Comparative Analysis Of Perfusion Therapy After Transcatheter Closure Of Bladder Cancer With PA-MSHA And Pirarubicin

BackgroundBladder cancer(BC)is a relatively common urinary tumor,and its incidence is ranked ninth in the global cancer.According to the depth of invasion of bladder cancer,it can be divided into two categories,namely muscle invasive bladder cancer(MIBC)and non-muscle invasive bladder cancer(NMIBC).Two types of bladder cancer treatment are based on surgery,but the operation is very different.70%-80% of bladder cancers are NMIBC,and the preferred surgical method is transurethral resection of bladder tumor(TUR-BT),which has a higher recurrence rate after surgery alone.Some studies have pointed out that the recurrence rate of NMIBC patients undergoing TUR-BT alone is as high as 50%-70% at 1 year after surgery,and among them,10%-20% of recurrent tumors show increased malignancy.Therefore,how to reduce the risk of recurrence of bladder cancer after NMBIC becomes a major problem in the treatment of bladder cancer.Clinically,for patients with NMIBC,conventional systemic chemotherapy or intravesical instillation after TUR-BT is performed.The side effects of systemic chemotherapy are relatively large.Therefore,intracorporeal infusion of drugs with small systemic response is usually used in clinical practice.Perfused drugs are broadly divided into two categories,one for chemotherapy and the other for immunomodulatory agents.The Pseudomonas aeruginosa-mannose sensitive hemagglutinin(PA-MSHA)is a Pseudomonas aeruginosa strain with mannosesensitive hemagglutinin discovered by Prof.Xi Xia.Adjuvant treatment for chemotherapy in the treatment of breast cancer,gastric cancer,lung cancer,malignant lymphoma,etc.,can effectively recur the rate of tumor recurrence.Lei Chang confirmed in animal experiments that PA-MSHA can inhibit the proliferation of bladder cancer cells,induce apoptosis of bladder cancer cells through the caspase pathway,and PA-MSHA can inhibit the activity of EGFR pathway [4],and use PA-MSHA Reports of clinical treatment of bladder cancer are rare.This study comparative analysis the Patient data.which reviewed the data of 68 patients with non-muscle-invasive bladder cancer who underwent intravesical instillation of PA-MSHA after TUR-BT surgery and 74 patients with intravesical instillation of pirarubicin in the same period of Zhengzhou University People’s Hospital,to study the safety of intravesical instillation after TUR-BT surgery,the effect of perfusion on the recurrence rate of bladder cancer,and the change of immune function after perfusion.PurposeTo investigate the efficacy and safety of intravesical instillation of PA-MSHA and pirarubicin in patients with non-muscle-invasive bladder transitional cell carcinoma who underwent transurethral resection of bladder tumors,and their cellular immunity.Methods This study is a retrospective study and we selected 142 patients with non-muscle invasive bladder transitional epithelial carcinoma admitted to our hospital from December 2014 to December 2016 as study objects.According to the choice of infusion drugs,they were divided into experimental group and control group.In the experimental group,PA-MSHA was infused into the experimental group,a total of 68 cases.Intravesical instillation of PS-MSHA within 24 hours after TUR-BT surgery.The control group was infused with Pirarubicin(THP),a total of 74 cases.Intravesical instillation of THP was performed within 24 hours after TUR-BT.The following two groups were treated with bladder perfusion for 1 year.To compare the safety,efficacy and cellular immune function of NMIBC patients after TUR-BT treatment with two infusion drugs.ResultThere was no significant difference in the age,gender,comorbidities,and bladder tumor examination between the experimental group and the control group(P>0.05);the TUR-BT operation time,catheter indwelling time,and bladder infusion time in the experimental group and the control group.The hospital stay and the overall cost were similar,with no statistically significant difference(P>0.05);There were 8 cases of acute cystitis,5 cases of hematuria,3 cases of fever,and 2 cases of gastrointestinal reactions in the experimental group.The incidence of adverse reactions was 26.47%(18/68).There were 18 cases of acute cystitis in the control group.Hematuria in 7 cases,fever in 5 cases,gastrointestinal reactions in 2 cases,The incidence of adverse reactions was 43.24%(32/74),and the difference between the two groups was statistically significant(P<0.05).There were differences in the ratio of CD4+,CD8+,and CD4+/CD8+ after surgery in both groups.There was no significant difference in the ratios of CD4+,CD8+,and CD4+/CD8+ between the experimental group and the control group before discharge(P>0.05),but the CD4+,CD8+,and CD4+/CD8+ ratios were statistically different at the 6-month follow-up.Significance(P<0.05).In addition,the ratios of CD4+,CD8+,and CD4+/CD8+ in the experimental group before and after the discharge were statistically significant(P<0.05),while the control group was reviewed before and after discharge at the time of discharge.CD4+ The difference of CD8+ and CD4+/CD8+ ratio was not statistically significant(P>0.05).Comparing the recurrence rate between the two groups,the experimental group recurred in 8 cases 6 months after operation,2 cases relapsed after 12 months,5 cases relapsed after 24 months,the total recurrence rate was 22.06%(15/68),the control group 6 11 cases recurred in months,2 cases relapsed in 12 months,and 6 cases relapsed in 24 months.The total recurrence rate was 26.39%(19/74).There was no significant difference between the two groups(P>0.05).In the two groups of relapsed patients,the recurrence-free survival time was 11.8±8.60 months in the experimental group and 6.58±5.85 months in the control group,the difference was statistically significant(P<0.05).Conclusion1.Intravesical instillation of TUR-BT in patients with NMIBC,there was no significant difference in the recurrence rate between PA-MSHA and THP;2.After intravesical instillation of TUR-BT in NMIBC patients,PA-MSHA has better safety than THP.3.Intravesical instillation of PA-MSHA after TUR-BT in NMIBC patients can improve the cellular immune function.