP-9)水平的影响。方法 :将132例行经尿道膀胱肿瘤切除术(TURBT)的SBC患者根据术后治疗方法分为对照组和观察组,各66例。对照组术后采用丝裂霉素膀胱灌注治疗,观察组术后采用吡柔比星膀胱灌注治疗。观察两组术后2年内复发率及治疗过程中不良反应情况,对比两组术后6月时血sICAM-1、VEGF及MMP-9水平变化。结果:观察组术后2年复发率明显低于对照组,且观察组术后6～12个月患者复发率及非原位复发率均显著低于对照组(P<0.05)。观察组患者复发时间明显迟于对照组(P<0.05)。术后6个月时,两组患者sICAM-1、VEGF及MMP-9水平均显著降低,且观察组各指标均小于对照组(P<0.05)。两组灌注治疗过程中不良反应情况比较,差异无统计学意义(P>0.05)。结论:吡柔比星膀胱灌注治疗可有效降低SBC患者TURBT术后血清sICAM-1、VEGF及MMP-9水平,抑制肿瘤复发,具有良好应用价值。

Objective:To explore the influence of pirarubicin intravesical therapy on serum soluble intercellular adhesion molecule-1(sICAM-1),vascular endothelial growth factor(VEGF)and matrix metalloproteinase-9(MMP-9)in patients with superficial bladder cancer(SBC).Methods:132 patients with SBC undergoing transurethral resection of bladder tumor(TURBT)were divided into control group and observation group according to the treatments,with 66 cases in each group.The patients in control group received mitomycin intravesical therapy after TURBT and those in observation group received pirarubicin intravesical therapy.The recurrence rate within 2 years after surgery and complication during treatment were observed in two groups.The changes in serum sICAM-1,VEGF and MMP-9 were compared between two groups 6 months after surgery.Results:The recurrence rate within 2 years after surgery in observation group was significantly lower than in control group,while the recurrence rate during 6 to 12 months after surgery and ectopic recurrence rate in observation group were significantly lower than in control group(P<0.05).The time of recurrence in observation group was significantly later than in control group(P <0.05).The serum sICAM-1,VEGF and MMP-9 levels were significantly reduced in two groups 6 months after surgery as compared with those before operation and those indexes in observation group were lower than in control group(P<0.05).There was no significant difference in complications between two groups during intravesical therapy(P>0.05).Conclusions:Intravesicaltherapy of pirarubicin can effectively reduce serum sICAM-1,VEGF and MMP-9 levels in patients with SBC,and inhibit the recurrence of bladder cancer,and has good application value.