聚维酮联合吡柔比星膀胱灌注预防浅表膀胱癌复发的初步研究

目的探讨聚维酮联合吡柔比星膀胱灌注预防浅表膀胱癌复发的疗效及抗肿瘤免疫.方法选择52例浅表膀胱癌患者,采用术前24～48h及术后膀胱灌注.其中观察组34例,以聚维酮作为吡柔比星的溶剂行膀胱灌注化疗;对照组18例,以生理盐水作为吡柔比星的溶剂行膀胱灌注化疗.镜下观察两组肿瘤切除标本间质中的淋巴细胞分布并计数,免疫组化法检测S-100和CD28的表达.结果随访5～26个月,观察组复发2例,复发率5.8%;血尿4例,膀胱刺激症6例(17.6%).对照组复发2例,复发率11%;血尿3例(16.7%),出现膀胱刺激症8例(44%).观察组淋巴细胞的计数、S-100和CD28表达明显高于对照组(P＜0.05).结论聚维酮联合吡柔比星膀胱灌注预防浅表膀胱癌复发有良好疗效,副作用少;免疫细胞集结分布和增强表达提示聚维酮可能增强机体的抗肿瘤免疫.

Intravesical instillation of polyvinyllpyrrolidone (PVP) combined with pirarubicin (THP) in prevention of postoperative recurrence of superficial bladder cancer

Objective To investigate the effects of intravesical instillation of polyvinylpyrrolidone com-bined with pirarubicin(PVP/THP)in prevention of postoperative recurrence of superficial bladder cancer.Methods Fifty-two patients with superficial bladder cancer received intravesical instillation before and after tumor resection.Among them34cases were instilled with THP(20mg)dissolved in10ml NS 20ml PVP(PVP/THP group);another18cases were instilled with THP(20mg)dissolved in30ml NS(control group).Lympho-cyte count in the interstitials of tumor was performed under light microscopy,S-100and CD28expression was examined immunohistochemically in tumor tissue.Results All52cases were followed up.In PVP/THP group,recurrence was found in2cases(5.8%),bladder irritation in6cases(17.6%)and hemoturia in4cases.In control group,recurrence was found in2cases(11%),bladder irritation in8cases(44%)and hemoturia in3cases(16.7%).Conclusion Intravesical instillation of PVP/THP is effective for prevention of postoperative re-currence of superficial bladder cancer with less side effects.and the enhancement of antitumor immunoresponse as well.[