Abstract: Objective To explore the clinical effect of Gemcitabine （GEM） bladder perfusion therapy in patients with non-muscular invasive bladder cancer （NMIBC） after transurethral resection of bladder tumor （TURBt） and its influence on serum VEGF. Methods 132 patients with NMIBC who were treated with TURBt in Yuxi People's Hospital from January 2015 to June 2019 were included in this study. The patients were randomly divided into GEM group and Pirarubicin group （Pirarubicin, THP group）, with 66 patients in each group. Both groups were treated with TURBt. The GEM group received GEM bladder perfusion immediately after the operation, and the THP group received THP bladder perfusion immediately after the operation. By comparing the adverse reactions of the two groups during postoperative perfusion treatment, and followed up for 1 year, the recurrence of the two groups was monitored 0.5 years and 1 year after the operation. 4ml fasting venous blood was drawn before the perfusion, 0.5 years and 1 year after the perfusion, respectively, to detect the level of serum VEGF. Results The recurrence rate of the GEM group was lower than that of the THP group at 0.5 and 1 year after perfusion, and the recurrence time was longer than that of the THP group, which was statistically significant （P<0.05）; the serum VEGF levels of the two groups were lower than before the 0.5 year and 1 year after perfusion. The serum VEGF levels of the two groups at 1 year after perfusion were in a decreasing trend compared with 0.5 years after perfusion. However, the serum VEGF levels in the GEM group were significantly lower than those in the THP group at 0.5 and 1 year after perfusion, and the downward trend was greater and the difference was greater （P<0.05）. Conclusion GEM bladder perfusion therapy has achieved better clinical effects after TURBt in NMIBC patients, and has a significant effect on serum VEGF. It can not only effectively prevent and significantly reduce the recurrence rate of patients after surgery, but also improve the recurrence-free survival rate. It has less toxic side effects and causes adverse effects the response is less, which is more conducive to ensuring the prognosis and recovery of patients, and has high clinical application value. It is worthy of vigorous research in clinical treatment, strive for widespread application, and provide patients with appropriate treatment options.

Key words: gemcitabine, Pirarubicin, non-muscular infiltrating bladder cancer, serum VEGF

摘要： 目的 为探究吉西他滨（GEM）膀胱灌注治疗在经尿道膀胱肿瘤电切术（TURBt）后的非肌层浸润性膀胱癌（NMIBC）患者的临床效果以及对血清VEGF的影响。方法 回顾性选取2015年1月~2019年6月在玉溪市人民医院接受TURBt治疗的132例NMIBC患者为研究对象,将患者分为GEM组和吡柔比星组（THP组）,每组均为66例。两组均行TURBt治疗,GEM组术后立即采取GEM膀胱灌注,THP组术后立即采取THP膀胱灌注。通过对比两组术后灌注治疗过程中的不良反应,并随访1年,监测两组术后0.5年、1年的复发情形;分别在灌注前、灌注后0.5年及1年抽取4 mL空腹静脉血,检测血清VEGF的水平。结果 GEM组灌注后0.5年、1年复发率低于THP组,复发时间长于THP组,具有统计学意义（P<0.05）;两组灌注后0.5年、1年血清VEGF水平均低于灌注前,两组灌注后1年血清VEGF水平与灌注后0.5年水平相比,处于一个降低的趋势,但GEM组患者灌注后0.5年、1年血清VEGF均明显低于THP组,下降的趋势更大,差异有统计学意义（P<0.05）。结论 GEM膀胱灌注治疗在NMIBC病人行TURBt后取得的临床效果较好。

关键词: 吉西他滨, 吡柔比星, 非肌层浸润型膀胱癌, 血清VEGF