双极等离子切除术治疗高龄高危膀胱肿瘤复发情况及其与癌组织VEGF、Survivin表达水平的关系

摘要

目的:探讨双极等离子切除术治疗高龄高危肌层浸润性膀胱肿瘤复发情况及其与癌组织血管内皮生长因子(VEGF)、生存素(Survivin)表达水平的关系.方法:选取2012年9月~2016年9月收治的高龄高危肌层浸润性膀胱肿瘤患者100例,行双极等离子切除术治疗并随访至少半年.采用免疫组化法检测患者癌组织VEGF、Survivin表达水平并统计患者随访期间膀胱肿瘤复发情况.比较复发和无复发患者癌组织VEGF、Survivin表达水平,分析其与癌组织VEGF、Survivin表达水平复发的关系及其对复发的预测价值.结果:100例高龄高危膀胱肿瘤患者随访期间复发率为16.00%.与无复发患者比较,复发患者癌组织VEGF、Survivin阳性表达率均较高(P<0.05).Spearman无条件相关分析结果显示,高龄高危膀胱肿瘤行双极等离子切除术治疗患者癌组织VEGF、Survivin阳性表达率与其复发率均呈正相关(r=0.844,0.879,P<0.05).进一步诊断性试验分析结果显示,高龄高危膀胱肿瘤行双极等离子切除术治疗患者癌组织VEGF、Survivin表达水平预测其复发的价值良好,其中以两者联合预测患者复发的价值最优.结论:双极等离子切除术治疗高龄高危膀胱肿瘤复发率较高,与其癌组织VEGF、Survivin表达水平密切相关,且与其癌组织VEGF、Survivin表达水平联合预测其复发的价值良好,因此,其癌组织VEGF、Survivin表达水平可能作为其复发评估的参考指标.%Objective:To investigate the relationship between cancer tissue vascular endothelial growth factor (VEGF) and Survivin expression with the recurrence of elderly patients with myometrial Infiltrative bladder cancer treated with bipolar plasmakinetic resection.Methods:100 cases of elderly patients with myometrial Infiltrative bladder cancer in our hospital from September 2012 to September 2016 were treated with bipolar plasmakinetic resection and followed up for at least half of a year.Immunohistochemical method was applied to detect the VEGF and Survivin expression in cancer tissue of the patients and the recurrence of bladder tumor was observed.VEGF and Survivin expression in cancer tissues of patients with or without bladder tumor recurrence was compared,and relationship between VEGF and Survivin expression in cancer tissues with recurrence was analyzed.Results:The recurrence rate of 100 cases of elderly patients with high-risk bladder tumor was 16%.As compared with the patients without recurrence,VEGF and Survivin positive expression rate in cancer tissues of the patients with recurrent cancer was significantly increased (P<0.05).Spearman unconditional correlation analysis showed that cancer tissue VEGF and Survivin positive expression rate and the recurrence rate of patients with advanced bladder cancer treated with bipolar plasmakinetic resection showed a positive correlation (r=0.844,0.879,P<0.05).Further diagnostic test analysis showed that value of cancer tissue VEGF and Survivin positive expression rate predicting the recurrence of patients with advanced bladder cancer treated with bipolar plasmakinetic resection was excellent,in which the value of combination of 2 factors predicting the recurrence was the best.Conclusions:Recurrence rate in patients with advanced bladder cancer treated with bipolar plasmakinetic resection is high and related to the cancer tissue VEGF and Survivin expression,and the value of cancer tissue VEGF and Survivin expression in combination predicting the recurrence was excellent,therefore,the cancer tissue VEGF and Survivin expression may be reference index for the assessment of the cancer recurrence of the patients.