ABSTRACT
Objective To observe the clinical efficacy and safety of second transurethral resection combined with instillation therapy and transfusion therapy of dendritic cells pulsed with tumor cells on non muscle-invasive bladder cancer.MethodsEighty patients with stage T1 non muscle-invasive bladder cancer were included in this protocol in which all patients prospectively received second transurethral resection within 4 to 6 weeks following initial resection.All 80 cases were divided into a DC group and a control group.In the DC group,dendritic cells pulsed with tumor cells were transfused between 6 -8 weeks.Bladder instillation therapy and follow-up was applied on the control group.The recurrence rate,the clinical efficacy and adverse reactions were observed and compared between the two groups.ResultsIn the initial resection,21.3％,67.5％ and 11.2％ had G1,G2 and G3 transitional cell carcinoma,respectively.Twenty-seven (33.7％) had residual tumors at the second TUR,8 patients had Ta(29.6％ ) and 19 had T1 (70.4％).After the initial TUR-Bt,residual tumors were detected in 11.1％,70.4％ and 18.5％ in G1,G2 and G3,respectively.In the 8 Ta cases,2 cases moved to a higher grade,while the grade was unchanged in 6 cases.In the 19 cases with stage T1,12 had a higher grade,5 had a lower grade and 2 remained the same.In the DC group,5 cases suffered chills and fever when dendritic cells were transfused.The fever was releaved when dexamethasone was administered.The white blood cells count,creatinine and alanine aminotransferase had no statistically significance change at pre-therapy,one year after therapy and two years after therapy (P ＞0.05).The index of CD4 、CD8 、CD4/CD8 had statistically significance change at pre-therapy,one year after therapy and two years after therapy ( P ＜ 0.05 ),while the difference between one year after therapy and two years after therapy was not statistically significance ( P ＞ 0.05 ).The first and second year recurrence rate was 2％ and 6％ in the DC group,while in the control group it was 20％ and 30％.The difference was statistically significant ( P ＜ 0.05 ).Conclusion Second transurethral resection combined with instillation therapy and transfusion therapy of dendritic cells pulsed with tumor cells could be an effective therapeutic approach to lower the recurrence rate on non muscle-invasive bladder cancer.
ABSTRACT
Objective To investigate the expression of CD40 protein in bladder urothelium cancer and to explore its correlation with clinical stage, pathological grades, cell apoptosis. Methods Expression of CD4o protein was evaluated by immunohistochemistry in paracancerous tissues (20 cases) and bladder urothelium cancer tissues (78 cases). Apoptosis of bladder urothelium cancer tissues was detected by Hoechst to determine the apoptotic rate (AR). Results The expression rate of CD40 protein was 2/20(10 %) in the cases of paracancerous tissues, 55/78(70.5%) in the cases of bladder urothelium cancer tissues, a statistically significant differences of CD40 staining was observed between paracancerous tissues and bladder urothelium cancer tissues (P ＜0.01). Overexpression of CD40 was strongly inversely related to the tumor grade and clinical stage; the positive group of CD40 protein was (12.60±0.38)%, the negative group of CD40 protein was (6.77±0.53)%, a statistically significant differences of apoptosis were observed between CD40 protein positive group and CD40 protein negative group (P ＜0.01). It showed CD40 protein might induce cell apoptosis. Conclusion Expression of CD40 protein is closely related with clinical stage, pathological grade and cell apoptotic rate and may offer reliable evidence for diagnosis, treatment and prognosis in bladder urothelium cancer.
