【摘要】 目的探讨浅表性膀胱癌术后灌注表柔比星与丝裂霉素对浅表性膀胱癌患者的临床疗效及预后情况。方法根据术后处理方法的不同将80例初发浅表性膀胱癌患者分为观察组和对照组,观察组予以50mg表柔比星膀胱灌注治疗,对照组予以50mg丝裂霉素灌注治疗。比较两组患者的术后复发情况、生存质量、血清炎症因子[可溶性细胞间黏附分子1(sICAM-1)、可溶性血管细胞黏附分子1(sVCAM-1)、C反应蛋白(CRP)]水平、血清肿瘤标志物[重组人Dickkopf蛋白1(DKK1)、细胞角质蛋白19片段抗原21-1(CYFRA21-1)、血管内皮生长因子(VEGF)]水平及不良反应发生情况。结果观察组术后1、2年复发率分别为2.38%、9.52%,均低于对照组的15.79%、26.32%(P<0.05)。术后6个月,观察组患者的生存质量评分明显高于对照组患者(P<0.01)。治疗后,两组患者的血清sICAM-1、sVCAM-1、CRP水平均低于本组治疗前,且观察组患者的上述血清炎症因子水平均低于对照组(P<0.05)。治疗后,两组患者的血清DKK1、CYFRA21-1、VEGF水平均低于本组治疗前,且观察组患者的上述血清肿瘤标志物水平均低于对照组(P<0.05)。结论表柔比星膀胱灌注能够有效降低浅表性膀胱癌术后患者的血清炎症因子水平,抑制肿瘤活力,减少术后复发,提高患者的生存质量,且安全性好。更多还原

【Abstract】 Objective To analyze and compare the clinical efficacy and safety of postoperative intravesical instillation of epirubicin and mitomycin in the treatment of superficial bladder cancer.Method The clinical data of 80 patients with primary superficial bladder cancer who underwent transurethral resection of bladder tumor(TURBT) were analyzed retrospectively.The subjects involved were divided into study group and control group according to dnterent postoperative managements.The study group was given 50 mg epirubicin through intravesical instillation on the same day after operation,and the control group was administered with 50 mg nntomycin instead,both groups were treated continuously for12 months.The postoperative recurrence,quality of life,serum inflamiriatory factors [soluble intercellular adhesion molecule-1(sICAM-1),soluble vascular cell adhesion molecule-1(sVCAM-1) and C-reaction protein(CRP)],the serum tumor markers [recombinant human Dickkopf 1(DJCK1) protein,cytokeratin 19 fragment antigen 21-1(CYFRA21-1) and vascular endothelial growth factor(VEGF)] and adverse reactions were compared between the two groups.Result The1-year and 2-year recurrence rates in the study group were 2.38% and 9.52%,respectively,which were significantly lower than those in control group at 15.79% and 26.32%,respectively(P<0.05).The score of quality of life in study group was significantly better than that in the control group 6 months after operation(P<0.05).After treatment,the levels of serum inflammatory factors of sICAM-1,sVCAM-1,CRP and the serum tumor markers of DJCK1,CYFRA21-1 and VEGF in study group were significantly lower than those in the control group(P<0.05).Conclusion Intravesical instillation of epirubicin can effectively reduce serum inflammatory factors,inhibiting tumor activity,reducing postoperative recurrence and improve the quality of life of patients with superficial bladder cancer after TURBT surgery.更多还原