A randomized controlled study to compare 1-hexylcarbamoyl-5-fluorouracil (HCFU) and 1-(2-tetrahydrofuryl)-5-fluorouracil (Tegafur) for the prevention of post-operative recurrence of bladder cancer

To evaluate the effect of 1-hexylcarbamoyl-5-fluorouracil (HCFU), a derivative of 5-fluorouracil (5-FU), in preventing postoperative recurrence of bladder cancer, a randomized controlled study with 1-(2-tetrahydrofuryl)-5-fluorouracil (Tegafur) as the reference standard was performed. HCFU was given orally 600 mg a day and Tegafur was given orally, 800 mg a day. The following results were obtained: Of 103 patients, 51 were given HCFU and 52 Tegafur, the non-recurrence rate in the group treated with HCFU was 70.8% after 1 year and 54.9% after 2 years of follow up, and that of the group treated with Tegafur was 56.5% and 46.2% respectively. The rate of non-recurrence in the HCFU group was significantly higher (p less than 0.01) than that of the Tegafur group during the period of follow up between 450 and 539 days. Of the 87 patients, who took the drugs for more than 90 days, the rate of non-recurrence in 43 patients receiving HCFU was 79.2% after 1 year and 60.4% after 2 years, compared to 62.5% and 50.0% respectively for 44 patients receiving Tegafur. The non-recurrence rate of the HCFU group was also significantly higher than that of the Tegafur group in the period between 450 and 539 days after operation (p less than 0.05). The incidence of side effects was 35.6% and 51.7% in HCFU and Tegafur patients, respectively. No significant difference of side effects was found between HCFU and Tegafur.     

膀胱癌组织中Ki-67、p63的表达与肿瘤复发的关系

目的:探讨浅表性膀胱癌组织学形态以及Ki67、p63表达与肿瘤复发的关系。方法:将3年来随访的60例浅表性膀胱癌分为复发组和无复发组。免疫组化法检测Ki-67和p63的表达并比较复发组与无复发组的差异。结果:在平均28个月的随访中,40例复发,复发1~4次,Ki-67和p63阳性率在两组之间有明显差别,复发组均明显高于无复发组(P<0.05)。在不同病理分级TCC中p63和Ki-67表达有明显差异,病理分级高的明显高于分级低的(P<0.01)。结论:Ki-67、p63阳性表达尤其是联合阳性表达对判断膀胱癌复发具有重要意义。     

预防膀胱肿瘤术后复发的临床研究

目的 探讨不同方法预防膀胱肿瘤术后复发的效果,降低膀胱肿瘤复发率。方法对１９８２～１９９７年间采用膀胱灌注ＢＣＧ、丝裂霉素Ｃ（ＭＭＣ）、噻替呱、口服中药猪苓煎剂、后装腔内放疗５ 不同方法预防膀胱肿瘤复发,评价其效果。结果 随访２～１５年,其复发率分别为ＢＣＧ组３５．１％,猪苓３４．９％,ＭＭＣ组４１．７％,噻替呱组５２．６％,空白对照组６４．７％。后装放疗组处理高危性膀胱癌２５例,随访１２～４２个     

浅表膀胱癌TURBt术后吡柔比星膀胱保留灌注化疗预防复发的随访研究

目的随访观察浅表膀胱癌经尿道膀胱肿瘤电切术（TURBt）后毗柔比星膀胱保留灌注化疗对干预膀胱癌复发的影响。方法选取浅表膀胱癌TURBt术后患者109例,分为观察组62例和对照组47例。术后,对照组未给予膀胱保留灌注化疗,观察组予以膀胱保留灌注吡柔比星治疗．随访2年．观察两组的复发率,以及观察组膀胱保留灌注化疗的不良反应。结果术后3～6个月内,对照组膀胱癌复发率呈下降趋势,此后呈逐渐升高的趋势;观察组各时间段内膀胱癌复发率基本呈现降低趋势;两组累积复发率均呈逐渐升高的趋势,但观察组累积复发率升高趋势平缓,而对照组累积复发率升高趋势急剧。各时间段内观察组膀胱癌复发率、累积复发率均低于对照组（P〈0．05）。结论吡柔比星膀胱保留灌注化疗有效降低了浅表膀胱癌TURBt术后膀胱癌的复发率,且未出现严重的不良反应,临床应用比较安全,对预防TURBt术后膀胱癌复发具有积极而重要的干预意义。     

Comparative study on prophylactic intravesical instillation of bacillus Calmette-Guerin (BCG) and adriamycin for superficial bladder cancers

In this study we evaluated 77 patients with superficial bladder cancer who were treated with either intravesical bacillus Calmette-Guerin (BCG) (44 patients) or doxorubicin hydrochloride (Adriamycin, ADR) (33 patients) for prophylaxis of tumor recurrence after transurethral resection. The estimated actuarial probability of non-recurrence rate at three years for the BCG group was 73.0%, and the actuarial non-recurrence rate for the ADR group was 27.3%; a statistically significant difference (p = 0.0013). A comparison between the two groups was also made according to the patient's background, including whether the tumor was initial or recurrent, solitary or multiple, and the tumor grade. In all areas of the study, except for grade-1 tumors, the BCG group was significantly superior to the ADR group. The efficacy of BCG therapy as a result of different BCG treatment protocol was evaluated for six weekly instillations 1) without further maintenance instillation, 2) followed by 12 months of maintenance, and 3) followed by more than 18 months of maintenance. Long-term maintenance BCG instillation group (more than 18 months) showed the most favorable results, however, the differences were not statistically significant. These results indicate that intravesical BCG instillation was significantly superior to ADR in the prevention of bladder cancer recurrence and that six weekly intravesical BCG instillations may provide adequate prophylactic effects against recurrence of superficial bladder cancers.     

吡柔比星术后即刻膀胱灌注联合常规灌注预防表浅性膀胱癌术后复发的对照研究

目的：比较吡柔比星两种膀胱内灌注方法预防表浅性膀胱癌术后复发的有效性及安全性。方法：将52例经尿道膀胱癌电切术后表浅性膀胱癌患者随机分为两组。每次吡柔比星灌注剂量30mg,治疗组术后24h内膀胱灌注1次,此后每周灌注1次,连续8周,再改为每月灌注1次,至术后1年。对照组术后2周开始灌注,此后每周灌注1次,连续8周,再改为每月灌注1次,至术后1年。结果：全部病例均获随访,时间为12～24个月,平均随访16．3个月。其中治疗组随访期内2例复发,复发率8％;对照组随访期内4例复发,复发率14％,两组复发率比较差异有统计学意义（P〈0．05）,不良反应主要为尿路刺激症状。结论：本研究显示,吡柔比星膀胱灌注预防表浅性膀胱癌术后复发的疗效满意,用药方便,患者耐受性好;术后即刻膀胱灌注联合常规灌注较常规灌注可以降低肿瘤复发率,值得推荐。     

Prophylactic effect of UFT in combination with intravesical chemotherapy on the recurrence of superficial bladder tumor]

The influence of N1-(2-tetrahydrofuryl)-5-fluorouracil plus uracil (UFT) on the recurrence of superficial bladder tumors was evaluated in a randomized clinical study. Group A (n = 196) underwent transurethral resection (TUR) and the intravesical chemoprophylaxis, while group B (n = 193) received 400 mg per a day of UFT orally for 6 months in addition to the instillation therapy. These adjuvant therapy was started one week after TUR. Consequently, 30 patients in group B showed UFT-related toxicity and administration of UFT was discontinued in 10 of them. In addition, 87 patients in group B did not complete the 6-month course of UFT administration. Comparison of 2-year actuarial non-recurrence curves revealed no significant difference between groups A and B. However, UFT seemed to have a favorable prophylactic effect when recurrence rates were compared among those patients with recurrent tumors (generalized Wilcoxon: p = 0.1277), and those with recurrent multiple tumors (p = 0.0847).     

5 years intravesical instillation with mitomycin-C and pirarubicin as a prophylactic treatment for superficial bladder cancer

PURPOSE: We studied prophylactic intravesical instillation of mitomycin C (MMC) and pirarubicin (THP) following transurethral resection of bladder tumor (TUR-Bt) for superficial bladder cancer. MATERIALS AND METHODS: Forty-six evaluable patients were administered intravesically 20 mg of MMC dissolved in 20 ml saline on day 1 and 20 mg of THP dissolved 20 ml 5% dextrose on day 2. The patients were followed up by cystscopy and urinary cytology. Intravesical instillations were performed once a month and continued for 5 years. RESULTS: The non-recurrence rates at 1, 3 and 5 years were 88.8%, 79.5% and 67.0%, respectively. No significant differences were observed between grade 1-2 and 3, male and female, and solitary and multiple tumors. Although the side effects were relatively mild, 6 patients were stopped intravesical instillation. CONCLUSIONS: Because non-recurrence rates of our report is not better than previous reports with shorter treatment periods, intravesical MMC and THP instillation for 5 years is not beneficial to the patients with superficial bladder cancer.     

Efficacy of oral UFT as adjuvant chemotherapy to curative resection of colorectal cancer: multicenter prospective randomized trial

BACKGROUND: The purpose of this study is to evaluate the efficacy of postoperative adjuvant chemotherapy using uracil and tegafur (UFT) for colorectal cancer. METHODS: In a multicenter trial among 43 institutions for patients who underwent curative resection of Dukes' B or C colorectal cancer, a surgery alone group (control group) and a treatment group (UFT group) to which UFT was administered at 400 mg/day for 2 years following surgery were compared. A total of 320 patients were registered between March 1991 and April 1994, and 289 of these patients were analyzed as a full-analysis set. RESULTS: The 5-year disease-free survival rate was 75.7% in the UFT group and 60.1% in the control group, respectively, and the stratified log-rank test showed the statistical significance ( P=0.0081). This difference was marked in rectal cancer ( P=0.0016) and, in particular, the local recurrence was reduced. No significant difference was observed in the 5-year survival rate. The incidence of adverse reactions on administration of UFT was low, and there was no serious adverse reaction. CONCLUSION: It is suggested that the consecutive administration of UFT at 400 mg/day was an effective and highly safe therapeutic method as postoperative adjuvant chemotherapy for rectal cancer.     

ERCC1和RRM1基因与膀胱肿瘤临床特征及非肌层浸润性膀胱肿瘤吉西他滨膀胱灌注疗效的关系

目的探讨核苷酸切除修复交错互补基因1（ERCC1）和核糖核苷酸还原酶M1（RRM1）基因在膀胱肿瘤的表达情况及其与非肌层浸润性膀胱癌肿瘤经膀胱灌注吉西他滨的疗效的关系。 方法回顾性总结2014年07月至2018年07入我院经病理证实膀胱癌患者共86例,其中非浸润型50例,浸润型36例,同期选择30例膀胱良性肿瘤;采用实时荧光定量PCR检测膀胱癌组织ERCC1和RRM1 mRNAs定量表达水平。随访时间15～63个月,中位时间41.5个月,记录非浸润型患者的无进展生存时间（PFS）、中位生存期、总复发率和生存率,分析ERCC1和RRM1基因表达与灌注效果的相关性。 结果与膀胱良性肿瘤组患者比较,膀胱癌患者肿瘤组织RRM1呈高表达,ERCC1呈低表达,并且浸润型患者RRM1明显高于非浸润型,ERCC1明显低于非浸润型（P<0.05）。并且,肿瘤组织ERCC1和RRM1表达水平与肿瘤分期和分级密切相关（P<0.05）,而与患者性别、年龄、肿瘤直径无关（P>0.05）。针对非浸润型患者灌注后共复发7例（14.0%）,复发组患者肿瘤组织RRM1表达水平明显高于无复发组,而ERCC1水平明显低于无复发组（P<0.05）。 结论膀胱癌患者肿瘤组织ERCC1低表达和RRM1高表达不仅与肿瘤分期和病理分级密切相关,还与吉西他滨的灌注疗效有关;检测ERCC1和RRM1表达对早期预测灌注效果,延长患者生存时间具有重要的参考价值。     

A randomized study of prophylactic intravesical instillation of pirarubicin (THP) prior to transurethral resection of superficial bladder cancer

A prospective randomized study was conducted to evaluate the efficacy of prophylactic intravesical instillation of pirarubicin (THP) prior to transurethral resection (TUR) of superficial bladder cancer. A total of 63 patients were randomized into two groups, the THP group and the control group. In the THP group, 30 mg of THP dissolved in 50 ml saline was administered 4 times intravesically for 4 consecutive days before TUR. In the control group, no instillation was performed before TUR. The patients were followed by cystoscopy and urinary cytology every 3 months. The non-recurrence rates in the THP group and control group were 54.1% versus 37.6% at 1 year and 40.4% versus 26.8% at 2 years, respectively (P = 0.086). Time to recurrence for tumors larger than 1 cm was significantly longer in the THP group (P = 0.0137). Time to recurrence for single and grade 1+2 tumors tended to be longer in the THP group (P = 0.09, P = 0.079). No significant adverse effects were observed in any patient. Our findings suggest that intravesical THP instillation prior to TUR would be effective for patients with single, low grade lesions larger than 1 cm of superficial bladder cancer.     

中国病人内镜取石后胆总管结石复发相关危险因素的Meta分析

目的用循证医学的方法探讨中国病人内镜取石后胆总管结石复发的相关危险因素,为预测和预防结石复发提供理论依据。方法检索中国知网、维普和万方等数据库,收集自建库至2016年12月期间公开发表的有关内镜取石后胆总管结石复发危险因素的相关文献,运用固定或随机模型对各个因素进行合并分析。结果共纳入11项研究,6 137例内镜治疗病人。Meta分析结果显示,复发组中有胆道手术史的病人比例高于未复发组(OR=8.70,95%CI:5.22~14.50;P0.01);复发组中有乳头旁憩室的病人比例高于未复发组中的病人(OR=3.14,95%CI:2.32~4.25;P0.01);复发组中多发结石的病人比例高于未复发组(OR=1.57,95%CI:1.11~2.22;P0.05);复发组中结石直径10 mm的病人比例高于未复发组(OR=7.12,95%CI:4.98~10.19;P0.01);复发组中碎石的病人比例高于未复发组(OR=2.03,95%CI:1.66~2.49;P0.01)。结论既往有胆道手术史、合并乳头旁憩室、多发结石、结石直径10 mm和机械碎石是内镜治疗后胆总管结石复发的危险因素。     

E—cd在膀胱移行细胞癌中的表达及意义

本文用E-cd单克隆抗体对57例膀胱移行细胞癌及7例正常粘膜的石蜡标本进行了免疫组化研究。结果E-cd在不同分期及分级膀胱癌中的表达均有显著性差异(P<0.05)。E-cd在复发与未复发组膀胱癌中表达亦有显著性差异(P<0.01)。随访发现E-cd表达与患者生存率有显著关系(P<0.01)。提示E-cd表达可以作为判断膀胱癌恶性程度及复发和预后的生物学指标。     

The significance of urine cytology three consecutive days after transurethral resection as a predictor of superficial bladder cancer recurrence

To determine whether there was any correlation between recurrence of superficial bladder cancer and the results of urinary cytology examined for 3 consecutive days after transurethral resection of the bladder cancer (TURBT), we retrospectively studied 64 patients with newly diagnosed Ta/T1 transitional cell carcinoma (TCC) of the bladder who had previously undergone TURBT. Urine cytology samples were reported as negative (class I, II) or positive (class III, IV, V). We used the Kaplan-Meier method to calculate the non-recurrence rate, and Cox-proportional hazard models to determine the prognostic significance of clinical and pathological findings. If any sample among the three consecutive cytology examinations was positive, we defined the case as positive. After a mean follow up of 19.5 months, 22 cases (34.4%) demonstrated recurrence probabilities of 24.1% and 42.3%, at 12 and 24 months, respectively. Of the positive cytology group (n = 33), 15 patients (45.5%) had recurrent tumor, while in the negative group (n = 31), only 7 cases (22.6%) developed recurrence. Multivarite analysis demonstrated that tumor size (p = 0.0022, Hazard ratio 8.9316), result of urine cytology for three consecutive days after TUR (p = 0.0051, Hazard ratio 4.5728), and age (p = 0.0124, Hazard ratio 3.7652) were associated with tumor recurrence. We suggest that positive results on urinary cytology for three consecutive days after TUR are indicative for tumor recurrence.     

Intravesical instillation of bacillus Calmette-Guerin for superficial bladder carcinoma: study on significance of additional maintenance instillations of bacillus Calmette-Guerin

The efficacy of maintenance bacillus Calmette-Guerin (BCG) instillations for superficial bladder tumors was studied by prospective randomized trial. From June 1985 to October 1988, 42 newly diagnosed patients with superficial bladder carcinoma (pTa or pT1) were treated by transurethral tumor resection and subsequent five daily instillations of mitomycin C. Then they were divided into non-maintenance group (22 patients) and maintenance group (20 patients) by randomization. The patients received six weekly instillations of 80 mg of BCG. Tokyo strain (Japan BCG manufacturing Co., Tokyo, Japan), suspended in 40 ml of physiological saline, and the patients in the maintenance group received four additional instillations of BCG every three months. We could not complete the six-week course of BCG instillations in three patients due to adverse effects (two in non-maintenance group and one in maintenance group) and we lost six patients from follow-up within one year (one in non-maintenance group and five in maintenance group). The mean follow-up period of the remaining 33 patients was 28.1 months. Of these 33 patients, six patients had been found to have recurrent tumors, and the over-all three-year non-recurrence rate was 82%. Before employing BCG, when we used only mitomycin C after TUR-Bt, the three year non-recurrence rate was 58%. This indicates prophylactic effect of BCG instillations. The stage of the initial tumor of the six recurrent cases were all pT1b. The non-recurrence rate of the patients with pT1b tumor was significantly lower than that of the patients with pTa and pT1a tumor. However, multiplicity and grade of tumors did not affect the non-recurrence rate.(ABSTRACT TRUNCATED AT 250 WORDS)     

Prophylactic intravesical instillation of mitomycin C and cytosine arabinoside for prevention of recurrent bladder tumors following surgery for upper urinary tract tumors: A prospective randomized study

BACKGROUND: A recurrence of bladder tumors following surgery for transitional cell carcinoma of the upper urinary tract is not rarely observed. A prospective randomized study was conducted to examine the significance of prophylactic intravesical instillation of mitomycin C (MMC) and cytosine arabinoside (Ara-C) to prevent recurrent bladder tumors after surgery for superficial transitional cell carcinoma of the upper urinary tract. METHODS: The patients were randomized into an instillation group, who received postoperative intravesical instillation of MMC (20 mg) and Ara-C (200 mg) 28 times over a period of 2 years, and a non-instillation group. The non-recurrence rate was then compared between the groups. RESULTS: Of the 27 patients registered, 25 patients (13 with instillation and 12 without instillation) were able to be evaluated, with a median follow-up period of 45 months. The non-recurrence rate of bladder tumors in the instillation group was higher than that in the non-instillation group. Although the difference was not statistically significant, the P-value (P = 0.079) demonstrated a strong trend. When any possible bias was allowed for a multivariate analysis, the difference was almost significant (P = 0.0567). No patients withdrew from this study due to any side-effects. CONCLUSION: The postoperative instillation of MMC and Ara-C may be a useful approach for reducing the recurrence of bladder tumors after surgery for upper urinary tract tumors.     

Clinical effect of UFT on urogenital tumors

Clinical study of UFT which was a mixture of FT and uracil, was conducted on 16 patients with urogenital malignancies. Seven patients had renal cell carcinoma, 5 patients had bladder cancer and 4 patients had prostatic cancer. UFT was continuously administrated at doses of 300 mg or 600 mg per day. One of the patients with renal cell carcinoma and 1 of the patients with bladder cancer showed a complete response, and 1 patient with each cancer showed a partial response, but none of the 4 patients with prostatic cancer responded. In total, complete or partial responses were obtained in 4 of the 16 patients, given an effective rate of 25.0%. Concerning side effects, 3 of the 16 patients complained of anorexia, nausea and vomiting, and stomatitis, but no hepatic or renal disorders, or marrow depression was observed.     

趋化因子受体7在膀胱癌组织中的表达及其临床意义

目的 探讨趋化因子受体7(CXCR7)蛋白在膀胱癌中的表达情况,并分析其与临床生物学行为及复发的关系.方法 选择148例膀胱移行细胞癌标本,30例正常膀胱组织标本:肿瘤标本中非肌层浸润性癌104例,肌层浸润性癌44例;G147例、G2 73例、G3 28例;单发肿瘤89例,多发肿瘤59例;非肌层浸润性癌中未复发40例,复发64例.采用LSAB免疫组织化学方法,检测膀胱癌和正常组织中CXCR7蛋白的表达,并结合临床资料进行分析. 结果正常组织中CXCR7蛋白的表达水平为10.0%(3/30),肿瘤组织为85.1%(126/148);单发及多发肿瘤CXCR7蛋白高表达率分别为49.4%(44/89)和71.2%(42/59),G1、G2、G3膀胱癌CXCR7蛋白高表达阳性率分别为34.0%(16/47)、65.8%(48/73)、78.6%(22/28),差异均有统计学意义(P＜0.01).非肌层浸润性肿瘤和肌层浸润性肿瘤中CXCR7蛋白高表达阳性率为51.9%和72.7%,组间差异有统计学意义(P＜0.05).非肌层浸润性膀胱癌中,复发组与未复发组中CXCR7蛋白高表达阳性率为64.1%和32.5%,差异有统计学意义(P＜0.01).Kaplan-Merier曲线显示,CXCR7蛋白高表达组患者和CXCR7蛋白低表达组患者术后无复发生存率比较,差异有统计学意义(P＜0.01). 结论CXCR7蛋白高表达与膀胱移行细胞癌的恶性程度及预后相关,提示CXCR7与膀胱癌的发生发展存在相关性.

Abstract：

Objective To explore the expression of CXCR7 in bladder cancer and analyze its clinical significance and relationship with bladder cancer recurrence. Methods The expressions of CXCR7 protein in 148 specimens of bladder cancer and 30 specimens of normal bladder tissues were detected by immunohistochemical staining and its clinical significance was then analyzed. Results The expression of CXCR7 protein was higher in bladder cancers than in the adjacent normal tissues (P＜0.01). CXCR7 protein expression rates were 49. 4% and 71.2% in mutifocal tumors and unifocal tumors, while 34.0%, 65.8% and 78. 6% in G1, G2, and G3 tumors, respectively (P＜0. 01). Expression of CXCR7 protein was higher in muscle invasive bladder cancers than in non-muscle invasive bladder cancers (72. 7% versus 51.9% ,P＜0.05). In patients followed up for 2-95 months, CXCR7 protein expression was significantly higher in patients with recurrence than with non-recurrence (64. 1% versus 32.5%, P＜0.01). Kaplan-Meier analysis and the log-rark test showed that the recurrence-free survival was significantly different between the group of lower CXCR7 expression group and the higher expression group (P＜0.01). Conclusions The expression of CXCR7 protein is high in bladder cancer and the analysis of CXCR7 protein expression is potentially valuable in prognostic evaluation of bladder cancers. CXCR7 may play a role in the development of bladder urothelial cell cancer.     

膀胱尿路上皮癌组织中HMGA2蛋白表达及其临床意义

目的 探讨高迁移率族蛋白A2(high mobility group protein A2,HMGA2)在膀胱癌组织中的表达情况,并分析其与临床病理特征及复发的关系.方法 膀胱尿路上皮癌标本148例,正常膀胱组织标本30例,采用免疫组织化学方法检测2组标本组织中HMGA2蛋白的表达,并结合临床资料进行分析.结果 正常膀胱组织中无HMGA2蛋白表达,肿瘤组织中随病理分级和分期增加,HMGA2蛋白相对表达量逐渐增高.HMGA2蛋白在G1、G2、G3组织中表达阳性率分别为21.3%、60.3%、82.1%,差异有统计学意义(P＜0.001).非肌层浸润性膀胱尿路上皮癌和肌层浸润性膀胱尿路上皮癌中HMGA2蛋白表达的阳性率分别为43.3%和72.7%,差异有统计学意义(P=0.003).随访2～95个月,复发64例,复发组与未复发组中HMGA2蛋白表达阳性率分别为54.7%和25.0%,差异有统计学意义(P=0.007).结论 HMGA2蛋白表达在膀胱癌组织中明显高于正常组织,HMGA2蛋白表达与膀胱癌的分级、分期、复发有关;与患者年龄、性别、肿瘤数目无相关性.检测HMGA2蛋白有助于膀胱癌的诊断及预后的评估.

Abstract：

Objective This study was to explore the expression and significance of HMA2 in bladder cancer , analyze its correlations to clinicopathologic and recurrence of bladder cancer. Methods The expression of HMGA2 protein in 148 specimens of bladder cancer and 30 specimens of normal bladder tissues was detected by immunohistochemtry, its correlations to clinicopathologic features was analyzed. Results There was no expression of HMGA2 protein in normal bladder tissues,while the expression level of HMGA2 protein was getting higher with the increase of tumor pathology grade and stage. The positive rate of HMGA2 protein was 21.3% in G1 bladder cancer, 60. 3% in G2 bladder cancer, 82.1% in G3 bladder cancer, its difference is significant (P＜0. 001). It was significantly lower in non-muscle invasive bladder cancer than in muscle invasive bladder cancer (43.3% vs 72. 7%, P=0. 003). The patients were followed up for 2～95 months, patients of recurrence was 64,HMGA2 protein expression was significantly higher in patients with recurrence than with non-recurrence (54.7% vs 25.0%, P=0. 007). Conclusions The expression of HMGA2 protein was highly in bladder cancer, the positive rate of HMGA2 protein expression was related with classification,TMN stage and recurrence, but not with sex, age, tumor number (P＞0. 05). The detection of the expression of HMGA2 protein is in favor of diagnosis and prognostic evaluation of bladder cancer.     

Inhibitory effect of Chinese herb medicine zhuling on urinary bladder cancer. An experimental and clinical study

Inhibitory effect of Zhuling (Grifola umbellata pilat) on urinary bladder cancer was determined experimentally and clinically. The results showed that zhuling inhibited significantly the induction of bladder cancer in rats exposed to N-butyl-N-(4-hydroxybutyl) nitrosamine (BBN), decreasing from 100% (18/18) in control group to 61.1% (11/18) in zhuling (P less than 0.01). Zhuling was given to 22 patients with recurrent bladder cancer after TUR or partial cystectomy. The patients were followed up for 12 to 38 months (average 26.5 months). Bladder cancer recurred in seven of the patients with a longer recurrence interval (19.2 months) after medication than before medication (P less than 0.05). The remaining 15 patients had no recurrence. The mechanism of Zhuling is discussed.