Clinical Investigation Of Peripheral Blood T Lymphcyte Subsets In Different Dose Of BCG Intracavitary Instillation Treated Patients With Transitional Cell Carcinoma

Objective: Transitional cell carcinoma in the bladder is the most frequent tumour in the urinary system. These tumours demonstrat a higher tendency to recur either the same stage or as deeply invasive tumours after initial surgical resection. The Bacillus Calmette-Guerin (BCG) is an effective intravesical immunomodultor in preventing the recurrence and progression of the transitional cell carcinoma. The mechanism of action of intracavitary instillation with BCG remains partially known. Some evidences demonstrated that intracavitary BCG instillations improves the local and systemic immune response. The purpose of this study investigats the quantitative nanlysis of T lymphocyte subsets in the patients peripheral blood after intracavitary instill-lation BCG, in this way to know the influence of the systemic immune responses after different dose of BCG intracavitary instillation and its predictive value and the side effects of BCG.Materials and Methods: A total of 63 patients with transitional cell carcinoma in the bladder were randomlydivided in two groups in our investigative period. They were treated with the doses of 60mg or 120mg BCG respectively. Instillation were repeated once a week for 6 weeks. The regimen was 6 weeks. Blood samples were obtained before and after regimen within 24 hours. These samples were quantitatively analysed with flow cytometery .Results: Two groups patients treated with dosage 60mg or 120mg BCG respectively. The parameter CD3 CD4 CDS in the obtained blood samples were altered before and after BCG intracavitary instillation. In these parameters, the degree of CD4 were higher after instillation than before and was statistically significant increase in the same dosage, P< 0.05, but the degree of CDS were lower after instillation than before and was statistically significant decrease, P< 0.05 . The tendence of this alteration was the same. Between two groups, it did not have statistic value compared with the same parameter, P> 0.05. In the group of instillation dosage of 60mg, the side effect were much lower than the group of dosage of 120mg.Conclusion: The systemic immune responses were altered after BCG intracavitary instillation in the patients with transitional cell carcinoma in the bladder. The alteration in the systemic immune responses were the same in different groups according to T lymphocyte subsets CD3 CD4 CDS in peripheral blood. The patients who treated with the low dosage of BCG could be subjected to much lower sideeffects than the large dosage group. To test the parameter CD3 CD4 CDS in the peripheral blood may have predictive value in the patients who treated with BCG.