摘要
目的观察吉西他滨辅助经尿道等离子膀胱肿瘤切除术(PKRBT)治疗非肌层浸润性膀胱癌(NMIBC)的临床效果。方法本研究为前瞻性研究,选择洛阳市东方人民医院2020年1月至2022年5月期间收治的90例NMIBC患者为研究对象,以计算机随机分组法将其分为手术组和联合组,各45例。所有患者均实施PKRBT手术治疗,联合组通过术中注射吉西他滨辅助治疗,所有患者开展为期1年随访,比较两组患者的近期疗效及短期预后。结果在不同治疗方案下,联合组治疗后的人类软骨糖蛋白(YKL-40)、重组人Dickkopf相关蛋白(DKK-1)分别为(50.25±10.36)ng/mL、(6.62±1.45)ng/mL,均低于手术组[(55.38±10.72)ng/mL、(8.65±2.82)ng/mL];联合组治疗后的癌胚抗原(CEA)、甲胎蛋白(AFP)、可溶性细胞间黏附分子-1(sICAM1)分别为(255.65±20.33)ng/mL、(345.25±30.36)μg/L、(411.24±40.62)μg/L,均低于手术组[(270.33±20.41)ng/mL、(368.72±30.61)μg/L、(441.36±40.27)μg/L];联合组治疗后的客观缓解率(ORR)、疾病控制率(DCR)分别为77.78%(35/45)、88.89%(40/45),均高于手术组[55.56%(25/45)、62.22%(28/45)];联合组的1年内的中位无进展生存期(PFS)、中位总生存期(OS)分别为(10.25±2.21)个月、(11.36±2.41)个月,均高于手术组[(8.14±1.65)个月、(9.29±1.33)个月],病情复发率17.78%(8/45)低于手术组33.33%(15/45);联合组的癌症病人生命质量测定量表体系(QLICP-BL)量表中躯体功能、心理功能、社会功能、共性症状及副作用等维度评分分别为(35.25±5.11)分、(40.32±5.29)分、(35.26±5.22)分、(30.23±5.18)分,均高于手术组[(32.11±5.46)分、(37.45±5.25)分、(32.28±5.21)分、(27.44±5.13)分],差异均有统计学意义(P<0.05)。结论在NMIBC患者的PKRBT术中经膀胱黏膜多点注射吉西他滨能有效改善其近期疗效,对改善患者短期预后、降低病情复发风险,并提升患者生活质量均有积极意义。
【Objective】To observe the clinical effect of gemcitabine assisted plasmakinetic resection of bladder tumor(PKRBT)in the treatment of non-muscle invasive bladder cancer(NMIBC).【Methods】This study is a prospective study that selected 90 NMIBC patients admitted between January 2020 and May 2022 as the study subjects.They were randomly divided into a surgical group(45 cases)and a combination group(45 cases)using computer randomization.All patients underwent PKRBT,while the combination group received adjuvant treatment with intraoperative injection of gemcitabine.All patients underwent a one-year follow-up to compare the short-term efficacy and prognosis of the two groups of patients.【Results】Under different treatment regimens,the YKL-40 and DKK-1 levels in the combination group were 50.25±10.36 ng/mL and 6.62±1.45 ng/mL,lower than the surgical group(55.38±10.72 ng/mL and 8.65±2.82 ng/mL).The CEA,AFP,and sICAM1 of the combination group after treatment were 255.65±20.33 ng/mL and 345.25±30.36μg/L,411.24±40.62μg/L,lower than the surgical group(270.33±20.41 ng/mL,368.72±30.61μg/L,441.36±40.27μg/L).The ORR and DCR of the combination group after treatment were 77.78%(35/45)and 88.89%(40/45),higher than those of the surgical group[55.56%(25/45)and 62.22%(28/45)].The PFS and OS of the combination group within one year were 10.25±2.21 months and 11.36±2.41 months,higher than those of the surgical group(8.14±1.65 months and 9.29±1.33 months),with a relapse rate of 17.78%(8/45)lower than 33.33%(15/45)of the surgical group.The scores of physical function,psychological function,social function,common symptoms,and side effects in the QLICP-BL scale of the combination group were 35.25±5.11 points,40.32±5.29 points,35.26±5.22 points,and 30.23±5.18 points,higher than those in the surgical group(32.11±5.46 points,37.45±5.25 points,32.28±5.21 points,and 27.44±5.13 points)(P<0.05).【Conclusion】Multi point injection of gemcitabine through the bladder mucosa during PKRBT in NMIBC patients can effectively improve their short-term efficacy,improve their short-term prognosis,reduce the risk of disease recurrence,and improve their quality of life.
作者
李伟
秦建瑞
LI Wei;QIN Jianrui(Department of Urology,Luoyang Dongfang People's Hospital(Third Affiliated Hospital of Henan University of Science and Technology),Luoyang,Henan 471000,China)
出处
《中国医学工程》
2024年第11期55-59,共5页
China Medical Engineering
基金
河南省医学科技攻关项目(LHGJ20210161)。
关键词
非肌层浸润性膀胱癌
经尿道等离子膀胱肿瘤切除术
吉西他滨
近期疗效
短期预后
non-muscle invasive bladder cancer
transurethral plasmakinetic resection of bladder tumor
gemcitabine
recent efficacy
short term prognosis
