IMMUNOLOGICAL ANALYSIS OF ANTICANCER MECHANISM TO HUMAN BLADDER CANCER OF BCG

为探讨卡介苗（bovis bacillus Calmette-Guerin， BCG）抗尿道癌的作用机制，进行了以下实验我们证明卡介苗诱导人树突状细胞（DC）成熟。卡介苗可提高人未成熟DC细胞表面CD40、CD80、CD83和CD86的表达，其作用与肿瘤坏死因子α (tnf - α)相似体外刺激后，采用荧光活化细胞分选法（FACS）检测卡介苗活化T细胞分泌TNFalpha、干扰素γ、白细胞介素2 （IL-2）的细胞因子染色。卡介苗的再刺激不能促进细胞因子的分泌。我们分析了卡介苗灌注治疗上尿路原位癌（CIS）的疗效和安全性，对6例细胞学诊断为上尿路原位癌的患者进行了卡介苗灌注治疗，并在输尿管和膀胱之间逆行置管6f输尿管导管或8f留置JJ输尿管支架。平均随访22个月；所有患者均未死亡，上尿路尿液细胞学检查均为阴性42例膀胱CIS患者行膀胱内灌注BCG。随访6 ~ 116个月，膀胱内灌注卡介苗治疗膀胱CIS的有效率为81.0%。两名患者死于膀胱癌。42例患者中10例行全膀胱切除术，8例病理发现肌层浸润。

To analyze the mechanism of bovis bacillus Calmette-Guerin (BCG) against urithelial carcinoma, the following experiments were performed.1 We demonstrated that the BCG induces maturation of human dendritic cells (DC). Surface expression of CD40, CD80, CD83, and CD86 was increased by BCG on human immature DC, and the effect was similar to those of tumor necrosis factor alpha (TNF-alpha).2 Secretion of TNFalpha, interferon-gamma, interleukin-2 (IL-2) by BCG activated T cell was determined by intracellular cytokine staining with fluorescence-activated cell sorting (FACS) after ex vivo stimulation. Restimulation by BCG did not facilitate secretion of cytokines, .We analysed the efficacy and safety of BCG perfusion for carcinoma in situ (CIS)1 Treatment for CIS of the upper urinary tract, 6 patients with cytologically diagnosed CIS of the upper urinary tract were treated by BCG instillation via retrograde catheterization using a 6 F ureteric catheter or an 8 F indwelling JJ ureteric stent between the ureter and bladder. The mean follow-up was 22 months ; none of the patients died, and all were negative for cytology in urine collected from the upper urinary tracts.2 Forty-two patients with CIS of bladder underwent intravesical instillation of BCG.In the follow-up period from 6 to 116 months, the efficacy rate of intravesical BCG instillation for CIS of the bladder was 81.0%. Two patients died from the bladder cancer. Total cystectomy was performed in 10 of 42 patients, and pathological findings of muscle layer invasion were detected in 8 patients.