关键词: 非肌层浸润性膀胱癌, 膀胱灌注治疗, 复发, 内皮细胞特异性分子-1, 胆碱酯酶, 鸢尾素

Abstract: Objective To investigate the relationship between endothelial cell specific molecule-1 (ESM-1),cholinesterase (ChE),irisin and the recurrence of Non-muscle-invasive bladder cancer after bladder perfusion therapy.Methods A total of 86 patients with Non-muscle-invasive bladder cancer admitted to our hospital from December 2019 to December 2022were selected.All patients received bladder perfusion therapy.Serum levels of ESM-1,ChE and irisin were detected before treatment.After the treatment,they were followed up for 2 years and the recurrence was statistically analyzed.Multivariate COX proportional regression analysis was used to analyze the factors affecting recurrence in patients with Non-muscle-invasive bladder cancer after bladder perfusion therapy,and the value of ESM-1,ChE and irisin in predicting recurrence was analyzed by receiver operating characteristic (ROC) curve.ResultsThe serum ESM-1 level of Non-muscle-invasive bladder cancer patients at T1 stage of low differentiation and TNM stage was higher than that at Ta stage of middle and high differentiation and TNM stage,and the serum ChE and irisin levels were lower than that at Ta stage of middle and high differentiation and TNM stage (P<0.05).Three cases were lost to follow-up.Among the remaining 83 patients,11 relapsed and 72 did not relapse.Serum ESM-1 level in relapsed group was higher than that in non-relapsed group [(4.89±0.42)ng/ml vs. (4.17±0.53)ng/ml,P<0.05],ChE and irisin levels were lower than those in non-relapsed group [(4 618.35±531.29)U/L vs (5 663.27±502.71)U/L,(21.06±3.46)ng/ml vs (25.00±3.06 )ng/ml,P<0.05].TNM stage T1 and high ESM-1 were risk factors for recurrence of Non-muscleinvasive bladder cancer after bladder perfusion therapy (P<0.05),while high ChE and high irisin were protective factors (P<0.05).The area under the curve of ESM-1,ChE and irisin in predicting the recurrence of patients with Non-muscle-invasive bladder cancer after bladder perfusion therapy was 0.776,0.726 and 0.664,respectively,and the area under the curve of combined prediction was 0.871,which was higher than that of single prediction (P<0.05).Conclusion The increase of serum ESM-1 level and the decrease of ChE and irisin levels in patients with Non-muscle-invasive bladder cancer are related to the recurrence after bladder perfusion treatment,and the combination of the three is of high value in predicting the recurrence after bladder perfusion treatment.

Key words: Non-muscle-invasive bladder cancer, bladder perfusion therapy, recurrence, endocan or endothelial cell specific molecule-1, colinesterase；irisin