阿霉素加环孢素膀胱灌注预防膀胱癌术后复发

目的 探讨膀胱癌术后复发率。方法 应用阿霉素加环孢素化疗方案行膀胱腔内灌注化疗预防复发；同时采用免疫组织化学方法检测初发膀胱癌组织４２例标本Ｐ－糖蛋白（Ｐ－ｇｐ）和多药耐受相关蛋白（ＭＲＰ）的表达。结果 ４２例患者应阿霉素和环孢素联合腔内灌注化疗，平均观察２０．４个月。随访期间未复发３８例；４例复发，复发率为９．５２％，病理分级与前次相同。初发膀胱癌中，ＭＲＰ总阳性率为３８．１％，Ｐ－ｇｐ总阳性率为４０．４％。结论 环孢素与细胞毒制剂联合化疗，能不增加毒副作用的同时，增加化疗效果，抑制耐药性的形成，降低复发率，具有广泛的临床应用前景。

Adriamycin plus cyclosporine preventing bladder cancer from postoperation relapse

Objective To reduce bladder cancer relapse after operation. Methods The preliminary therapeutic effects of 42 patients with bladder cancer with no prior exposure to chemotherapeutics drug treated with combined therapy of adriamycin and cyclosprine were observed. At the same time, the P glycoprotein (P gp) and the multidrug resistance associated protein (MRP) expression were determined using immunohistochemistry in the specimens from the 42 patients. Results 42 patients were treated by intravesical installation of combined adriamycin and cyclosprine, following up for 20.4 months. Four cases had recurrence. Recurrence rate was 9.52%, much lower than other intravesical chemotherapy. The MRP positive rate in primary bladder cancers were 38.1%, and the P gp positive rate was 40.4%. Conclusion Combined chemotherapy of adriamycin and cyclosporine can be widely used in the treatment of bladder cancer, can elevate the chemotherapeutic effect while not increasing the side effect, can inhibit the development of MDR and reduce the rate of recurrence.