Den Otter W, Dobrowolski Z, Bugajski A, Papla B, Van Der Meijden A P, Koten J W, Boon T A, Siedlar M, Zembala M
Department of Functional Morphology, Utrecht University, The Netherlands.
J Urol. 1998 Apr;159(4):1183-6. doi: 10.1097/00005392-199804000-00021.
We evaluate the therapeutic effect of intravesical interleukin-2 (IL-2) on T1 papillary bladder carcinoma after incomplete transurethral resection.
After incomplete transurethral resection we treated 10 patients in whom the marker lesion was left in place with 3 x 10(6) Chiron units IL-2 in 50 ml. saline plus 0.1% human serum albumin. The solution remained in the bladder for 2 hours and it was instilled on 5 consecutive days. The effect of IL-2 treatment on the marker lesion was evaluated by cystoscopy and repeat biopsy of the marker site 2 months after treatment. In addition, the effect on the recurrence of bladder tumors was studied.
At 2 months 8 of the 10 marker lesions (80%) had completely regressed and there were no tumor cells on repeat biopsy. Four patients remained tumor-free after 30 to 54 months. We noted no toxic effects. In 1 patient with a 7-year history of bladder cancer the marker was only partially regressed after 2 months. After removal of the marker this patient remained tumor-free at a followup of 54 months.
To our knowledge this report represents the first study of the effect of IL-2 on marker lesions left in place after transurethral resection. The results indicate that IL-2 instillations are feasible, and the combination of transurethral resection and IL-2 instillation may have a powerful antitumor effect. The therapeutic effects may not simply be due to intravesical IL-2, because previous transurethral resection probably caused some influx of infiltrating cells and the marker may have had tumor associated antigens. Consequently these effects may be due to the interaction of tumor associated antigens, infiltrating cells and IL-2.
我们评估经尿道膀胱肿瘤电切术（TURBt）不完全切除后膀胱内注射白细胞介素-2（IL-2）对T1期乳头状膀胱癌的治疗效果。
在TURBt不完全切除后，我们对10例残留标记病变的患者进行治疗，将3×10(6) 希龙单位的IL-2溶于50 ml生理盐水加0.1%人血清白蛋白中。溶液在膀胱内保留2小时，连续5天进行灌注。通过膀胱镜检查和治疗后2个月对标记部位重复活检来评估IL-2治疗对标记病变的效果。此外，还研究了其对膀胱肿瘤复发的影响。
2个月时，10个标记病变中有8个（80%）完全消退，重复活检未见肿瘤细胞。4例患者在30至54个月后无肿瘤复发。我们未观察到毒性作用。1例有7年膀胱癌病史的患者，其标记病变在2个月后仅部分消退。切除标记病变后，该患者在54个月的随访中无肿瘤复发。
据我们所知，本报告是关于IL-2对TURBt后残留标记病变影响的首次研究。结果表明，IL-2灌注是可行的，TURBt与IL-2灌注联合应用可能具有强大的抗肿瘤作用。治疗效果可能不仅仅归因于膀胱内注射IL-2，因为先前的TURBt可能导致了一些浸润细胞的流入，且标记病变可能具有肿瘤相关抗原。因此，这些效果可能是由于肿瘤相关抗原、浸润细胞和IL-2之间的相互作用所致。
