Effect of submucosal injection of gemcitabine into bladder during transurethral resection of bladder tumor combined with vitamin A and vitamin Bi supplementation on non-muscle invasive bladder cancer
Objective To investigate the efficacy and safety of submucosal injection of gemcitabine into bladder during transurethral resection of bladder tumor combined with vitamin A(VitA)and vitamin B1(VitB1)supplementation in the treatment of non-muscle invasive bladder cancer(NMIBC).Methods Serum levels of VitA and VitB1 in 100 NM1BC patients underwent transurethral resection of bladder tumor plus intraoperative submucosal injection of gemcitabine into bladder were detected before surgery.Another 100 healthy volunteers were taken as the controls.The NMIBC patients were divided into two groups of A(vitamin deficiency)and C(without vitamin deficiency)based on serum levels of VitA and VitB1.Group A and C were subdivided into four groups of A1,C1(receiving postoperative oral supplementation of VitA and VitB1)and A2,C2(not receiving postoperative oral supplementation of VitA and VitB1)with 20 cases each.The tumor recurrence-free rate and urine fluorescence in situ hybridization(FISH)recurrence-free rate at 1 and 2 years after surgery and incidence of adverse reactions within 1 year after surgery were compared among four groups of A1,A2,C1 and C2.The changes of T lymphocyte subsets in peripheral blood were detected before and 1 year after surgery in the four groups.Results Compared with healthy volunteers,serum levels of VitA and VitB1 in NMIBC patients were decreased(P＜0.05).Compared with group A2,group A1 had a higher tumor recurrence-free rate and urine FISH recurrence-free rate at 1 and 2 years after surgery(P＜0.01).No serious adverse reactions occurred in the four groups.Compared with before surgery,the percentage of CD4+T lymphocyte subsets and CD4+/CD8+T lymphocyte ratio in peripheral blood of group A1 were increased,while the percentage of CD8+T lymphocyte subsets was decreased 1 year after surgery(P＜0.01).Conclusion NMIBC patients may have VitA and VitB1 deficiency.For NMIBC patients lacking VitA and VitB1,intraoperative submucosal injection of gemcitabine during transurethral resection of bladder tumor combined with VitA and VitB1 supplementation can effectively reduce the recurrence rate of NMIBC,which may be related to inducing CD4+T lymphocyte differentiation.
Non-muscle invasive bladder cancerVitamin AVitamin B1GemcitabineTransurethral resection of bladder tumor
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