关键词: 新辅助化疗, 经尿道肿瘤电切术, 膀胱癌, 膀胱肿瘤抗原, 复发率

Abstract: Objective To investigate the effects of neoadjuvant chemotherapy combined with transurethral resection of bladder tumor(TURBT) on tumor diameter,urine bladder tumor antigen(BTA) level and recurrence rate in patients with bladder cancer.Methods A retrospective analysis was conducted on the clinical data of 83 patients with myometrial invasion and bladder cancer(MIBC) admitted to our hospital from February 2017 to September 2018,and they were divided into group A(n=41) and group B(n=42) according to different treatment methods.Group A was treated with TURBT,group B was treated with neoadjuvant chemotherapy on the basis of group A,and all patients received intravesical chemotherapy after operation.The tumor diameters of group B before chemotherapy and after 3 cycles of chemotherapy were measured,the toxic and side effects of group B were counted,the operation indexes of the two groups were recorded,the levels of urinary bladder tumor antigen(BTA) and nuclear matrix protein 22(NMP-22) were detected when the two groups were enrolled and 6 months after the operation,and the long-term survival rate and recurrence rate of the two groups were understood.Results The maximum diameter and minimum diameter of the tumor [(2.68±0.73)cm,(1.53±0.47)cm] after chemotherapy in group B were significantly smaller than those before chemotherapy[(3.49±0.81)cm,(2.35±0.69)cm](P＜0.05).Patients in group B usually had blood system and digestive tract reactions after chemotherapy,mainly mild,which could be tolerated by patients,the operation time and blood loss[(47.11±6.03) min,(52.43±5.62) ml] in group B were significantly less than that in group A [(52.75±8.42) min,(61.16±7.58) ml](P＜0.05).The levels of urine BTA  and NMP-22 [group A:(6.86±1.50) U/L,(10.24±2.03) U/ml;group B:(4.61±1.27) U/L,(6.58±1.42) U/ml] in the two groups after operation were significantly lower than those at the time of entry[group A:(13.89±2.62) U/L,(26.57±2.71) U/ml;group B:(14.73±2.95) U/L,(27.26±3.92) U/ml](P＜0.05),and group B were significantly lower than group A(P＜0.05).The 1-year,2-year,and 3-year survival rates of group B were 95.24%,90.48% and 83.33%,respectively,which were significantly higher than the group A(80.49%,70.73% and 63.41%,P＜0.05).The 1-year,2-year,and 3-year recurrence rates in group B were were 4.76%,11.19% and 19.05%,respectively,which were significantly lower than the group A(21.95%,34.15% and 39.02% ,P＜0.05).Conclusion Firstly,neoadjuvant chemotherapy for MIBC patients can effectively shrink tumors,and then TURBT can significantly shorten the operation time,significantly reduce the amount of intraoperative blood loss,and help improve the long-term survival rate and reduce the recurrence rate.

Key words: neoadjuvant chemotherapy, transurethral resection of bladder tumor, bladder cancer, bladder tumor antigen, recurrence rate