THP内镜检查可提高非肌层浸润性膀胱癌的诊断率：一项前瞻性、单中心的初步研究.pdfVIP

JOURNAL OF ENDOUROLOGY Transurethral and Lower Tract Procedures Volume 24, Number 11, November 2010 ª Mary Ann Liebert, Inc. Pp. 1801–1806 DOI: 10.1089=end.2009.0680 Improved Detection of Nonmuscle Invasive Urothelial Carcinoma of the Bladder Using Pirarubicin Endoscopy: A Prospective, Single-Center Preliminary Study Jinli Han, M.D., Ph.D., Tianxin Lin, M.D., Ph.D., Kewei Xu, M.D., Ph.D., Chun Jiang, M.D., Hai Huang, M.D., Xinbao Yin, M.D., Wenlian Xie, M.D., Ph.D., Yousheng Yao, M.D., Ph.D., Caixia Zhang, M.D., Ph.D., and Jian Huang, M.D., Ph.D. Abstract Background and Purpose: Fluorescence cystoscopy (FC) with intravesical instillation of a photosensitizing agent has emerged as an adjunctive and safe diagnostic tool with high sensitivity and reasonable specificity; however, it has not been widely accepted, because it is time-consuming and expensive. The aim of the present study was to determine whether the use of the fluorescent dye pirarubicin [(2@R)-40-O-tetrahydropyranyl doxorubicin] (THP) in endoscopy can improve detection of nonmuscle invasive urothelial carcinoma of the bladder. Patients and Methods: Forty-eight patients with known or suspected bladder urothelial carcinoma were en- rolled in this prospective study between January 2008 and April 2009. The Storz D-light system was used to detect fluorescence 15 minutes after intravesical instillation with 30 mg THP. Endoscopic findings, histopatho- logic evaluation of biopsy lesions, and adverse effects of THP were recorded. Results: After THP uptake, the lesions appear bright orange under white light, and produce bright red fluo- rescence under blue light. Among 238 biopsies evaluated (84 malignant, 20 dysplasia, and 134 benign), sensi- tivity of overall tumors, carcinoma in situ (CIS), and dysplasia detection us