PDF(Pubmed)
Abstract：
UNASSIGNED: To evaluate the clinical value of intravesical gemcitabine combined with immunotherapy in patients with non-muscle-invasive bladder carcinoma (NMIBC) after transurethral resection of bladder tumor (TURBT).
UNASSIGNED: Eighty patients with non-muscle-invasive urothelial carcinoma treated in Baoding No.1 Hospital from November 2016 to November 2019 were randomly divided into two groups, with 40 patients in each group. Both groups underwent TURBT. After surgery, the research group was treated with intravesical chemotherapy using gemcitabine combined with ubenimex, while the control group was given 40 mg pirarubicin by intravesical instillation. Postoperative condition was evaluated by cystoscopy every three months in both groups. The recurrence six months, one year and two years after treatment, the incidence of lower urinary tract symptoms such as dysuria, hematuria and frequent urination, general adverse drug reactions such as rashes, liver function damage and gastrointestinal reaction, as well as the changes in CD3+, CD4+, CD8+ and CD4+/CD8+ T lymphocyte subsets before and after treatment were comparatively analyzed between the two groups.
UNASSIGNED: The recurrence rate showed no statistical significance between the two groups 6 months after treatment (p=0.17), but significant differences one year (p=0.04) and two years (p=0.03) after treatment, which were significantly lower in the research group than the control group. The incidence of adverse drug reactions was 22.5% in the research group and 7.5% in the control group, without significant difference (p=0.36). The incidence of lower urinary tract symptoms was 32.5% and 55%, respectively, in the research group and the control group. The incidence of lower urinary tract symptoms in the research group was significantly lower compared with the control group, with a statistically significant difference (p=0.04). After treatment, CD3+, CD4+ and CD4+/CD8+ levels in the research group increased significantly than those in the control group, with statistically significant differences (CD3+, p=0.01; CD4+, p=0.00; CD4+/CD8+, p=0.00).
UNASSIGNED: For NMIBC patients receiving bladder-preserving surgery, intravesical gemcitabine combined with immunotherapy can reduce the recurrence rate, relieve lower urinary tract symptoms, increase the tolerance of patients to intravesical chemotherapy and significantly improve the function of T lymphocytes, without obvious increase in adverse drug reactions. Therefore, it is safe and effective, and has certain clinical value.
UNASSIGNED: Eighty patients with non-muscle-invasive urothelial carcinoma treated in Baoding No.1 Hospital from November 2016 to November 2019 were randomly divided into two groups, with 40 patients in each group. Both groups underwent TURBT. After surgery, the research group was treated with intravesical chemotherapy using gemcitabine combined with ubenimex, while the control group was given 40 mg pirarubicin by intravesical instillation. Postoperative condition was evaluated by cystoscopy every three months in both groups. The recurrence six months, one year and two years after treatment, the incidence of lower urinary tract symptoms such as dysuria, hematuria and frequent urination, general adverse drug reactions such as rashes, liver function damage and gastrointestinal reaction, as well as the changes in CD3+, CD4+, CD8+ and CD4+/CD8+ T lymphocyte subsets before and after treatment were comparatively analyzed between the two groups.
UNASSIGNED: The recurrence rate showed no statistical significance between the two groups 6 months after treatment (p=0.17), but significant differences one year (p=0.04) and two years (p=0.03) after treatment, which were significantly lower in the research group than the control group. The incidence of adverse drug reactions was 22.5% in the research group and 7.5% in the control group, without significant difference (p=0.36). The incidence of lower urinary tract symptoms was 32.5% and 55%, respectively, in the research group and the control group. The incidence of lower urinary tract symptoms in the research group was significantly lower compared with the control group, with a statistically significant difference (p=0.04). After treatment, CD3+, CD4+ and CD4+/CD8+ levels in the research group increased significantly than those in the control group, with statistically significant differences (CD3+, p=0.01; CD4+, p=0.00; CD4+/CD8+, p=0.00).
UNASSIGNED: For NMIBC patients receiving bladder-preserving surgery, intravesical gemcitabine combined with immunotherapy can reduce the recurrence rate, relieve lower urinary tract symptoms, increase the tolerance of patients to intravesical chemotherapy and significantly improve the function of T lymphocytes, without obvious increase in adverse drug reactions. Therefore, it is safe and effective, and has certain clinical value.
摘要：
■评价膀胱内吉西他滨联合免疫治疗在非肌层浸润性膀胱癌(NMIBC)经尿道膀胱肿瘤电切术(TURBT)后的临床价值。
■选取2016年11月至2019年11月保定市第一医院收治的非肌层浸润性尿路上皮癌患者80例，随机分为两组，每组40例。两组均接受TURBT。手术后,研究组采用吉西他滨联合乌苯美司膀胱灌注化疗,对照组给予吡柔比星40mg膀胱灌注。两组患者术后每3个月进行膀胱镜检查。6个月后复发,治疗后一年和两年，下尿路症状如排尿困难的发生率，血尿和尿频，一般药物不良反应，如皮疹，肝功能损害和胃肠道反应，以及CD3+的变化，CD4+,比较两组患者治疗前后CD8+、CD4+/CD8+T淋巴细胞亚群的差异。
■两组治疗后6个月复发率无统计学意义(p=0.17)。但治疗后一年(p=0.04)和两年(p=0.03)有显著差异，研究组明显低于对照组。研究组药物不良反应发生率为22.5%,对照组为7.5%,无显著性差异(p=0.36)。下尿路症状的发生率分别为32.5%和55%,分别,研究组和对照组。研究组下尿路症状发生率明显低于对照组,具有统计学上的显著差异(p=0.04)。治疗后,CD3+,研究组CD4+和CD4+/CD8+水平明显高于对照组,差异有统计学意义(CD3+，p=0.01;CD4+,p=0.00;CD4+/CD8+,p=0.00)。
■对于接受膀胱保留手术的NMIBC患者，吉西他滨联合免疫治疗可降低复发率,缓解下尿路症状，增加患者对膀胱灌注化疗的耐受性，显著改善T淋巴细胞功能，无明显的药物不良反应增加。因此,它是安全有效的，具有一定的临床应用价值。
■选取2016年11月至2019年11月保定市第一医院收治的非肌层浸润性尿路上皮癌患者80例，随机分为两组，每组40例。两组均接受TURBT。手术后,研究组采用吉西他滨联合乌苯美司膀胱灌注化疗,对照组给予吡柔比星40mg膀胱灌注。两组患者术后每3个月进行膀胱镜检查。6个月后复发,治疗后一年和两年，下尿路症状如排尿困难的发生率，血尿和尿频，一般药物不良反应，如皮疹，肝功能损害和胃肠道反应，以及CD3+的变化，CD4+,比较两组患者治疗前后CD8+、CD4+/CD8+T淋巴细胞亚群的差异。
■两组治疗后6个月复发率无统计学意义(p=0.17)。但治疗后一年(p=0.04)和两年(p=0.03)有显著差异，研究组明显低于对照组。研究组药物不良反应发生率为22.5%,对照组为7.5%,无显著性差异(p=0.36)。下尿路症状的发生率分别为32.5%和55%,分别,研究组和对照组。研究组下尿路症状发生率明显低于对照组,具有统计学上的显著差异(p=0.04)。治疗后,CD3+,研究组CD4+和CD4+/CD8+水平明显高于对照组,差异有统计学意义(CD3+，p=0.01;CD4+,p=0.00;CD4+/CD8+,p=0.00)。
■对于接受膀胱保留手术的NMIBC患者，吉西他滨联合免疫治疗可降低复发率,缓解下尿路症状，增加患者对膀胱灌注化疗的耐受性，显著改善T淋巴细胞功能，无明显的药物不良反应增加。因此,它是安全有效的，具有一定的临床应用价值。
