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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 relapse of bipolar plasma membrane grafts in the treatment of high-risk mycotic invasive bladder tumor and its relationship with the expression of vascular endothelial growth factor (VEGF) and survivin in cancer tissues. Methods: A total of 100 elderly patients with invasive bladder cancer at high risk for myometrial invasion from September 2012 to September 2016 were selected and treated with bipolar plasmapheresis and followed up for at least six months. Immunohistochemistry was used to detect the expression of VEGF and Survivin in the cancer tissue and the recurrence rate of the bladder tumor during the follow-up period was calculated. To compare the expression of VEGF and Survivin in patients with recurrent and non-recurrent cancer, and to analyze the relationship between the expression of VEGF and Survivin and the prognostic value of recurrence. Results: The recurrence rate of 100 elderly patients with high-risk bladder cancer during follow-up was 16.00%. Compared with the patients without recurrence, the positive expression rates of VEGF and Survivin in cancer tissues of recurrence patients were higher (P <0.05). Spearman unconditional correlation analysis showed that the positive rates of VEGF and Survivin in the high-risk patients with high-risk bladder cancer were significantly correlated with the recurrence rate (r = 0.844,0.879, P <0.05). The results of further diagnostic tests showed that the value of VEGF and Survivin expression predicted by advanced bipolar plasmaassay in the treatment of advanced cancer patients with high-risk bladder cancer was good, and the value of combined prediction of the two was the best. CONCLUSION: Bipolar plasma ion implantation has a high recurrence rate in elderly high-risk bladder cancer, which is closely related to the expression of VEGF and Survivin in cancerous tissues. The value of VEGF and Survivin in predicting the relapse is good with the expression of VEGF and Survivin. Therefore, VEGF, Survivin expression levels may be used as a reference for assessment of recurrence.