Diagnosis of bladder carcinoma using protoporphyrin IX fluorescence induced by 5-aminolaevulinic acid
Diagnosis of bladder carcinoma using protoporphyrin IX fluorescence induced by 5-aminolaevulinic acid
复制标题
DOI：
10.1046/j.1464-410x.1999.00917.x
复制
发表时间：
1999-01-01
影响因子：
4.5
通讯作者：
Deutsch, TF
中科院分区：
文献类型：
--
作者：
Koenig, F;McGovern, FJ;Deutsch, TF
目的报告一项临床研究的结果，调查诊断恶性和发育不良性膀胱病变的原卟啉IX（PPIX）荧光，并比较它们与那些从早期study.Patients和方法该研究包括55例疑似膀胱癌（在初步诊断或肿瘤随访）; 130例膀胱活检49例进行了病理分析。所有患者在膀胱镜检查前平均135 min接受50 mL 3% 5-氨基乙酰丙酸（ALA）溶液膀胱内滴注，然后在白色和蓝光下进行。结果63例良性病变和67例恶性/发育不良病变活检; 10例恶性/发育不良病变（4例移行细胞癌，2例原位癌，4例发育不良）在常规白光膀胱镜检查中未检出，但在蓝光下被发现。与标准白光膀胱镜检查相比，荧光膀胱镜检查将恶性/发育不良膀胱病变的总体诊断提高了18%。异型增生病变和原位癌的改善更大（50%）。结论基于ALA的荧光检测系统可显著提高膀胱良恶性/异型增生病变的诊断率。然而，确定最佳药物暴露时间需要使用表征良好的仪器和研究方案进行进一步研究，然后可以比较不同组的结果。
Objective To report the results of a clinical study investigating the diagnosis of malignant and dysplastic bladder lesions by protoporphyrin IX (PPIX) fluorescence and to compare them with those from earlier studies.Patients and methods The study included 55 patients with suspected bladder carcinoma (at initial diagnosis or at tumour follow-up visits); 130 bladder biopsies from 49 patients were classified by pathological analysis. All patients received an intravesical instillation of 50 mL, of a 3% 5-aminolaevulinic acid (ALA) solution a mean of 135 min before cystoscopy, which was then performed under white and blue light. Malignant/ dysplastic lesions showing red fluorescence under blue-light excitation were noted and the increase in detection rate calculated.Results There were 63 benign and 67 malignant/dysplastic areas biopsied; 10 malignant/dysplastic lesions (four transitional cell carcinoma, two carcinoma in situ, four dysplastia) were not detected during routine white-light cystoscopy but were identified under blue light. Fluorescence cystoscopy improved the overall diagnosis of malignant/dysplastic bladder lesions by 18% over standard white-light cystoscopy. The improvement was greater for dysplastic lesions and carcinoma in situ (50%). However, the improvement over standard cystoscopy was less than that found by other groups,Conclusion The ALA-based fluorescence detection system significantly enhanced the diagnosis of malignant/dysplastic bladder lesions. However, determining the optimum drug exposure time requires further investigation using well-characterized instrumentation and study protocols, which would then allow comparison of the results from different groups.