Abstract:
BACKGROUND AND PURPOSE:A major problem diagnosing bladder cancer using conventional white-light cystoscopy is that flat and tiny papillary neoplasms can be overlooked. Fluorescence cystoscopy is based on the detection of protoporphyrin IX (PpIX)-induced fluorescence in urothelial neoplasms through the topical administration of 5-aminolevulinic acid (ALA). The diagnostic efficacy of fluorescence cystoscopy in urothelial neoplasms was evaluated in this study. The focus of this investigation was to ascertain whether fluorescence cystoscopy could make a major contribution to staging and improving the choice of adjuvant therapy after transurethral resection. PATIENTS AND METHODS:A series of 62 patients with suspected bladder cancer were investigated by fluorescence cystoscopy. An intravesical instillation of ALA was conducted 2 hours prior to fluorescence. A total of 274 tissue samples were obtained from the fluorescing and nonfluorescing areas of the bladder. RESULTS:The sensitivity and negative predictive value of fluorescence cystoscopy were 98.0% and 94.7%, respectively, but the specificity was low (42.9%). Among a total of 148 lesions of urothelial neoplasm, 58 foci (dysplasia in 5, carcinoma in situ in 19, stage Ta in 15, T1 in 15, above T2 in 4) that were invisible under white-light cystoscopy were detected by fluorescence cystoscopy. The final histopathologic status was changed in 45% of patients (28/62) according to this technique. Among these patients, eight (13%) needed additional therapy, including a radical cystectomy in one patient and intravesical therapy in 10. CONCLUSIONS:The ALA-based fluorescence cystoscopy technique is a safe and simple procedure that enhances the detection of flat and papillary urothelial neoplasms. Moreover, it will be able to provide useful information that will enable proper staging and appropriate further treatment.
journal_name
J Endouroljournal_title
Journal of endourologyauthors
Jeon SS,Kang I,Hong JH,Choi HY,Chai SEdoi
10.1089/08927790152596370subject
Has Abstractpub_date
2001-09-01 00:00:00pages
753-9issue
7eissn
0892-7790issn
1557-900Xjournal_volume
15pub_type
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journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.1994.8.345
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pub_type: 杂志文章
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pub_type: 杂志文章,评审
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journal_title:Journal of endourology
pub_type: 杂志文章
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journal_title:Journal of endourology
pub_type: 杂志文章,评审
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journal_title:Journal of endourology
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journal_title:Journal of endourology
pub_type: 临床试验,杂志文章
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pub_type: 临床试验,杂志文章
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