二次电切治疗高危非肌层浸润性膀胱癌28例

发布时间：2018-03-19 20:29

本文选题：非肌层浸润性膀胱癌　切入点：二次电切　出处：《实用医学杂志》2015年03期 　论文类型：期刊论文

【摘要】：目的:探讨二次电切(repeat transurethral resection,re-TUR)治疗高危非肌层浸润性膀胱癌(non-muscle invasive bladder cancer,NMIBC)的临床意义。方法 :收集68例首次经尿道电切术(transurethral resection,TUR)诊断为高危NMIBC的患者资料,其中28例2~6周内接受re-TUR(观察组),40例未接受re-TUR(对照组),术后常规吡柔比星膀胱灌注化疗。评估首次TUR肿瘤残留率及病理分期的低估率,并比较两组膀胱肿瘤复发、进展情况。结果:观察组肿瘤残留率为46.43%(13/28),病理分期低估率为21.43%(6/28)。随访12~48个月(平均25个月),观察组肿瘤残留者与无肿瘤残留者的进展率分别为44.44%、6.67%(P0.05);观察组肿瘤总复发率及1、2年内复发率均比对照组低(P0.05),但在进展方面两组无差异(P0.05)。结论:高危NMIBC电切术后肿瘤残留率、复发率、进展率高。re-TUR治疗高危NMIBC不仅在诊断和治疗,而且在预后判断方面都具有临床应用价值,但re-TUR不能够延缓膀胱肿瘤进展,仍需辅助其他方法进行综合治疗。
[Abstract]:Objective: To investigate the two TURP (repeat transurethral resection, re-TUR) for high-risk non muscle invasive bladder cancer (non-muscle invasive bladder cancer, NMIBC) and the clinical significance. Methods: We collected 68 cases of the first transurethral resection (transurethral resection, TUR) diagnosis for patients with high-risk NMIBC data, including 28 cases of 2~6 take re-TUR weeks (observation group), 40 patients received re-TUR (control group), after routine intravesical instillation of pirarubicin chemotherapy. Assessing the TUR tumor residual rate and pathological staging underestimated the rate, and compare the two groups of bladder tumor recurrence and progress. Results: in the observation group, the residual tumor rate was 46.43% (13/28), pathological staging underestimated the rate of 21.43% (6/28). The follow-up of 12~48 months (average 25 months) in the observation group, tumor residual and no tumor residual rate were 44.44%, 6.67% (P0.05); the observation group total tumor recurrence rate and recurrence rate were 1,2 years Lower than the control group (P0.05), but in the progress of no significant difference between two groups (P0.05). Conclusion: high risk NMIBC residual tumor after transurethral resection rate, recurrence rate, high rate of progress of.Re-TUR for high risk NMIBC not only in the diagnosis and treatment, and the judgment has clinical value in prognosis, but re-TUR can not delay bladder tumor progression, still need to assist other methods of treatment.

【作者单位】：广西自治区人民医院泌尿外科;
【基金】：广西卫生厅科研基金项目(编号:Z2010249)
【分类号】：R737.14

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