经尿道膀胱肿瘤电切术治疗老年肌层浸润性膀胱肿瘤的疗效
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摘要
目的:研究经尿道膀胱肿瘤电切术(TURBT)治疗老年肌层浸润性膀胱癌(MIBC)患者的临床疗效,考察治疗前后血清胰岛素样生长因子(IGF-1)和血管内皮生长因子(VEGF)及尿液膀胱癌特异性核基质蛋白-4(BLCA-4)和白细胞介素-8(IL-8)水平变化情况。方法 :选取本院收治的老年MIBC患者56例,分为治疗组(n=30)和对照组(n=26),对照组采用根治性膀胱全切术,治疗组采用TURBT,术后行膀胱灌注化疗。观察两组手术并发症及生存情况,检测两组手术前后血清IGF-1和VEGF水平及尿液BLCA-4和IL-8水平变化,并统计分析。结果:两组术前血清IGF-1和VEGF水平比较,差异均无统计学意义(P>0.05);两组术后7d血清IGF-1和VEGF水平均显著低于术前(P<0.01),且组间差异显著(P<0.05或P<0.01);观察组术后2年、3年无瘤生存率显著高于对照组(P<0.05)。结论:TURBT治疗老年MIBC临床效果较好,缩短手术时间,对患者创伤小,不良反应少。
Objective:To study the clinical efficacy of transurethral resection of bladder tumor(TURBT)in the treatment of elderly muscle-invasive bladder cancer(MIBC),and observe the changes of serum IGF-1,VEGF,BLCA-4,and IL-8levels before and after treatment.Methods:A total of 56 elderly patients with MIBC who were admitted in our hospital were included in the study and divided into the treatment group(n=30)and the control group(n=26).The patients in the control group were given radical cystectomy,while the patients in the treatment group were given TURBT and bladder irrigation chemotherapy after operation.The surgical complications and survival in the two groups were observed.The serum IGF-1and VEGF levels,and urine BLCA-4and IL-8levels before and after treatment in the two groups were detected.Results:The comparison of serum IGF-1and VEGF levels before operation between the two groups was not statistically significant(P>0.05).The serum IGF-1and VEGF levels 7dafter operation were significantly reduced when compared with before operation(P<0.01),and the comparison between the two groups was statistically significant(P<0.05 or P<0.01).The tumor-free survival rate 2and 3years after operation in the observation group were significantly higher than those in the control group(P<0.05).Conclusions:TURBT in the treatment of elderly MIBC has a preferable clinical effect,and can shorten the operation time,with a small trauma and less side effects.
Objective:To study the clinical efficacy of transurethral resection of bladder tumor(TURBT)in the treatment of elderly muscle-invasive bladder cancer(MIBC),and observe the changes of serum IGF-1,VEGF,BLCA-4,and IL-8levels before and after treatment.Methods:A total of 56 elderly patients with MIBC who were admitted in our hospital were included in the study and divided into the treatment group(n=30)and the control group(n=26).The patients in the control group were given radical cystectomy,while the patients in the treatment group were given TURBT and bladder irrigation chemotherapy after operation.The surgical complications and survival in the two groups were observed.The serum IGF-1and VEGF levels,and urine BLCA-4and IL-8levels before and after treatment in the two groups were detected.Results:The comparison of serum IGF-1and VEGF levels before operation between the two groups was not statistically significant(P>0.05).The serum IGF-1and VEGF levels 7dafter operation were significantly reduced when compared with before operation(P<0.01),and the comparison between the two groups was statistically significant(P<0.05 or P<0.01).The tumor-free survival rate 2and 3years after operation in the observation group were significantly higher than those in the control group(P<0.05).Conclusions:TURBT in the treatment of elderly MIBC has a preferable clinical effect,and can shorten the operation time,with a small trauma and less side effects.
引文
1黄健,陈旭,林天歆.膀胱癌精准治疗现状与展望[J].中华泌尿外科杂志,2015,36(7):484-486.
2 李文文.经尿道膀胱肿瘤切除术治疗膀胱癌的临床疗效[J].医学信息,2015,18(20):244-245.
3 吴开杰,刘丽霞,范晋海,等.经尿道激光和传统电切手术治疗非肌层浸润型膀胱肿瘤的Meta分析[J].现代泌尿外科杂志,2015,20(7):478-483.
4 尹学来,张亚强.TURBT在肌层浸润性膀胱肿瘤保留膀胱的作用[J].临床与病理杂志,2015,35(6):1170-1174.
5 那彦群,叶章群,孙颖浩,等.2014版中国泌尿外科疾病诊断治疗指南[M].北京:人民卫生出版社,2014.
6 张继红,张廷继,侯瑞鹏.经尿道膀胱肿瘤选择性绿激光汽化术联合表柔比星治疗非肌层浸润性膀胱癌的临床研究[J].临床泌尿外科杂志,2015,30(1):31-33.
7 伍沛,李乐之.肌层浸润性膀胱癌化疗进展[J].中南医学科学杂志,2016,44(1):112-116.
8 陈伟.经尿道钬激光膀胱肿瘤切除术与经尿道膀胱肿瘤电切术治疗表浅层膀胱癌的疗效和安全性:对比研究[J].中国全科医学,2014,7(2):223-225.
9 舒辉.选择性膀胱部分切除术对浸润性膀胱癌预后的影响因素[J].实用癌症杂志,2014,29(6):705-709.
10 罗松涛,王应洪,李绪鲲,等.膀胱部分切除术与经尿道膀胱肿瘤电切术治疗非肌层浸润性膀胱癌的临床疗效分析[J].吉林医学,2015,12(1):51-52.
11 王国举,董锐,王宁华,等.经尿道激光膀胱肿瘤剜除术与电切术治疗浅表性膀胱肿瘤的疗效比较[J].西南军医,2016,18(1):41-42.
12 胡卫东,赵传印.肌层浸润性膀胱癌患者行保留膀胱手术可行性探讨[J].临床医学,2016,36(4):87-89.
13 李超.经尿道绿激光膀胱肿瘤切除术与TURBT治疗非肌层浸润性膀胱肿瘤的临床疗效比较[D].济南:山东大学,2015.
14 Christopoulos PF,Philippou A,Koutsilieris M.Pattern of IGF-1variants'expression in human cancer cell lines using a novel qRT-PCR approach.[J].Anticancer Res,2015,35(1):107-115.
15 Cai Q,Wu Y,Guo Z,et al.Urine BLCA-4exerts potential role in detecting patients with bladder cancers:apooled analysis of individual studies[J].Oncotarget,2015,6(35):37500-37510.
16 周晓峰,丁振山,方丹波,等.经尿道保留膀胱的不同手术方法对老年肌层浸润性膀胱癌的疗效分析[J].中华医学杂志,2016,96(16):1278-1280.
17 范欣荣,李汉忠,纪志刚,等.保留器官的综合治疗-膀胱癌治疗的新模式(附107例报告)[J].中华泌尿外科杂志,2016,37(2):131-134.
2 李文文.经尿道膀胱肿瘤切除术治疗膀胱癌的临床疗效[J].医学信息,2015,18(20):244-245.
3 吴开杰,刘丽霞,范晋海,等.经尿道激光和传统电切手术治疗非肌层浸润型膀胱肿瘤的Meta分析[J].现代泌尿外科杂志,2015,20(7):478-483.
4 尹学来,张亚强.TURBT在肌层浸润性膀胱肿瘤保留膀胱的作用[J].临床与病理杂志,2015,35(6):1170-1174.
5 那彦群,叶章群,孙颖浩,等.2014版中国泌尿外科疾病诊断治疗指南[M].北京:人民卫生出版社,2014.
6 张继红,张廷继,侯瑞鹏.经尿道膀胱肿瘤选择性绿激光汽化术联合表柔比星治疗非肌层浸润性膀胱癌的临床研究[J].临床泌尿外科杂志,2015,30(1):31-33.
7 伍沛,李乐之.肌层浸润性膀胱癌化疗进展[J].中南医学科学杂志,2016,44(1):112-116.
8 陈伟.经尿道钬激光膀胱肿瘤切除术与经尿道膀胱肿瘤电切术治疗表浅层膀胱癌的疗效和安全性:对比研究[J].中国全科医学,2014,7(2):223-225.
9 舒辉.选择性膀胱部分切除术对浸润性膀胱癌预后的影响因素[J].实用癌症杂志,2014,29(6):705-709.
10 罗松涛,王应洪,李绪鲲,等.膀胱部分切除术与经尿道膀胱肿瘤电切术治疗非肌层浸润性膀胱癌的临床疗效分析[J].吉林医学,2015,12(1):51-52.
11 王国举,董锐,王宁华,等.经尿道激光膀胱肿瘤剜除术与电切术治疗浅表性膀胱肿瘤的疗效比较[J].西南军医,2016,18(1):41-42.
12 胡卫东,赵传印.肌层浸润性膀胱癌患者行保留膀胱手术可行性探讨[J].临床医学,2016,36(4):87-89.
13 李超.经尿道绿激光膀胱肿瘤切除术与TURBT治疗非肌层浸润性膀胱肿瘤的临床疗效比较[D].济南:山东大学,2015.
14 Christopoulos PF,Philippou A,Koutsilieris M.Pattern of IGF-1variants'expression in human cancer cell lines using a novel qRT-PCR approach.[J].Anticancer Res,2015,35(1):107-115.
15 Cai Q,Wu Y,Guo Z,et al.Urine BLCA-4exerts potential role in detecting patients with bladder cancers:apooled analysis of individual studies[J].Oncotarget,2015,6(35):37500-37510.
16 周晓峰,丁振山,方丹波,等.经尿道保留膀胱的不同手术方法对老年肌层浸润性膀胱癌的疗效分析[J].中华医学杂志,2016,96(16):1278-1280.
17 范欣荣,李汉忠,纪志刚,等.保留器官的综合治疗-膀胱癌治疗的新模式(附107例报告)[J].中华泌尿外科杂志,2016,37(2):131-134.