术前动脉化疗对膀胱移行细胞癌ras-p21表达及预后的影响

目的 研究术前腹壁下动脉插管化疗对膀胱移行细胞癌ras-p21表达及预后的影响.方法 术前动脉化疗组44例术前盆腔区域化疗1周(1疗程),再行开放手术;单纯手术对照组68例单纯行开放手术.采集肿瘤标本,行ras-p21的免疫组织化学染色,检测癌基因蛋白的表达,同时对病人随访.结果 ras-p21的表达与膀胱移行细胞癌的临床分期呈正相关(P＜0.05);术前动脉化疗组ras-p21表达阳性率为54.5%,对照组ras-p21表达阳性率为70.6%,术前动脉化疗降低T2～T4膀胱移行细胞癌的ras-p21表达阳性率(P＜0.05);术前动脉化疗组3年复发率18.2%,5年生存率81.1%,10年生存率54.5%,对照组3年复发率55.9%,5年生存率50.0%,10年生存率26.5%.结论 术前动脉化疗降低ras-p21表达,可提高膀胱移行细胞癌患者的生存率、降低复发率.

Effect of preoperative arterial chemotherapy on the expression of ras-p21 in the bladder transitional cell carcinoma and its prognostic value

Objective To observe the influence of preoperative arterial chemotherapy on ras-p21 expression in bladder transitional cell carcinoma and its prognostic value on bladder cancer.Methods One hundred and twelve patients with bladder cancer were investigated.Forty-four surgical specimens were obtained from patients treated with preoperative arterial chemotherapy;sixty-eight specimens were obtained from patients treated with surgery only.Eight specimens of human normal bladder tissue were used as control.All specimens were examined by spimmunohistochemical method,for detection of ras-p21 expressions.Results The expression of ras was closely associated with the clinical stage(P<0.05);the ras-p21 positive rate was 54.5% in the group of preoperative arterial chemotherapy;and it was 70.6% in control group;ras-p21 expression in the normal bladder tissue could not be detectable.The three-year recurrence rate,five-year survival rate and ten-year survival rate were 18.2%,81.8%,and 54.5%,respectively in preoperative arterial chemotherapy group,while those were 55.9%,50.0%,and 26.5%,respectively in control group.Conclusion Preoperative arterial chemotherapy can decrease the ras-p21 expression in transitional cell carcinoma of bladder,and increase the survival rate and decrease the recurrence rate of bladder cancer patients.