卡介苗素膀胱灌注预防膀胱癌术后复发的临床研究

目的探讨卡介苗素膀胱内灌注预防膀胱癌术后复发的疗效、安全性．方法47例膀胱癌术后患者分2组。分别应用卡介苗素和卡介苗定期行膀胱内灌注，随访10～32个月，了解灌注后肿瘤复发情况及并发症。并于灌注前、后检测2组尿液中IL－2、IL－6、IL－8的变化情况．结果卡介苗膀胱灌注组肿瘤复发4例（17．4％）。副反应发生18例（78．3％），卡介苗素膀胱灌注组肿瘤复发5例（20．8％）。副反应发生率11例（45．8％），2组尿液中IL－2、IL－6、IL－8值灌注后高于灌注前（P〈0．05）．两组肿瘤复发率、IL-2、IL-6、IL-8值灌注前后比较无显著差异，副反应卡介苗组明显高于卡介苗素组（P〈0．05）．结论卡介苗素膀胱灌注预防膀胱癌术后复发的有效率与卡介苗相同，但不良反应明显减少。患者耐受性好，因此卡介苗素可成为膀胱浅表移行上皮细胞癌临床治疗和预防复发的一种有效药物．

The Clinical study of Intravesical of BCG PSN for Preventing Postoperative Recurrence of Bladder- Cancer

Objective To observe the efficacy and security intravesical instillation of Polysaccharide-nucleic acid fraction of Bacillus Calmette Guerin(BCG PSN) for preventing postoperative recurrence of bladder cancer.Methods Fourty-seven postoperative patients with bladder cancer were divided into two groups to receive intravesical instillation of BCG PSN and Bacillus Calmette-Guerin(BCG) respectively,once a week for six weeks,then once a month to one year.All the patients were followed up for 10-32 months,the tumor recurrence rate and the side effects associated with therapy were observed.and the levels of urinary cytokines interleukin-2(IL-2),cytokines interleukin-6(IL-6),cytokines interleukin8(IL-8) were measured.Results The tumor recurrence rate of BCG groups were 17.4%(4/23),side effects were 78.3%(18/23),and the levels of urinary IL-2,IL-6,IL-8 increased significantly after BCG therapy.The tumor recurrence rate of BCG PSN were 20.8%(5/24),side effects were 45.8%(11/24),and the levels of urinary IL-2,IL-6,IL-8 increased significantly after BCG PSN therapy.The tumor recurrence rate and the levels of urinary IL-2,IL-6,IL-8 after intravesical instillation of the two groups failed to show any significant change. Conclusions Intravesical instillation of BCG PSN for preventing postoperative recurrence of superficial bladder cancer is effective and well tolerated.It is worth to spread in the clinical use.