| 齐磊 卢洪凯 都靖 王梅利 王永传 刘海涛 夏术阶.TURis-Bt 术前膀胱灌注表柔比星治疗NMIUC 的临床疗效观察[J].,2014,14(16):3097-3101 |
| TURis-Bt 术前膀胱灌注表柔比星治疗NMIUC 的临床疗效观察 |
| Observation on the Clinical Effect of Preoperative Epirubicin IntravesicalChemotherapy Combined TURis-Bt in the Treatment of Non-muscle-invasiveUrothelial Carcinoma of the Urinary Bladder |
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| DOI： |
| 中文关键词: 表柔比星 TURis-Bt 膀胱灌注 非肌层浸润性膀胱癌 |
| 英文关键词: Epirubicin TURis-Bt Superficial bladder cancer NMIUC |
| 基金项目:潍坊市科学技术发展计划项目(20112028) |
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| 中文摘要: |
| 目的：探讨TURis-Bt 术前膀胱灌注表柔比星治疗非肌层浸润性膀胱癌(NMIUC)的临床疗效。方法：选取2008 年9 月至
2012 年1 月潍坊市中医院和上海交通大学附属第一人民医院泌尿外科收治的76 例NMIUC 患者，并将其随机分为观察组
(TURis-Bt 术前膀胱灌注表柔比星+术后常规灌注组)41 例和对照组(TURis-Bt 术后常规表柔比星膀胱灌注组)35 例。灌注前将
50mg表柔比星溶解于50ml 5%葡萄糖注射液，术前膀胱保留灌注30 分钟后膀胱镜观察肿瘤组织及周围膀胱粘膜染色情况，将表
柔比星橙染的膀胱粘膜活检并行TURis-Bt；对照组取瘤旁2 cm处及其他部位膀胱粘膜多点活检。比较两组的原位癌(CIS)、非典
型性增生及腺性膀胱炎等病变检出率和术后肿瘤的复发率。结果：观察组患者瘤旁膀胱粘膜橙染56 处，其中7 处病理证实为膀
胱原位癌、5 处为非典型性增生、11 处为腺性膀胱炎；对照组患者膀胱原位癌1 处、非典型性增生3 处、腺性膀胱炎2 处，两组病
变阳性率分别为41.1％(23/56)和13.4％(17/127)，差异有显著统计学意义(P<0.01)。观察组与对照组术后2 年内肿瘤复发率分别为
10.3%(4/39)和35.3%(12/34)，差异有统计学意义(P<0.05)。结论：TURis-Bt 术前膀胱灌注表柔比星能提高NMIUC病变的早期检出
率并降低肿瘤术后复发率。 |
| 英文摘要: |
| Objective: To evaluate the clinical effect of preoperative Epirubicin (Pharmorubicin) intravesical instillation before
TURis-Bt in the treatment of non-muscle-invasive urothelial carcinoma of the urinarybladder (NMIUC).Methods:76 patientswith NMIUC
(Ta/T1) were randomly assigned to two groups: observation group (41 cases) was treated with TURis-Bt combined preoperative Epirubicin
intravesical instillation (50mg in 50ml 5%GS) and postoperative instillation, the control group (35 cases) was treated with TURis-Bt
combined postoperative intravesical instillation with Epirubicin. The positive rate of malignant diagnosis and the postoperative recurrence
rate were compared between the two groups.Results:There were 56 positive results with 7 pathological sections proved to be CIS, 5
atypical hyperplasia and 11 glandular cystitis in the observation group, and the others were chronic cystitis. There were 1 case of CIS, 3
cases of atypical hyperplasia and 2 cases of glandular cystitis in the control group, the others were chronic cystitis. Two groups of lesions
positive rates were 41.1％(23/56)and 13.4％(17/127). The significant difference was statistically significant (P<0.01). The 2-year tumor
recurrence rates of observation group and control group were respectively 10.3%(4/39)and 35.3%(12/34). Which was significantly lower
in the observation group(P<0.05).Conclusion:Preoperative Epirubicin intravesical chemotherapy combined TURis-Bt could enhance the
diagnostic rate of CIS and atypical hyperplasia and reduce the malignant recurrence of NMIUC. |
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