5-氨基乙酰丙酸盐酸盐光动力学诊断原位癌的临床应用与尿细胞学分级无关。

IF 2.6 3区医学 Q2 ONCOLOGY

Photodiagnosis and Photodynamic Therapy Pub Date : 2025-07-16 DOI:10.1016/j.pdpdt.2025.104722

Shinkuro Yamamoto , Hideo Fukuhara , Ryu Shigehisa , Takeshi Hara , Yasuhiko Shibanaka , Keiji Inoue

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引用次数: 0

摘要

背景：尿细胞学检查是诊断和监测膀胱癌的一种简便方法。虽然它提供了非常高的特异性，但其检测低级别尿路上皮癌的灵敏度有限。方法：一项III期前瞻性、开放标签、多中心试验（SPP2C101研究，jRCT2080222877），来自5所大学的60例患者，包括原发性和复发性患者。所有患者在经尿道膀胱肿瘤切除术（TURBT）前14天内进行尿细胞学检查，然后进行白光TURBT或光动力诊断（PDD）辅助TURBT。结果：我们分析了尿液细胞学分类与白光或PDD检测原位癌（CIS）的关系。在一些细胞学分类为I类和II类（无恶性发现）的患者中，仅通过PDD识别CIS。此外，在IV级（强烈怀疑为恶性的细胞）和V级（存在非典型恶性细胞）中，PDD比白光检测到更多的CIS病变。结论：在大多数术前尿细胞学分类中，PDD在患者和样本水平上检测到白光遗漏的CIS病例。因此，无论术前尿细胞学结果如何，只要患者适合这种方法，在TURBT期间应考虑PDD。

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Clinical utility of photodynamic diagnosis with 5-aminolevulinic acid hydrochloride for detecting carcinoma in situ independent of urine cytology classification

Background

Urine cytology is a simple method used for diagnosing and monitoring bladder cancer. Although it offers very high specificity, its sensitivity for detecting low-grade urothelial carcinoma is limited.

Methods

A phase III prospective, open-label, multicenter trial (SPP2C101 study, jRCT2080222877) was conducted with 60 patients—both primary and recurrent cases—from five universities. All patients underwent urine cytology within 14 days before transurethral resection of bladder tumors (TURBT), followed by either white light TURBT or photodynamic diagnosis (PDD)-assisted TURBT.

Results

We analyzed the relationship between urine cytology class and the detection of carcinoma in situ (CIS) using white light or PDD. CIS was identified exclusively via PDD in some patients with cytology classified as class I and II (no malignant findings). Additionally, in class IV (cells strongly suspected to be malignant) and class V (atypical malignant cells present), PDD detected more CIS lesions than white light.

Conclusion

Across most preoperative urine cytology classes, PDD detected CIS cases that white light missed, both at the patient and sample level. Therefore, PDD should be considered during TURBT regardless of preoperative urine cytology results, provided the patient is suitable for this approach.

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来源期刊

Photodiagnosis and Photodynamic Therapy ONCOLOGY-

CiteScore

5.80

自引率

24.20%

发文量

509

审稿时长

50 days

期刊介绍： Photodiagnosis and Photodynamic Therapy is an international journal for the dissemination of scientific knowledge and clinical developments of Photodiagnosis and Photodynamic Therapy in all medical specialties. The journal publishes original articles, review articles, case presentations, "how-to-do-it" articles, Letters to the Editor, short communications and relevant images with short descriptions. All submitted material is subject to a strict peer-review process.