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膀胱尿路上皮癌占膀胱癌总数的90%以上,其分为非肌层浸润性尿路上皮癌(NMIBC)和肌层浸润性尿路上皮癌(MIBC)。非肌层浸润性尿路上皮癌患者多采用经尿道膀胱肿瘤电切术(TURBT)治疗,并在术后采用膀胱灌注治疗以防复发。卡介苗(Mycobacterium bovis BCG)是由活的无毒牛型结核杆菌制成,通常作为膀胱内灌注的药剂并在非浸润性膀胱癌治疗中获得了成功的应用。灌注BCG虽然能够明显降低肿瘤的复发率,但由于其大剂量的使用和较强的副作用等原因经常造成治疗的失效。本文将重点针对BCG的临床应用、作用机理和面临的挑战等方面做一综述,特别探讨了如何利用合成生物学方法来对BCG进行重组改造,以获得高效、低毒副作用的重组BCG(r BCG),并最终使其更好地服务于临床。
Bladder urothelial carcinoma accounts for more than 90% of the total number of bladder cancers and is classified as non-myometrial invasive urothelial carcinoma (NMIBC) and myometrial invasive urothelial carcinoma (MIBC). Non-myometrial invasive urothelial carcinoma were mostly treated with transurethral resection of the bladder tumor (TURBT) and treated with intravesical instillation to prevent recurrence after surgery. Mycobacterium bovis BCG is made from live, non-toxic M. bovis bacterium and is commonly used as an agent for intravesical instillation and has been successfully used in the treatment of non-invasive bladder cancer. Although perfusion of BCG can significantly reduce the recurrence rate of the tumor, it often causes treatment failure due to its high dose of use and strong side effects. This article will focus on the clinical application of BCG, its mechanism of action and the challenges faced by a review, in particular, how to use the method of synthetic biology BCG recombinant transformation to obtain efficient and low toxic side effects of recombinant BCG (BCG ), And ultimately make it better to serve the clinical.