Autofluorescence guided biopsy for the early diagnosis of bladder carcinoma.
Autofluorescence guided biopsy for the early diagnosis of bladder carcinoma.
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DOI：
10.1016/s0022-5347(01)63183-5
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发表时间：
1998-06
期刊：
影响因子：
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通讯作者：
Frank Koenig;Francis J. McGovern;Henrik Enquist;Rickard Larne;Thomas F. Deutsch;K. Schomacker
中科院分区：
文献类型：
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作者：
Frank Koenig;Francis J. McGovern;Henrik Enquist;Rickard Larne;Thomas F. Deutsch;K. Schomacker
目的验证激光诱导自身荧光检测膀胱癌的有效性。材料与方法对75例疑似膀胱癌患者的荧光光谱进行分析。组织荧光被氮激光激发，使用石英光纤与感兴趣的区域轻轻接触。采用增强型光学多通道分析仪系统记录了激光诱导的自体荧光光谱。校正了光学系统的光谱响应，以及385和455nm处激光诱导自身荧光强度(I)的比值。（I385/I455）。我们之前建立了这个比率作为诊断算法。我们只纳入了可疑的膀胱病变（红斑、水肿、隆起等），这些病变难以通过膀胱镜检查诊断，以及随机活检的区域。荧光比值算法应用于130个膀胱区域。结果常规膀胱镜检查130例活检中，病理分类非恶性107例（82%）。相比之下，由于激光诱导的自身荧光有效地引导活检指向恶性病变，如果在标准膀胱镜检查中选择识别95%恶性病变的荧光比率（第95百分位数）作为判定标准，则只会从非恶性组织中获得30个活检（减少72%）。结论通过引导外科医生发现最可能为恶性的可疑病变，激光诱导的自身荧光大大减少了膀胱镜检查诊断膀胱癌时从非恶性组织中获得的活检次数。
PurposeWe validate the usefulness of laser-induced autofluorescence for the detection of bladder carcinoma.Materials and MethodsWe obtained and analyzed fluorescence spectra from 75 patients in whom bladder cancer was suspected. Tissue fluorescence was excited by a nitrogen laser using a quartz optical fiber placed in gentle contact with the area of interest. The laser-induced autofluorescence spectrum was recorded using an intensified optical multichannel analyzer system. Spectra were corrected for the spectral response of the optical system, and the ratios of laser-induced autofluorescence intensities (I) at 385 and 455 nm. (I385/I455) were determined. We had previously established this ratio as a diagnostic algorithm. We included only suspicious bladder lesions (erythematous, edematous, raised and so forth) that were difficult to diagnose by cystoscopy as well as areas from which random biopsies were obtained. The fluorescence ratio algorithm was applied to 130 bladder areas.ResultsOf the 130 biopsies obtained during routine cystoscopy 107 (82%) were nonmalignant by histological classification. In contrast, because laser-induced autofluorescence effectively guides biopsies towards malignant lesions, only 30 biopsies (72% fewer) would have been obtained from nonmalignant tissue if the fluorescence ratio that identifies 95% of malignant lesions (95th percentile) had been selected as the decision criterion during standard cystoscopy.ConclusionsBy guiding the surgeon to suspicious lesions that are most likely to be malignant, laser-induced autofluorescence substantially decreases the number of biopsies obtained from nonmalignant tissue during cystoscopy to diagnose bladder carcinoma.