| Objective:To evaluate the sensitivity and side effects of postoperative infusion of chemotherapeutic drugs in patients with bladder cancer by detecting the gene polymorphism in peripheral blood of patients with bladder cancer,and to explore the clinical significance of bladder cancer gene analysis in postoperative intravesical infusion of chemotherapeutic drugs.Methods:Eighty patients with NMIBC and T2aMIBC were included in TURBT from January 2021 to June 2022 in the affiliated Hospital of Chengde Medical College.By searching the domestic and foreign medical literature database,it was found that there were 27 genes related to the efficacy and side effects of chemotherapeutic drugs after BC.Among them,there are 12kinds of genetic factors（GSTP1,NQO1,GSTO1,ERCC1）related to the efficacy and side effects of anthracycline（pirarubicin,epirubicin,doxorubicin）and pyrimidines（gemcitabine）,while all 27 are related to the efficacy and side effects of systemic intravenous chemotherapy.The 27 gene polymorphisms in patients’peripheral blood samples were detected by NGS,and the evidence grades of different detection sites were sorted according to the pharm GKB database,and then the percentile method was used to assign the score.The average score of each drug was taken.The higher the score,the better the curative effect or the higher the side effects.Drugs with high sensitivity and low side effects were selected as postoperative intravesical instillation drugs.A total of 50 cases in this group were selected as sensitive group.Hydroxycamptothecin,a traditional chemotherapeutic drug without sensitive gene target,was selected as the control group with a total of 30cases.The recurrence,metastasis and adverse reactions of intravesical chemotherapeutic drugs after TURBT were followed up in both groups.Results:In the sensitive group,the recurrence and metastasis rate was 2.0%（1/50）within 3 months,4.0%（2/50）within 6 months and 4.0%（2/50）within1 year after operation.In the control group,the recurrence and metastasis rate was 16.7%（5/30）within 3 months,23.3%（7/30）within 6 months and33.3%（10/30）within 1 year after operation.The recurrence and metastasis rates of the sensitive group were significantly lower than those of the control group at 3 months,6 months and 1 year after Operation（P<0.05）.The incidence of hematuria in the sensitive group（2.0%,1/50）was significantly lower than that in the control group（20.0%,6/30）（P=0.019）.The bladder irritation sign was significantly lower in the sensitive group（4.0%,2/50）than that in the control group（23.3%,7/30）at 6 months after operation（P=0.022）.The incidence of nausea and vomiting was 2.0%（1/50）in the sensitive group and 3.3%（1/30）in the control group at 6 months after operation.There was no significant difference between the two groups（P=0.753）.Conclusions:1.There are individual differences in sensitivity and side effects of different chemotherapeutic drugs in BC patients.2.Through the analysis of gene polymorphism in peripheral blood samples of patients with NMIBC and T2aMIBC,we can predict the sensitivity and side effects of intravesical chemotherapy,guide the clinical selection of chemotherapy drugs with high sensitivity and low side effects,and effectively reduce tumor recurrence and adverse reactions. |
