免疫毒素膀胱灌注预防膀胱癌复发的临床研究

目的 评价免疫毒素在预防膀胱癌复发中的价值。方法 用免疫组化ＳＰ法检测抗人膀胱癌单克隆抗体（ＢＤＩ－Ｉ）与蓖麻毒素（ＲＴ）偶联制备的免疫毒素（ＢＤＩ－１－ＲＴ）与３８例不同分级分期膀胱移行细胞癌组织标本的结合活性。膀胱移行细胞癌患者术后３１例膀胱灌注ＢＤ－１－ＲＴ为实验组，３６例使用丝裂霉素Ｃ为对照组，观察二组疗效及副作用。以ＥＬＩＳＡ法检测实验组７例人抗鼠抗体（ＨＡＭＡ）。结果 ３１例（８２％）

An evaluation of intravesical immunotoxin to preveut the recurrence of bladder cancer

Objective To evaluate the intravesical application of immunotoxin as an adjuvant therapy to prevent recurrence after tumor resection in bladder cancer patients. Methods The immunoreacti- vity of BDI-1-RT with human bladder cancer tissue in different grades and stages was detected by immunohistochemical analysis. Intravesical administration of BDI-1-RT was applied to 31 patients whereas mitomycin (MMC) used in 36 patients serving as controls. The recurrence rates and the side-effects in both groups were observed. The development of human anti-mouse antibodies (HAMA) was assessed by ELISA. Results BDI-1-RT had immunoreactivity with 82% of bladder transitional cell carcinoma. The immunoreactivity of BDI-1-RT correlated with the tumor grade. High grade carcinoma had stronger stai- ning than low grade one ( P <0.05). There was no significant difference ( P >0.05) between BDI-1-RT groups ( 10.0 %) and MMC group (19.3%) in the recurrence rate. Side-effects were more frequent in the MMC group (11 of 36 patients versus 2 of 31, P <0.05). HAMA was not detected in any of 7 patients. Conclusions Immunotoxin may have some potential in the prophylaxis of bladder transitional cell carcinoma.