| Objective and Background:Urinary system tumors often occur after the age of40, more men than women about twice. Including kidney, renal pelvis, ureter, bladder, urethra and other parts of the tumor. Pelvis The following is a pipe organ cavity are covered urinary tract transitional cell, so the renal pelvis, ureter, bladder, urinary tract urothelial tumors are common, and may the incidence of multiple organ.Worldwide, bladder cancer among men the most common solid tumor in women ranked seventh. In China, the male incidence of bladder cancer among of systemic tumor eighth women came in twelfth place. In recent years, some cities in China tumor incidence report shows that there is an increasing trend in the incidence of bladder cancer. Muscle invasive bladder cancer prone to local invasion or distant metastasis, line cystectomy and lymph node dissection, the patient is often difficult to cure, is the main cause of death of the patient. Is still a lack of effective prevention and treatment of lymph node or distant organ metastases. Bladder cancer distant organ metastasis in patients unfit for surgery, the organ metastases specimens are difficult to obtain. In the treatment of superficial bladder cancer, carcinoma in situ to intravesical chemotherapy commonly used BCG, mitomycin, doxorubicin, interleukin and other factors, BCG effect. The limitations of superficial bladder cancer can be used for transurethral resection surgery, postoperative intravesical instillation of these drugs, but from a clinical point of view, the recurrence rate is still high. Chemotherapy for metastatic bladder cancer is most commonly used or can not rely on surgical resection for locally advanced bladder cancer. Approximately20%of bladder cancer by chemotherapy can make the tumor disappeared.Chemotherapy can bring many benefits, complete tumor resection, adjuvant chemotherapy can reduce the risk of recurrence in patients, the most common is the use of the following four chemical drugs combined with chemotherapy, this program can be abbreviated as MVAC, four letters represent,methotrexate (methotrexate), vinblastine (vinblastine), doxorubicin (adriamycin) and cisplatin (cisplatin). This program overall response rate was60%-70%, but only30%of patients in full force and effect, that complete tumor regression. These perfectly valid patients, almost everyone eventually will relapse. Not all patients can withstand chemotherapy, some patients do not even have effect.Recent studies have shown that gemcitabine (gemcitabine) and oxaliplatin (oxaliplatin) two low toxicity of the drugs can be obtained with the the MVAC program similar efficacy, and easier for patients to accept. In addition, many of bladder cancer clinical trials is to assess new drugs and chemotherapy, they are likely to benefit more patients.Fresh pathological specimens or biopsy for bladder cancer patients taken for genetic analysis, can effectively understand the patient which chemotherapy drug-sensitive and thus more targeted chemotherapy. Material and Methods:Collected in March2012to March2013, Tianjin Medical University General Hospital, Department of Urology hospitalization of20patients with bladder cancer. The use of intraoperative specimens from fresh pathological specimens or biopsy specimens for genetic analysis. BCRP, ERCC1, RRM1, TYMS, TUBB3gene using real-time quantitative-PCR technology to analyze the level of the clear tumor specimens match on chemotherapy drugs, in order to guide the patients with bladder local infusion therapy and systemic intravenous chemotherapy. Data application of statistical methods to process the data results.Results:1. The type of self-bladder carcinoma, BCRP, ERCC1, RRM1, TYMS, TUBB3gene mutations, expression, amplification detection, the detection result can be found that the low, medium and high.2. Bladder cancer patients commonly used chemotherapy drugs, such as gemcitabine (the [GEM Zefei]); anti-microtubule drugs (such as paclitaxel, docetaxel, vinca alkali, etc.); anthracycline (epirubicin[EPI]); platinum drugs (such as oxaliplatin [oxa]); fluorine-based drugs (such as5-FU, tegafur, capecitabine [Xeloda]) match varying degrees.3. Bladder cancer patients during transurethral resection or open surgery after surgery, according to the results of genetic testing, the use of the bladder infusion chemotherapy and intravenous chemotherapy drugs.Conclusions:1. Chemosensitivity of bladder transitional cell carcinoma are different, the same histological type and differentiation degree of bladder cancer differences in sensitivity to different chemotherapy drugs.2. Different individuals there are individual differences in sensitivity to chemotherapeutic drugs. 3. To expand the size of the clinical study and extend the clinical observation time, real-time fluorescence quantitative-PCR technology test results may become bladder cancer chemotherapy drugs reference bladder cancer after surgery, clinical medicine, individualized treatment. |
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