Integral spectrophotornetric analysis of 5-aminolaevulinic acid-induced fluorescence cytology of the urinary bladder
Integral spectrophotornetric analysis of 5-aminolaevulinic acid-induced fluorescence cytology of the urinary bladder
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DOI：
10.1111/j.1464-410x.2006.06094.x
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发表时间：
2006-05-01
影响因子：
4.5
通讯作者：
Stief, C
中科院分区：
文献类型：
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作者：
Tauber, S;Stepp, H;Stief, C
目的探讨5-氨基乙酰丙酸(ALA)诱导的荧光内窥镜检查(AFE)和细胞学检查在膀胱移行细胞癌(TCCB)诊断中的应用价值，并探讨用荧光分光光度法检测膀胱灌洗液中癌细胞的可行性。在AFE期间，进行活组织检查。在62例患者中，24例经组织学证实为TCCB(A组)，28例有TCCB病史但无疾病证据(13组)，10例TCCB阴性(C组)。A组所有患者的沉淀物均在635 nm处出现红色荧光，提示原卟啉IX(PPIX)。漂白信号在良、恶性肿块间差异有统计学意义(P=0.001)。在约620 nm处有另一个红色荧光峰，其中19例的荧光强度超过了PPIX信号的强度。结论灌洗液沉淀物的荧光光谱分析可用于检测TCCB中PPIX的肿瘤相关红色荧光。可以立即进行重要和客观的测量，这些测量可以进一步自动化，以便快速诊断TCCB。
OBJECTIVE To evaluate whether tumour cells can be detected in bladder lavage fluid samples by an objective spectrofluorometric method, as 5-aminolaevulinic acid (ALA)-induced fluorescence endoscopy (AFE) and cytology are promising valuable tools for detecting transitional cell carcinoma of the urinary bladder (TCCB).MATERIALS AND METHODS After instilling ALA into the urinary bladder, lavage samples were collected and their sediments analysed spectroscopically under blue excitation at approximate to 400 nm wavelength. During AFE, biopsies were taken. From 62 cases, 24 patients had a histologically confirmed TCCB (group A), 28 had a history of TCCB but no evidence of disease (group 13) and 10 were negative for TCCB (group C).RESULTS Lavage sediments of all patients fluoresced in the green spectral range, typical of cellular autofluorescence. Sediments of all patients of group A caused red fluorescence peaking at 635 nm, indicating protoporphyrin IX (PPIX). The PPIX signals derived from bleaching spectra were significantly different between benign and malignant findings (P = 0.001). There was another red fluorescence peak at approximate to 620 nm; in 19 cases its intensity exceeded the intensity of the PPIX signal.CONCLUSIONS Spectrofluorometric analysis of lavage sample sediments can be used to detect tumour-associated red fluorescence of PPIX in TCCB. Immediate significant and objective measurements are possible, which could be further automated for the rapid diagnosis of TCCB.