关键词: 非肌层浸润性膀胱癌, 经尿道膀胱肿瘤等离子整块剜除术, 排尿功能, 甲壳质酶蛋白40, 膀胱特异性核基质蛋白-1, 对氧磷酶-1

Abstract: Objective To explore the effects of transurethral en-blocresection of bladder tumor (TeURBT) on urination function,serum chitinase protein 40 (YKL-40),bladder specific nuclear matrix protein-1 (BLCA-1),and poxyfossase-1 (PON-1) levels in patients with non-muscle invasive bladder cancer (NMIBC).Methods 74 patients with NMIBC admitted to our Hospital from January 2019 to May 2022 were divided into TeURBT group and transurethral resection of bladder tumor (TURBT) group by random lottery,with 37 cases in each group.The effective tumor clearance rate,surgery and urination function indexes were compared between the two groups.Blood samples were collected before surgery,3 months,6 months and 12 months after surgery to determine the levels of serum YKL-40,BLCA-1 and PON-1,and the recurrence rate was analyzed at 12 months of follow-up.Results The effective resection rate of bladder tumor was 100.00% in both groups.The operative time in TeURBT group was significantly longer than that in TURBT group (P<0.05),and the intraoperative blood loss,catheter indwelling/bladder irrigation/hospitalization time in TeURBT group were significantly less than those in TURBT group (P<0.05).Urinary output and maximum urinary flow per second in both groups significantly increased on postoperative day 14 (P< 0.05),but there was no statistically significant difference in the above indexes between the two groups on postoperative day 14 (P>0.05).The levels of serum YKL-40 and BLCA-1 in the two groups at 3,6 and 12 months after surgery significantly decreased (P<0.05),while the level of PON-1 significantly increased (P<0.05).There were no statistically significant differences in serum YKL-40 and PON-1 levels between the two groups at 3 and 6 months after surgery (P>0.05),while serum YKL-40 and BLCA-1 levels in the TeURBT group were significantly lower than those in the TURBT group at 12 months after surgery (P<0.05),and PON-1 levels were significantly higher than those in the TURBT group (P<0.05).The stages in the TeURBT group could be accurately diagnosed after operation,and the postoperative pathological stages were Ta stage in 24 cases and T1 stage in 13 cases.The total incidence of postoperative complications in TeURBT group and cumulative incidence of recurrence in 1-year follow-up were 5.40%,which was significantly lower than 24.32% and 21.62% in TURBT group (P<0.05).Conclusion The effective resection rate of TeURBT and TURBT in the treatment of NMIBC tumor is similar,which can effectively improve the urination function of patients,downregulation of serum YKL-40 and BLCA-1 levels,and up-regulation of PON-1 levels.Compared with TURBT,TeURBT has advantages of less intraoperative blood loss,fewer postoperative complications,faster recovery,and lower recurrence rate.

Key words: non-muscle invasive bladder tumor, transurethral en-blocresection of bladder tumor, urination function, chitinase protein 40, bladder specific nuclear matrix protein-1, recombinant paraoxonase-1