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目的探讨经尿道肿瘤电切术(transurethral resection of bladder tumor,TURBt)术后辅以膀胱内灌注化疗在膀胱低度恶性潜能的乳头状尿路上皮肿瘤(bladder papillary urothelial neoplasms of low malignant potential,PUNLMP)的治疗效果。方法选取浙江省嘉兴市第一医院泌尿外科于2012年1月至2016年1月期间收治的且符合纳入标准的25例PUNLMP患者,按治疗方案不同分为单行TURBt组(A组)和TURBt术后辅以膀胱内灌注化疗组(B组),比较在两种不同治疗方案下,PUNLMP患者术后肿瘤复发的统计学差异。结果 A组8例PUNLMP患者中有3例术后复发,B组17例患者中1例术后复发,所有复发患者均再次行“TURBt术后辅以膀胱灌注化疗”方案治疗,随访期间,除A组中1例复发病例于二次TURBt术后第11个月再次复发,且病理被证实为低级别乳头状癌外,其余复发病例在二次术后随访期间无再次复发,肿瘤分级无进展。两组PUNLMP患者术后复发概率的差异具有统计学意义(P<0.05)。结论经TURBt治疗后出现复发的PUNLMP患者,存在进展为低级别乳头状癌的可能性。TURBt术后辅以膀胱内灌注化疗能够降低PUNLMP患者术后复发,改善PUNLMP患者的预后。
Objective To investigate the effect of transurethral resection of bladder tumor (TURBt) combined with intravesical chemotherapy on bladder low density malignant bladder papillary urothelial neoplasms of low malignant potential (PUNLMP) Therapeutic effect. Methods Twenty-five patients with PUNLMP admitted to Department of Urology, First Hospital of Jiaxing City, Zhejiang Province from January 2012 to January 2016 were enrolled in this study. Patients were divided into two groups according to the treatment regimen: single TURBt group (group A) and TURBt After supplemented with intravesical chemotherapy group (B group), in two different treatment options, PUNLMP patients with postoperative tumor recurrence statistical differences. Results In group A, 3 of 8 patients with PUNLMP recurred postoperatively, and 1 of 17 patients in group B recurred after operation. All patients with recurrent disease were treated with “TURBt combined with intravesical chemotherapy”, during follow - up , Except one case of recurrence in group A relapsed on the 11th month after secondary TURBt, and the pathology was confirmed as low-grade papillary carcinoma. The other recurrence cases did not relapse again during the second postoperative follow-up. The tumor grade No progress. The difference of postoperative recurrence probability between the two groups of PUNLMP patients was statistically significant (P <0.05). Conclusions Patients with PUNLMP who have relapsed after TURBt treatment have the potential to develop low-grade papillary carcinoma. TURBt supplemented with intravesical chemotherapy can reduce postoperative recurrence in PUNLMP patients and improve the prognosis of patients with PUNLMP.