丝裂霉素与吡柔比星膀胱灌注化疗对膀胱癌术后患者VEGF、FGF及MMP-9水平的影响

摘要

Objective To study the effect of mitomycin and pirarubicin intravesical chemotherapy on VEGF,FGF and MMP-9 level in patients with bladder cancer after surgery.Methods A retrospective analysis of 124 cases bladder cancer patients were conducted.All the patients had transurethral resection.They were divided into the observation group(62 cases)and the control group(62 cases)according to the different treatment methods.The observation group was treated with intravesical pirarubicin.The control group was treated with mitomycin.Serum VEGF,FGF and MMP-9 levels of the 2 groups were compared.Results After the treatment,the serum levels of VEGF,FGF,MMP-9 were significantly lower than those of the control group,the differences were statistically significant(P<0.05).6-,12-,24-,and 36-month survival rates of the observation group were significantly higher than those of the control group,the differences were statistically significant(all P<0.05).12-,24-,and 36-month recurrence rates of the observation group were 3.23％,8.06％,11.29％,which were significantly lower than those of the control group,14.52％,24.19％,35.38％.The differences were statistically significant(P<0.05).There was no significant difference between the 2 groups in the adverse reactions(P>0.05).Conclusion Intravesical instillation of pirarubicin has low impact on the levels of VEGF,FGF and MMP-9 in patients with bladder cancer after operation,and has high survival rate,less postoperative recurrence,low adverse reaction rate,safety and reliability,and is worthy of clinical application.%目的 研究丝裂霉素与吡柔比星膀胱灌注化疗对膀胱癌术后患者VEGF、FGF及MMP-9水平的影响.方法 回顾性分析124例膀胱癌患者的资料,所有患者都经尿道电切术治疗.因治疗方法 不同将患者分成观察组(62例)和对照组(62例).其中观察组给予吡柔比星进行化疗,对照组给予丝裂霉素进行治疗.对比两组患者术后血清血管内皮生长因子(vascular endothelium growth factor,VEGF),成纤维细胞生长因子(fibroblast growth factor,FGF)以及基质金属蛋白酶-9(matrix metalloproteinase-9,MMP-9)水平.结果 治疗后观察组血清VEGF、FGF、MMP-9水平均显著低于对照组,差异均有统计学意义(均P<0.05).观察组患者6个月、12个月、24个月以及36个月生存率显著高于对照组,差异均有统计学意义(P均<0.05).观察组12个月、24个月以及36个月复发率分别为3.23％、8.06％、11.29％,均显著低于对照组14.52％、24.19％、35.38％,差异均有统计学意义(P均<0.05).两组患者各项不良反应差异无统计学意义(P>0.05).结论 柔比星膀胱灌注化疗在对膀胱癌术后患者VEGF、FGF及MMP-9水平中影响较低,积累生存高,术后复发少,不良反应率低,安全可靠,值得临床推广应用.