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Histologic subtypes of non-muscle invasive bladder cancer
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作者 Nicola Giudici Roland Seiler 《World Journal of Clinical Oncology》 2024年第7期835-839,共5页
The majority of bladder cancers(BCs)are non-muscle invasive BCs(NMIBCs)and show the morphology of a conventional urothelial carcinoma(UC).Aberrant morphology is rare but can be observed.The classification and characte... The majority of bladder cancers(BCs)are non-muscle invasive BCs(NMIBCs)and show the morphology of a conventional urothelial carcinoma(UC).Aberrant morphology is rare but can be observed.The classification and characterization of histologic subtypes(HS)in UC in BC have mainly been described in muscle in-vasive bladder cancer(MIBC).However,the currently used classification is ap-plied for invasive urothelial neoplasm and therefore,also valid for a subset of NMIBC.The standard transurethral diagnostic work-up misses the presence of HS in NMIBC in a considerable percentage of patients and the real prevalence is not known.HS in NMIBC are associated with an aggressive phenotype.Conse-quently,clinical guidelines categorize HS of NMIBC as“(very)high-risk”tumors and recommend offering radical cystectomy to these patients.Alternative strategies for bladder preservation can only be offered to highly selected patients and ideally within clinical trials.Novel treatment strategies and biomarkers have been established MIBC and NMIBC but have not been comprehensively invest-igated in the context of HS in NMIBC.Further evaluation prior to implementation into clinical practice is needed. 展开更多
关键词 Urothelial carcinoma non-muscle invasive bladder cancer Muscle invasive bladder cancer Histologic subtypes Histologic variants
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A Th2-score in the tumor microenvironment as a predictive biomarker of response to Bacillus Calmette Guérin in patients with non-muscle invasive bladder carcinoma:A retrospective study
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作者 GUSTAVO MARTÍN VILLOLDO MARÍA TERESA POMBO +11 位作者 MARIANA ARIS JOAQUÍN CHEMI PABLO MANDÓ SUPRIYA NAGARAJU JUAN CAMEAN ADRIÁN BURIONI DEBORAH EGEA MORA AMAT JOSÉLEÓN MELLADO JOSÉMORDOH ALBERTO VILLARONGA MARÍA MARCELA BARRIO 《Oncology Research》 SCIE 2023年第2期207-220,共14页
Intravesical Bacillus Calmette Guerin(BCG)is the gold standard therapy for intermediate/high-risk nonmuscle invasive bladder cancer(NMIBC).However,the response rate is~60%,and 50%of non-responders will progress to mus... Intravesical Bacillus Calmette Guerin(BCG)is the gold standard therapy for intermediate/high-risk nonmuscle invasive bladder cancer(NMIBC).However,the response rate is~60%,and 50%of non-responders will progress to muscle-invasive disease.BCG induces massive local infiltration of inflammatory cells(Th1)and ultimately cytotoxic tumor elimination.We searched for predictive biomarker of BCG response by analyzing tumor-infiltrating lymphocyte(TIL)polarization in the tumor microenvironment(TME)in pre-treatment biopsies.Pre-treatment biopsies from patients with NMIBC who received adequate intravesical instillation of BCG(n=32)were evaluated retrospectively by immunohistochemistry.TME polarization was assessed by quantifying the T-Bet+(Th1)and GATA-3+(Th2)lymphocyte ratio(G/T),and the density and degranulation of EPX+eosinophils.In addition,PD-1/PD-L1 staining was quantified.The results correlated with BCG response.In most non-responders,Th1/Th2 markers were compared in pre-and post-BCG biopsies.ORR was 65.6%in the study population.BCG responders had a higher G/T ratio and a greater number of degranulated EPX+cells.Variables combined into a Th2-score showed a significant association with higher scores in responders(p=0.027).A Th2-score cut-off value>48.1 allowed discrimination of responders with 91%sensitivity but lower specificity.Relapse-free survival was significantly associated with the Th2-score(p=0.007).In post-BCG biopsies from recurring patients,TILs increased Th2-polarization,probably reflecting BCG failure to induce a pro-inflammatory status and,thus,a lack of response.PD-L1/PD-1 expression was not associated with the response to BCG.Our results support the hypothesis that a preexisting Th2-polarized TME predicts a better response to BCG,assuming a reversion to Th1 polarization and antitumor activity. 展开更多
关键词 non-muscle invasive bladder cancer BCG predictive biomarkers Lymphocyte polarization
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Treatment and surveillance for non-muscle-invasive bladder cancer:a clinical practice guideline(2021 edition) 被引量:2
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作者 Ying-Hui Jin Xian-Tao Zeng +31 位作者 Tong-Zu Liu Zhi-Ming Bai Zhong-Ling Dou De-Gang Ding Zhi-Lu Fan Ping Han Yi-Ran Huang Xing Huang Ming Li Xiao-Dong Li Yi-Ning Li Xu-Hui Li Chao-Zhao Liang Jiu-Min Liu Hong-Shun Ma Juan Qi Jia-Qi Shi Jian Wang De-Lin Wang Zhi-Ping Wang Yun-Yun Wang Yong-Bo Wang Qiang Wei Hai-Bo Xia Jin-Chun Xing Si-Yu Yan Xue-Pei Zhang Guo-You Zheng Nian-Zeng Xing Da-Lin He Xing-Huan Wang on behalf of the Chinese Urological Doctor Association(CUDA),Urological Association of Chinese Research Hospital Association(CRHA-UA),Uro-Health Promotive Association of China International Exchange,Promotive Association for Medical,Health Care(CPAM-UHPA) 《Military Medical Research》 SCIE CAS CSCD 2023年第2期141-161,共21页
Non-muscle invasive bladder cancer(NMIBC)is a major type of bladder cancer with a high incidence worldwide,resulting in a great disease burden.Treatment and surveillance are the most important part of NIMBC management... Non-muscle invasive bladder cancer(NMIBC)is a major type of bladder cancer with a high incidence worldwide,resulting in a great disease burden.Treatment and surveillance are the most important part of NIMBC management.In 2018,we issued“Treatment and surveillance for non-muscle-invasive bladder cancer in China:an evidencebased clinical practice guideline”.Since then,various studies on the treatment and surveillance of NMIBC have been published.There is a need to incorporate these materials and also to take into account the relatively limited medical resources in primary medical institutions in China.Developing a version of guideline which takes these two issues into account to promote the management of NMIBC is therefore indicated.We formed a working group of clinical experts and methodologists.Through questionnaire investigation of clinicians including primary medical institutions,24 clinically concerned issues,involving transurethral resection of bladder tumor(TURBT),intravesical chemotherapy and intravesical immunotherapy of NMIBC,and follow-up and surveillance of the NMIBC patients,were determined for this guideline.Researches and recommendations on the management of NMIBC in databases,guideline development professional societies and monographs were referred to,and the European Association of Urology was used to assess the certainty of generated recommendations.Finally,we issued 29 statements,among which 22 were strong recommendations,and 7 were weak recommendations.These recommendations cover the topics of TURBT,postoperative chemotherapy after TURBT,Bacillus Calmette–Guérin(BCG)immunotherapy after TURBT,combination treatment of BCG and chemotherapy after TURBT,treatment of carcinoma in situ,radical cystectomy,treatment of NMIBC recurrence,and follow-up and surveillance.We hope these recommendations can help promote the treatment and surveillance of NMIBC in China,especially for the primary medical institutions. 展开更多
关键词 non-muscle invasive bladder cancer bladder cancer Transurethral resection of bladder tumor TREATMENT SURVEILLANCE GUIDELINE
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Molecular Assessment of Non-Muscle Invasive and Muscle Invasive Bladder Tumors: Mapping of Putative Urothelial Stem Cells and Toll-Like Receptors (TLR) Signaling
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作者 Rafael Mamprin Stopiglia Wagner Eduardo Matheus +5 位作者 Patrick Vianna Garcia Athanase Billis Mariana Anteghini Castilho Vitor Hugo Figueiredo de Jesus Ubirajara Ferreira Wagner José Fávaro 《Journal of Cancer Therapy》 2015年第2期129-140,共12页
Purpose: The main objectives of this study were to characterize and compare the urothelial stem cells (healthy and cancer cells) and TLRs features in the urinary bladder of men without lesionsand with non-muscle-invas... Purpose: The main objectives of this study were to characterize and compare the urothelial stem cells (healthy and cancer cells) and TLRs features in the urinary bladder of men without lesionsand with non-muscle-invasive and muscle invasive urothelial tumors. Materials and Methods: Thirty samples of the urinary bladder of 50 to 80-year-old men, with and without diagnosis of malignant urothelial lesions were used. The 30 samples were divided into 3 groups (n = 10 per group): Normal Group;Non-Muscle Invasive Bladder Cancer Group;Muscle Invasive Bladder Cancer Group. The samples were histopathologically and immunohistochemically analyzed. The study was conducted at teaching Hospital of the University of Campinas (UNICAMP). Results: The CD44 and CD133 immunoreactivities were significantly intense in the muscle-invasive cancer group when compared to the other groups. The ABCG2 biomarker demonstrated intense immunoreactivities in both non-muscle and muscle invasive groups, and absent immunoreactivity in the normal group. All groups showed weak CD117 immunoreactivity. Putative Healthy Stem Cells (CD44/CD133/ CD117+) occurred in all groups. Putative Cancer Stem Cells (CD44/CD133/ABCG2+) only occurred in the non-muscle and muscle invasive cancer groups. TLR2 immunoreactivity was significantly lower in the non-muscle invasive cancer group and absent in the muscle invasive cancer group. TLR4 immunoreactivity was significantly lower in both cancer groups. Conclusions: This study leads us to the conclusion that putative cancer stem cell occurrence was sensitive to the decreased in TLR2 and TLR4 immunoreactivities. Also, TLR2 and TLR4 demonstrated their involvement in the regulation of the different biomarkers for putative healthy and cancer urothelial stem cells, probably acting as negative regulators of urothelial carcinogenesis. Taken together data obtained suggest that use of TLRs agonists could be a promising alternative for the treatment of non-muscle and muscle invasive bladder tumors. 展开更多
关键词 non-muscle invasive bladder CANCER MUSCLE invasive bladder CANCER Toll-Like Receptors CANCER STEM Cell STEM Cells Biomarkers
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Intravesical bacillus Calmette-Guerin(BCG)in treating non-muscle invasive bladder cancer—analysis of adverse effects and effectiveness of two strains of BCG(Danish 1331 and Moscow-I) 被引量:2
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作者 Yuvaraja B.Thyavihally Preetham Dev +6 位作者 Santosh Waigankar Abhinav Pednekar Nevitha Athikari Abhijit Raut Archan Khandekar Naresh Badlani Ashishkumar Asari 《Asian Journal of Urology》 CSCD 2022年第2期157-164,共8页
Objective:To compare the differences in adverse effects and efficacy profile between bacillus Calmette-Guerin(BCG)Danish 1331 and BCG Moscow-I strain in management of non-muscle invasive bladder cancer.Methods:Clinica... Objective:To compare the differences in adverse effects and efficacy profile between bacillus Calmette-Guerin(BCG)Danish 1331 and BCG Moscow-I strain in management of non-muscle invasive bladder cancer.Methods:Clinical data of 188 cases of non-muscle invasive bladder cancer treated with BCG between January 2008 and December 2018 in our institute were collected prospectively and analysed retrospectively,and 114 patients who completed a minimum of 12 months of follow-up were analysed.Patient and tumor characteristics,strain of BCG,adverse effects,and tumor progression were included for analysis.Intravesical BCG was instilled in intermediate-and high-risk patients.Six weeks of induction BCG,followed by three weekly maintenance BCG at 3,6,12,18,and 24 months was advised in high-risk patients.Results:Overall 68 patients received BCG Danish 1331 strain and 46 patients received Moscow-I strain.Patient and tumor characteristics were well balanced between the two groups.The median follow-up period was 42.5 months and 34.5 months in Danish 1331 and Moscow-I groups,respectively.Adverse events like dropout rate,antitubercular treatment requirement,and need of cystectomy were higher in Moscow-I group(n=31,67.4%)when compared to Danish 1331 strain(n=33,48.5%)(p=0.046).On direct comparison between Danish 1331 and Moscow-I strain,there was similar 3-year recurrence-free survival(80.0%vs.72.9%)and 3-year progression-free survival(96.5%vs.97.8%).Conclusion:Study results suggest no significant differences between Danish 1331 and Moscow-I strain in recurrence-free survival and progression-free survival,but a significantly higher incidence of moderate to severe adverse events in BCG Moscow-I strain. 展开更多
关键词 Adjuvant bacillus Calmette-Guerin Bacillus Calmette-Guerin adverse effects Danish 1331 strain Intravesical therapy Moscow-I strain non-muscle invasive bladder cancer
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Molecular mechanisms and novel therapeutic strategies of BCG-unresponsive non-muscle invasive bladder cancer: Emerging immunotherapy has become a new choice?
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作者 Xin-Ming Hu Lei Xu +4 位作者 Jun Gu Hua-Lei Chen Ting-Ming Wu Shen Xu Xian-Ping Che 《Journal of Hainan Medical University》 2020年第14期58-62,共5页
Objective:THigh-risk non-invasive bladder cancer(NMIBC)has a high rate of recurrence and disease progression.At present,there are still insufficient effective prevention and treatment methods,especially for patients w... Objective:THigh-risk non-invasive bladder cancer(NMIBC)has a high rate of recurrence and disease progression.At present,there are still insufficient effective prevention and treatment methods,especially for patients who have failed BCG treatment.This article reviews the research progress of the molecular mechanism of BCG unresponsive NMIBC,and summarizes the current status and prospects of emerging therapeutic strategies represented by immunotherapy,providing a theoretical basis for the immunotherapy of BCG non-reactive NMIBC.Methods:We searched the PubMed and CNKI journal full-text database search system for keywords"non-muscle invasive bladder cancer,BCG unresponsive,disease recurrence,disease progression,and immunotherapy"with 126 English and 538 Chinese articles.The literature,as well as the relevant clinical research in ClinicalTrials.gov,were integrated together to obtain the results.Results:Immunotherapy was performed in various types of tumors,and the use of immunotherapeutic drugs with different oncotargets administered alone,sequentially or in combination for the treatment of BCG-unresponsive NMIBC have achieved favorable effects,and more Clinical research is still ongoing.Conclusion:Immunotherapy is currently the most promising treatment for cancer,and it is indispensable for patients with NMIBC,both biologically and clinically.We look forward to more laboratory and clinical research in immunotherapy in the future. 展开更多
关键词 BCG unresponsive non-muscle invasive bladder cancer Disease progression IMMUNOTHERAPY
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Recirculating chemohyperthermia as a treatment for non-muscle invasive bladder cancer:Current and future perspectives
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作者 Javier Flores-Carbajal Alejandro Sousa-Escandón +3 位作者 Daniel Sousa-Gonzalez Silvia Rodriguez Gomez Manuel Lopez Saavedra M Elia Fernandez Martinez 《World Journal of Clinical Urology》 2017年第2期34-39,共6页
About 75% of all bladder cancer diagnosed are non-muscle invasive bladder cancer(NMIBC), recurring over 50% of them after transurethral resection of the bladder tumor. In order to prevent recurrences, adjuvant intrave... About 75% of all bladder cancer diagnosed are non-muscle invasive bladder cancer(NMIBC), recurring over 50% of them after transurethral resection of the bladder tumor. In order to prevent recurrences, adjuvant intravesical chemotherapy with mitomycin C and immunotherapy with bacillus Calmette-Gu-érin(BCG) is traditionally used. Unfortunately, many patients relapse after receiving these treatments and a significant proportion of them require surgery. After a one-to-three years BCG maintenance, the risk for progression at 5 years was 19.3% for T1G3 tumors. Many new treatment approaches are being investigated to increase the effectiveness of adjuvant intravesical therapy. One of the developing treatments for intermediate and high-risk NMIBC is the combination of intravesical chemotherapy and hyperthermia, called chemohyperthermia. This article provides a review of the mechanism of action, current status and indications, results and future perspectives. 展开更多
关键词 bladder cancer THERMOTHERAPY non-muscle invasive Chemohyperthermia Recirculating INTRAVESICAL chemotherapy TREATMENT Mechanism of action
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Did the Scientific Innovations in the Management of Non-Muscle Invasive Bladder Cancer Patients Improve the Outcome during the Last 2 Decades?
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作者 Walid F. Alame Nehme Raad Serge Ibrahim 《Open Journal of Urology》 2022年第11期563-587,共25页
Objectives: Previous reviews reported the outcome of each scientific modality in the management of T1 high-grade bladder cancer. The objective of this review is to assess and evaluate the available scientific modaliti... Objectives: Previous reviews reported the outcome of each scientific modality in the management of T1 high-grade bladder cancer. The objective of this review is to assess and evaluate the available scientific modalities used during the last two decades and determine whether they were able to improve the clinical outcome. Literature Search Methodology: A systematic literature review was conducted from 2000-2020 using PubMed, Medline, Embase, and other database sites looking at randomized controlled trials (RCTs), clinical trials, research, review articles, and original articles addressing the different scientific modalities used to diagnose and manage patients with non-muscle invasive Bladder cancer (NMIBC)during the last 2 decades. More than 573 studies were retrieved following the preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines and PICOS criteria (Population, Intervention, Comparators, Outcomes, and Study design). Only 85 articles were selected for review including 19 prospective trials, 44 RCTs, original articles, research articles, one review article, and clinical trials—Retrospective studies were excluded to limit bias as much as possible in the analysis. Results: Randomized controlled trials (RCTs) have become the gold standard for evaluating the efficacy of new treatments. They are considered the highest standard of evidence-based medicine and are the method of choice. Overall, we selected 85 studies for review, among them 63 prospective trials and RCTs, with a total of 21,895 patients, published between 2000 and 2020. Previously conducted studies have shown that identifying rare histological types with poor prognoses can help improve outcomes, mainly the plasmacytoid type. Many articles addressed the role of biomarkers in the early identification of patients with NMIBC for recurrence and progression—P-cadherin expression and others were used to predict recurrence and/or progression with promising results. Despite the need for modifications, risk stratification is an important tool that should be used to improve the outcome of patients with NMIBC. Some found that fluorescence diagnostic cystoscopy (FDC) and Photodynamic diagnosis (PDD) improved recurrence-free survival but not progression and outcome. All authors agree that intravesical BCG is the most effective therapy that changes the course of high-grade T1 mainly progression. Re-TURBT has become one of the recommendations of international societies, but its potential effect on survival improvement is debatable. Most of the articles showed the advantages of early cystectomy in NMIBC but all agree that the selection criteria must be clearly defined. Conclusions: This review analyzed the outcomes provided by the scientific advances in the field of management of NMIBC patients in the last two decades. Patients with T1 bladder cancer have variable outcomes because of tumor heterogeneity and clinical staging. Despite the great development in the field of diagnosis, risk stratification, and management, further large studies are mostly needed to better elucidate this subset of patients and avoid over and under-treatment. 展开更多
关键词 non-muscle invasive bladder Cancer OUTCOME Early Cystectomy Biomarkers Intravesical Agents Re-TURBT HISTOLOGY Risk Stratification
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Validation of Vesical Imaging Reporting and Data System score for the diagnosis of muscle-invasive bladder cancer: A prospective cross-sectional study 被引量:2
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作者 Kumawat Ghanshyam Vyas Nachiket +4 位作者 Sharma Govind Priyadarshi Shivam Gupta Bhagwan Sahay Singla Mohit Kumar Ashok 《Asian Journal of Urology》 CSCD 2022年第4期467-472,共6页
Objective:Vesical Imaging Reporting and Data System(VIRADS)score was developed to standardize the reporting and staging of bladder tumors on pre-operative multiparametric magnetic resonance imaging.It helps in avoidin... Objective:Vesical Imaging Reporting and Data System(VIRADS)score was developed to standardize the reporting and staging of bladder tumors on pre-operative multiparametric magnetic resonance imaging.It helps in avoiding unnecessary repeat transurethral resection of bladder tumor in high-risk non-muscle-invasive bladder cancer patients.This study was done to determine the validity of VIRADS score prospectively for the diagnosis of muscleinvasive bladder cancer.Methods:This study was conducted from March 2019 to March 2020 at Sawai Man Singh Medical College and Hospital,Jaipur,Rajasthan,India.Patients admitted with the provisional diagnosis of bladder tumor were included as participants.All these patients underwent a 3 Tesla mpMRI to obtain a VIRADS score before they underwent transurethral resection of bladder tumor and these data were analyzed to evaluate the correlation of pre-operative VIRADS score with mus-cle invasiveness of the tumor in final biopsy report.Results:A cut-off of VIRADS≥4 for prediction of detrusor muscle invasion yielded a sensitivity of 79.4%,specificity of 94.2%,positive predictive value of 90.0%,negative predictive value of 87.5%,and diagnostic accuracy of 86.4%.A cut off of VIRADS≥3 for prediction of detrusor muscle invasion yielded a sensitivity of 91.2%,specificity of 78.8%,positive predictive value of 73.8%,negative predictive value of 93.2%,and accuracy of 83.7%.The receiver operating curve showed the area under the curve to be 0.922(95%confidence interval:0.862e0.983).Conclusion:VIRADS score appears to be an excellent and effective pre-operative radiological tool for the prediction of detrusor muscle invasion in bladder cancer. 展开更多
关键词 Vesical Imaging Reporting and Data System bladder tumor Multiparametric magnetic resonance imaging Detrusor invasion
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新辅助放疗联合cTURBT和辅助化疗治疗直径≥3cm的T_(2)期MIBC的疗效与安全性
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作者 张志华 陈雅童 +2 位作者 罗飞 王亚申 李健 《现代泌尿生殖肿瘤杂志》 2024年第4期223-228,共6页
目的探讨新辅助调强适形放疗联合“最大化”经尿道膀胱肿瘤电切术(cTURBT)和辅助化疗治疗肿瘤直径≥3 cm的T 2期肌层浸润性膀胱癌(MIBC)的疗效与安全性。方法回顾性分析天津市人民医院泌尿外科收治的接受新辅助放疗联合cTURBT和辅助化疗... 目的探讨新辅助调强适形放疗联合“最大化”经尿道膀胱肿瘤电切术(cTURBT)和辅助化疗治疗肿瘤直径≥3 cm的T 2期肌层浸润性膀胱癌(MIBC)的疗效与安全性。方法回顾性分析天津市人民医院泌尿外科收治的接受新辅助放疗联合cTURBT和辅助化疗的31例病灶直径≥3 cm的T 2期MIBC患者的临床资料,随访患者复发、转移、生存、死亡情况。结果31例患者均接受新辅助放疗,放疗总剂量为48(44,50)Gy,放疗后3例(9.7%)完全缓解,19例(61.3%)部分缓解,客观缓解率为71.0%,疾病控制率为96.8%。所有患者顺利行cTURBT术,手术时间37(31,42)min,出血量为20(10,30)ml,无围手术期输血患者,术后住院时间为4(4,5)d,术中无闭孔神经损伤、膀胱穿孔、严重出血、经尿道电切综合征发生。随访患者12~36个月,9例(29.0%)患者复发,中位复发时间18(10,23.5)个月,6例患者为膀胱内复发,其中5例再次行cTURBT术联合膀胱灌注治疗,1例行挽救性根治性膀胱切除术(RC);2例出现膀胱内复发和淋巴结转移,其中1例行cTURBT联合免疫治疗,1例行挽救性RC;1例出现全身多发转移,行姑息性治疗。结论新辅助放疗联合cTURBT和辅助化疗治疗直径≥3 cm的T 2期MIBC患者,保膀胱成功率高,可作为不能或不愿接受RC患者的保膀胱治疗策略。 展开更多
关键词 肌层浸润性膀胱癌 新辅助调强适形放疗 “最大化”经尿道膀胱肿瘤电切术 肿瘤复发
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经尿道整块剜除术与经尿道膀胱肿瘤电切术在非肌层浸润性膀胱癌治疗中的疗效对比
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作者 黄沛东 林楚琪 +2 位作者 林坤城 陈晓生 卢勇 《泌尿外科杂志(电子版)》 2024年第4期55-58,共4页
目的对比经尿道整块剜除术(en bloc resection of bladder tumor,EBRBT)与经尿道膀胱肿瘤电切术(transurethral resection of bladder tumor,TURBT)在非肌层浸润性膀胱癌(non-muscle invasive bladder cancer,NMIBC)治疗中的疗效。方法... 目的对比经尿道整块剜除术(en bloc resection of bladder tumor,EBRBT)与经尿道膀胱肿瘤电切术(transurethral resection of bladder tumor,TURBT)在非肌层浸润性膀胱癌(non-muscle invasive bladder cancer,NMIBC)治疗中的疗效。方法选取2021年4月至2023年2月于揭阳市人民医院接受手术治疗的58例NMIBC患者作为研究对象,按照计算机随机法分为EBRBT组和TURBT组,每组29例,分别行EBRBT和TURBT。观察两组患者围手术期指标、并发症、术后肌层侵犯率及术后1年肿瘤复发情况。结果两组手术时间差异无统计学意义(P>0.05);EBRBT组术中出血量为(10.71±4.78)ml,较TURBT组(16.58±6.27)ml少,EBRBT组术后尿管留置时间与住院时间分别为(3.23±1.66)d及(4.92±1.06)d,少于TURBT组的(4.75±1.71)d及(5.87±1.82)d,差异有统计学意义(P<0.05);EBRBT组术后并发症发生率为3.45%(1/29),比TURBT组的20.69%(6/29)低,差异有统计学意义(P<0.05);术后EBRBT组肌层侵犯率、肿瘤复发率分别为92.59%和6.9%,显著低于和TURBT组的62.07%和26.67%,差异有统计学意义(P<0.05)。结论EBRBT相较于TURBT安全性更好,患者预后效果更佳。 展开更多
关键词 非肌层浸润性膀胱癌 经尿道整块剜除术 经尿道膀胱肿瘤电切术
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Can intravesical bacillus Calmette-Guerin reduce recurrence in patients with non-muscle invasive bladder cancer? An update and cumulative meta-analysis 被引量:6
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作者 Jiangang Pan Mo Liu Xing Zhou 《Frontiers of Medicine》 SCIE CAS CSCD 2014年第2期241-249,共9页
Approximately 70% of newly diagnosed bladder tumors are non-muscle invasive bladder cancer (NMIBC). NMIBC accounts for approximately 80% of total bladder cancer cases. Bacillus Calmette-Guerin (BCG) instillation a... Approximately 70% of newly diagnosed bladder tumors are non-muscle invasive bladder cancer (NMIBC). NMIBC accounts for approximately 80% of total bladder cancer cases. Bacillus Calmette-Guerin (BCG) instillation and maintenance is considered as the standard adjuvant treatment for superficial bladder cancer. A number of randomized studies have focused on the benefit of maintenance therapy following initial BCG induction. To provide further insights into the effect of intravesical instillation on recurrence in patients with NMIBC, we analyzed this relationship by conducting an updated detailed meta-analysis. Evidence suggested that adjuvant intravesical BCG with maintenance treatment is significantly effective for the prophylaxis of tumor recurrence in patients with NMIBC. 展开更多
关键词 non-muscle invasive bladder cancer bacillus Calmette-Guerin (BCG) META-ANALYSIS
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小剂量注射吉西他滨联合经尿道膀胱肿瘤电切术治疗中高危非肌层浸润性膀胱癌的临床研究
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作者 王以金 唐静 +17 位作者 杨超 徐凯 张梦蝶 高健 吴晓丽 张粤 牛晓兵 蒋鹤松 茆飞 周闪 姜熙 郭忠英 孙苏安 徐明 徐宗源 王恒兵 李歆 傅广波 《中国药物警戒》 2024年第9期1044-1050,共7页
目的 对比经尿道膀胱肿瘤电切术(TURBT),探讨黏膜下小剂量注射吉西他滨(SIOG)联合TURBT治疗中高危非肌层浸润性膀胱癌(NMIBC)的治疗效果及药物经济学评价。方法 收集2015年1月1日至2020年8月31日本院270例中高危NMIBC患者(TURBT 213例,S... 目的 对比经尿道膀胱肿瘤电切术(TURBT),探讨黏膜下小剂量注射吉西他滨(SIOG)联合TURBT治疗中高危非肌层浸润性膀胱癌(NMIBC)的治疗效果及药物经济学评价。方法 收集2015年1月1日至2020年8月31日本院270例中高危NMIBC患者(TURBT 213例,SIOG+TURBT 57例)的临床资料,应用倾向性评分匹配以1∶1的比例匹配,每组病例为52人,分析2组的临床疗效,核算其成本,构建1年为循环周期,1 000人10年的Markov模型对2组治疗方案进行药物经济学评价。结果 TURBT组患者3、6、12个月肿瘤未复发率和SIOG+TUR BT组患者3、6、12个月肿瘤未复发率分别为90.38%vs 100.00%、84.62%vs 98.08%、78.85%vs92.31%,术后6个月时肿瘤未复发率2组差异具有统计学意义(P <0.05),经log-r a n k检验,2组1年时肿瘤未复发率差异具有统计学意义(P <0.05)。TURBT方案和SIOG+TURBT方案累积人均成本分别为217 117.20元和190 701.12元,获得的健康效果分别为5.56质量调整生命年(quality-adjusted life years,QALYs)和5.77QALYs。与TURBT治疗方案相比,SIOG+TURBT治疗方案提高了0.21QALYs,节约了26 416.08元。SIOG+TURBT方案对于TURBT方案具有成本-效用优势。结论 与TURBT相比,SIOG+TURBT治疗中高危NMIBC具有更优的临床效果及经济性。 展开更多
关键词 非肌层浸润性膀胱癌 经尿道膀胱肿瘤电切术 吉西他滨 黏膜下注射 MARKOV模型 临床研究 药物经济学评价
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术前尿BTA、NMP22定量联合检测对膀胱癌的诊断价值研究
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作者 杨礼宾 许汉标 +2 位作者 杨海超 钟继生 廖振文 《岭南现代临床外科》 2024年第1期37-41,共5页
目的探讨术前尿BTA、NMP22定量联合测定对膀胱癌的诊断价值。方法选取2021年1月至2022年09月于惠州市中心人民医院泌尿外科确诊为膀胱癌的73例患者作为观察组,另选取同期就诊的73例泌尿系统良性疾病患者作为对照组。检测两组患者术前尿... 目的探讨术前尿BTA、NMP22定量联合测定对膀胱癌的诊断价值。方法选取2021年1月至2022年09月于惠州市中心人民医院泌尿外科确诊为膀胱癌的73例患者作为观察组,另选取同期就诊的73例泌尿系统良性疾病患者作为对照组。检测两组患者术前尿BTA、NMP22定量水平,根据检测结果回顾性分析两个指标在膀胱癌中的单项及联合诊断价值,同时分析不同临床肿瘤特征患者上述两个指标的阳性率差异情况。结果观察组和对照组的术前尿BTA定量水平分别为(997.85±237.73)pg/mL、(691.33±190.16)pg/mL;NMP22定量水平分别为(8.57±1.49)ng/mL、(6.23±1.29)ng/mL。与对照组相比,观察组患者术前尿BTA、NMP22水平均明显升高(P<0.01)。术前尿BTA、NMP22在膀胱癌诊断中的灵敏度分别为76.7%和78.1%,特异度为90.4%和91.8%,曲线下面积分别为0.849和0.867,此时两者的最佳截断值分别为834.55 pg/mL和7.47 ng/mL。两者联合诊断的灵敏度、特异度、曲线下面积分别为89.0%、87.7%、0.931,其中灵敏度及曲线下面积均较单项检测高。不同年龄、性别、BMI、吸烟情况患者的BTA和NMP22阳性率比较,差异无统计学意义(P>0.05);而不同肿瘤直径、肿瘤数目、肿瘤分级、肿瘤分期患者的BTA和NMP22阳性率比较,差异具有统计学意义(P<0.05)。结论术前尿BTA、NMP22定量水平测定对膀胱癌具有较好的诊断效能,具备无创、便捷、可批量检测等优点,且两者联合检测可提高诊断敏感度,减少漏诊可能,值得用于临床实践。 展开更多
关键词 膀胱癌 尿液无创诊断 尿膀胱肿瘤抗原 核基质蛋白22
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卡介苗用于我国中高危非肌层浸润性膀胱癌患者TUR-BT术后灌注治疗的药物经济学评价
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作者 苏志铖 李璐 +2 位作者 姚强 朱彩蓉 贾涛 《中国药房》 CAS 北大核心 2024年第22期2773-2778,共6页
目的对卡介苗(BCG)与表柔比星用于中高危非肌层浸润性膀胱癌(NMIBC)患者经尿道膀胱肿瘤切除术(TUR-BT)术后膀胱灌注治疗的经济性进行评价。方法从我国卫生体系角度出发,基于ChiCTR-IIR-16008357研究构建Markov队列模型。以质量调整生命... 目的对卡介苗(BCG)与表柔比星用于中高危非肌层浸润性膀胱癌(NMIBC)患者经尿道膀胱肿瘤切除术(TUR-BT)术后膀胱灌注治疗的经济性进行评价。方法从我国卫生体系角度出发,基于ChiCTR-IIR-16008357研究构建Markov队列模型。以质量调整生命年(QALYs)作为健康产出,意愿支付阈值设定为1倍2023年中国人均国内生产总值(89358元/QALY)。采用成本-效用分析比较BCG方案相对表柔比星方案用于我国中高危NMIBC患者TUR-BT术后膀胱灌注治疗的增量成本-效果比(ICER),并进行敏感性分析。结果BCG方案相比于表柔比星方案的增量成本为34309.51元,增量效用为0.800 QALYs,ICER为42871.33元/QALY,低于意愿支付阈值。当意愿支付阈值为89358元/QALY时,概率敏感性分析中BCG方案可被接受的概率为77.70%,高于表柔比星方案,且BCG方案的可接受性随意愿支付阈值的增加而增加。结论以1倍2023年我国人均GDP为意愿支付阈值时,相比表柔比星,BCG用于中高危NMIBC患者TUR-BT术后膀胱灌注治疗具有更好的经济性。 展开更多
关键词 卡介苗 非肌层浸润性膀胱癌 经尿道膀胱肿瘤切除术 膀胱灌注 表柔比星 药物经济学
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ACKR1在尿路上皮膀胱癌组织中的表达及其与预后的相关性
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作者 李如鹏 罗蓉 +1 位作者 赵建 高宏飞 《现代肿瘤医学》 CAS 2024年第20期3942-3947,共6页
目的:探讨非典型趋化因子1(ACKR1)在尿路上皮膀胱癌(UBC)组织中的表达情况,并探讨其与预后的相关性。方法:收集428例UBC样本转录组基因表达数据进行差异基因分析并用ESTIMATE法进行肿瘤免疫微环境分析。随后,回顾性分析2019年1月至2021... 目的:探讨非典型趋化因子1(ACKR1)在尿路上皮膀胱癌(UBC)组织中的表达情况,并探讨其与预后的相关性。方法:收集428例UBC样本转录组基因表达数据进行差异基因分析并用ESTIMATE法进行肿瘤免疫微环境分析。随后,回顾性分析2019年1月至2021年12月我院泌尿外科收治的81例膀胱癌患者的临床资料,根据患者预后分为复发组(n=42)和未复发组(n=39),比较两组各临床特征的差异。采用免疫组织化学法检测组织中ACKR1表达情况,比较膀胱壁各层瘤内组织与瘤周组织ACKR1表达差异,并分析其与UBC患者临床病理特征的关系;采用乘积极限法(Kaplan-Meier)分析UBC患者预后状况,并采用Log-Rank检验进行显著性比较;采用Cox模型分析UBC患者不良预后的影响因素。结果:428例样本数据的差异表达基因分析发现ACKR1在肿瘤组织内表达下降并且与较低的免疫评分相关。81例UBC患者样本的IHC结果结合临床资料发现在未复发组中固有层瘤周组织的ACKR1表达量要高于复发组。另外,存在肿瘤细胞血管浸润者较不存在者的ACKR1表达量更低,且差异具有统计学意义。与ACKR1低表达组相比,ACKR1高表达组患者具有更长无复发生存期且P<0.001。单因素Cox回归分析表明分化级别、浸润深度、肿瘤大小、脉管浸润及ACKR1表达与患者复发相关;多因素Cox回归分析表明ACKR1表达为膀胱癌复发的独立影响因素(P<0.05),即与ACKR1低表达的患者相比,ACKR1高表达的患者复发风险较低(OR=0.032,95%CI:0.0041~0.24,P<0.05)。结论:固有层瘤周组织内毛细血管内皮细胞表面的ACKR1低表达的患者可能倾向于较短的无复发生存期。 展开更多
关键词 膀胱癌 ACKR1 趋化因子 血管浸润 肿瘤免疫微环境
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Cell softness reveals tumorigenic potential via ITGB8/AKT/glycolysis signaling in a mice model of orthotopic bladder cancer
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作者 Shi Qiu Yaqi Qiu +18 位作者 Linghui Deng Ling Nie Liming Ge Xiaonan Zheng Di Jin Kun Jin Xianghong Zhou Xingyang Su Boyu Cai Jiakun Li Xiang Tu Lina Gong Liangren Liu Zhenhua Liu Yige Bao Jianzhong Ai Tianhai Lin Lu Yang Qiang Wei 《Chinese Medical Journal》 SCIE CAS CSCD 2024年第2期209-221,共13页
Background:Bladder cancer,characterized by a high potential of tumor recurrence,has high lifelong monitoring and treatment costs.To date,tumor cells with intrinsic softness have been identified to function as cancer s... Background:Bladder cancer,characterized by a high potential of tumor recurrence,has high lifelong monitoring and treatment costs.To date,tumor cells with intrinsic softness have been identified to function as cancer stem cells in several cancer types.Nonetheless,the existence of soft tumor cells in bladder tumors remains elusive.Thus,our study aimed to develop a microbarrier microfluidic chip to efficiently isolate deformable tumor cells from distinct types of bladder cancer cells.Methods:The stiffness of bladder cancer cells was determined by atomic force microscopy(AFM).The modified microfluidic chip was utilized to separate soft cells,and the 3D Matrigel culture system was to maintain the softness of tumor cells.Expression patterns of integrinβ8(ITGB8),protein kinase B(AKT),and mammalian target of rapamycin(mTOR)were determined by Western blotting.Double immunostaining was conducted to examine the interaction between F-actin and tripartite motif containing 59(TRIM59).The stem-cell-like characteristics of soft cells were explored by colony formation assay and in vivo studies upon xenografted tumor models.Results:Using our newly designed microfluidic approach,we identified a small fraction of soft tumor cells in bladder cancer cells.More importantly,the existence of soft tumor cells was confirmed in clinical human bladder cancer specimens,in which the number of soft tumor cells was associated with tumor relapse.Furthermore,we demonstrated that the biomechanical stimuli arising from 3D Matrigel activated the F-actin/ITGB8/TRIM59/AKT/mTOR/glycolysis pathways to enhance the softness and tumorigenic capacity of tumor cells.Simultaneously,we detected a remarkable up-regulation in ITGB8,TRIM59,and phospho-AKT in clinical bladder recurrent tumors compared with their non-recurrent counterparts.Conclusions:The ITGB8/TRIM59/AKT/mTOR/glycolysis axis plays a crucial role in modulating tumor softness and stemness.Meanwhile,the soft tumor cells become more sensitive to chemotherapy after stiffening,that offers new insights for hampering tumor progression and recurrence. 展开更多
关键词 Soft tumor cells 3D Matrigel STEMNESS non-muscle invasive bladder neoplasms Microfluidic analytical techniques
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经尿道针状电极膀胱肿瘤整块剜除术治疗非浸润性膀胱癌的临床效果
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作者 唐晓龙 甄洪涛 王继征 《临床医学工程》 2024年第1期17-18,共2页
目的探讨经尿道针状电极膀胱肿瘤整块剜除术(ERBT)治疗非浸润性膀胱癌的临床效果。方法将60例非浸润性膀胱癌患者随机分为研究组(n=30)和对照组(n=30)。对照组给予经尿道膀胱肿瘤切除术(TURBT)治疗,研究组给予ERBT治疗,比较两组的围手... 目的探讨经尿道针状电极膀胱肿瘤整块剜除术(ERBT)治疗非浸润性膀胱癌的临床效果。方法将60例非浸润性膀胱癌患者随机分为研究组(n=30)和对照组(n=30)。对照组给予经尿道膀胱肿瘤切除术(TURBT)治疗,研究组给予ERBT治疗,比较两组的围手术期指标、并发症及复发情况。结果研究组手术时间、膀胱冲洗时间、尿管留置时间及住院时间均短于对照组,术中出血量少于对照组(P<0.05)。研究组并发症发生率、复发率分别为6.67%、3.33%,低于对照组的30.00%、26.67%(P<0.05)。结论与TURBT治疗相比,ERBT治疗非浸润性膀胱癌能够明显缩短膀胱冲洗时间、手术时间、尿管留置时间及住院时间,减少术中出血量,降低并发症发生率及复发率。 展开更多
关键词 非浸润性膀胱癌 经尿道针状电极膀胱肿瘤整块剜除术 经尿道膀胱肿瘤切除术 并发症 复发
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非肌层浸润性膀胱癌患者术后膀胱痉挛发生的危险因素
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作者 吴培 董亚娟 李思思 《实用癌症杂志》 2024年第10期1721-1724,共4页
目的探讨非肌层浸润性膀胱癌患者术后膀胱痉挛发生的危险因素,为临床防治膀胱痉挛提供依据。方法回顾性分析经尿道膀胱肿瘤切除术治疗的96例非肌层浸润性膀胱癌患者临床资料,根据是否发生膀胱痉挛分为痉挛组、未痉挛组。收集2组患者性... 目的探讨非肌层浸润性膀胱癌患者术后膀胱痉挛发生的危险因素,为临床防治膀胱痉挛提供依据。方法回顾性分析经尿道膀胱肿瘤切除术治疗的96例非肌层浸润性膀胱癌患者临床资料,根据是否发生膀胱痉挛分为痉挛组、未痉挛组。收集2组患者性别、年龄、肿瘤分期、肿瘤数目、留置尿管时间等资料,先进行单因素分析,之后将具有统计学差异的变量纳入多因素Logistic回归模型,最终获取非肌层浸润性膀胱癌患者术后膀胱痉挛发生的危险因素。结果术后3 d,96例非肌层浸润性膀胱癌患者中,共有30例发生膀胱痉挛,占比为31.25%(30/96);其中轻度痉挛16例,中度痉挛8例,重度6例。痉挛组多发肿瘤、术前尿路感染、尿管留置时间>7 d、膀胱逼尿肌不稳定、术前焦虑患者占比均高于未痉挛组,差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,多发肿瘤、术前尿路感染、留置尿管时间>7 d、逼尿肌不稳定、术前焦虑是非肌层浸润性膀胱癌患者术后膀胱痉挛发生的危险因素(OR>1,P<0.05)。结论多发肿瘤、术前尿路感染、尿管留置时间>7 d、逼尿肌不稳定、术前焦虑是非肌层浸润性膀胱癌患者术后膀胱痉挛发生的危险因素,临床应加强对上述因素的重视并进行针对性干预,以达到预防或减少膀胱痉挛发生的目的。 展开更多
关键词 非肌层浸润性膀胱癌 膀胱痉挛 经尿道膀胱肿瘤切除术 危险因素
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吉西他滨膀胱灌注化疗在非肌层浸润性膀胱癌术后患者中的应用效果
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作者 欧阳威 张文元 +1 位作者 赵俊 杨彦峰 《癌症进展》 2024年第2期191-194,共4页
目的探讨吉西他滨膀胱灌注化疗在非肌层浸润性膀胱癌术后患者中的应用效果。方法根据治疗方法的不同将120例非肌层浸润性膀胱癌患者分为对照组和观察组,每组60例。所有患者均进行手术治疗,对照组患者术后给予吡柔比星膀胱灌注化疗,观察... 目的探讨吉西他滨膀胱灌注化疗在非肌层浸润性膀胱癌术后患者中的应用效果。方法根据治疗方法的不同将120例非肌层浸润性膀胱癌患者分为对照组和观察组,每组60例。所有患者均进行手术治疗,对照组患者术后给予吡柔比星膀胱灌注化疗,观察组患者术后给予吉西他滨膀胱灌注化疗。比较两组患者的临床疗效、肿瘤标志物[血清癌胚抗原(CEA)、尿纤维蛋白原降解产物(FDP)]水平、生活质量[欧洲癌症研究与治疗组织生命质量测定量表(EORTC QLQ-C30)]及不良反应发生情况。结果观察组患者的疾病控制率为88.33%,明显高于对照组患者的68.33%,差异有统计学意义(P﹤0.01)。治疗后,两组患者血清CEA、尿FDP水平均低于本组治疗前,观察组患者血清CEA、尿FDP水平均低于对照组,差异均有统计学意义(P﹤0.05)。治疗后,两组患者躯体功能、角色功能、社会功能、总体健康评分均高于本组治疗前,观察组患者躯体功能、角色功能、社会功能、总体健康评分均高于对照组,差异均有统计学意义(P﹤0.05)。两组患者的不良反应总发生率比较,差异无统计学意义(P﹥0.05)。结论吉西他滨膀胱灌注化疗可提高非肌层浸润性膀胱癌术后患者的临床疗效和生活质量,降低肿瘤标志物水平,且安全性良好。 展开更多
关键词 非肌层浸润性膀胱癌 吉西他滨 膀胱灌注化疗 临床疗效 肿瘤标志物 生活质量
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