二次电切联合盐酸吡柔比星膀胱灌注治疗高危非肌层浸润性膀胱尿路上皮癌疗效观察

目的探讨经尿道二次气化电切联合盐酸吡柔比星（THP）膀胱灌注治疗高危非肌层浸润性膀胱尿路上皮癌的疗效。方法选取2007年6月至2012年3月该院收治的已行第1次经尿道膀胱肿瘤电切术的高危非肌层浸润性膀胱尿路上皮癌患者68例,所有患者术后1周内给予盐酸THP 30 mg膀胱灌注,每周1次,连续10周。术后6周将患者随机分为对照组和治疗组,各34例。对照组患者继续采用盐酸THP膀胱灌注化疗,治疗组患者行第2次经尿道气化电切术,术后采用盐酸THP膀胱灌注。随访2年,观察比较两组患者肿瘤复发率。结果治疗组患者膀胱肿瘤的复发率14.71%（5/34）]较对照组35.29%（12/34）]显著降低,差异有统计学意义（P〈0.05）。至随访截止时,治疗组继续随访肿瘤复发率27.27%（9/33）]显著低于对照组71.88%（23/32）],差异有统计学意义（P〈0.05）,但两组进展为肌层浸润肿瘤的发生率比较,差异无统计学意义（P〉0.05）。结论经尿道二次气化电切联合THP膀胱灌注治疗高危非肌层浸润性膀胱尿路上皮癌,可显著降低肿瘤复发率,改善患者预后。

Clinical observation of second transurethral resection combined with intravesical instillation with pirarubicin hydrochloride in treatment of high-risk non-muscle invasive uroepithelium cell carcinoma of bladder

Objective To probe the clinic effects of second transurethral resection combined with intravesical instillation with pirarubicin hydrochloride THP in treatment of high-risk non-muscle invasive uroepithelium cell carcinoma of bladder （NMIUCCB）. Methods A total of 68 patients with high-risk NMIUCCB who had first transurethral resection in this hospital from Jun. 2007 to Mar. 2012 were treated with intravesical instillation with 30 mg pirarubicin hydrochloride in a week after operation, once for a week,lasting 10 weeks continuously. At 6 weeks after the operation, the patients were randomly divided into the control group and the treatment group, 34 of each group. The patients in the control group were treated with chemotherapy of intravesical instillation with pirarubicin hydrochloride while the treatment group with second transurethral resection combined with intravesical instillation. In the 2-year follow up, the tumor recurrence rate of the patients of the two groups were observed and compared. Results There was a significant reduction in the recurrence rate14.71% （5/34）] of human bladder tumor in the treatment group compared with that 35.29% （12/34）]of the control group （P〈0.05）. Up to the lasted follow-up day,the recurrence rate27.27% （9/33）] of human bladder tumor in the treatment group was obviously lower than that71.88% （23/32）] of the control group during the follow- up （P〈0.05）, however, there was no significant difference in growing to be muscle invasive uroepithelium cell carcinoma of bladder between the two groups （P〉0.05）. Conclusion The treatment of second transurethral resection combined with intravesical instillation with pirarubicin hydrochloride in treatment of high-risk non-muscle invasive uroepithelium cell carcinoma of bladder may effectively decrease the recurrence rate of tumor and improve their prognosis conditions.