Hungerhuber Edwin, Stepp Herbert, Kriegmair Martin, Stief Christian, Hofstetter Alfons, Hartmann Arndt, Knuechel Ruth, Karl Alexander, Tritschler Stefan, Zaak Dirk
Department of Urology, Klinikum Grosshadern, Ludwig-Maximilians-University of Munich, Munich, Germany.
Urology. 2007 Feb;69(2):260-4. doi: 10.1016/j.urology.2006.10.015.
Photodynamic diagnosis (PDD) using 5-aminolevulinic acid has proved to be a procedure with an outstanding sensitivity for the detection of transitional cell carcinoma of the bladder, in particular in the detection of flat urothelial lesions. We report on our clinical results with 875 patients (1713 PDD procedures) between March 1995 and March 2002.
A total of 1713 PDD procedures were done in 875 patients. Fluorescence imaging was performed 2 to 3 hours after instillation of 50 mL of a 3% solution of 5-aminolevulinic acid into the bladder by an incoherent light source. In total, specimens from 4630 lesions (2.7 lesions/PDD) were taken.
In 34.8% of all biopsies, the histologic finding was malignant; 23.7% of these biopsies had been taken only because of positive fluorescence. In 28.5% of the positive biopsies, flat lesions had been identified. Also, 43.4% of carcinoma in situ and 30.7% of dysplasia II degrees were detected only by positive fluorescence. Of all tumor lesions, 92.0% were detected by PDD compared with 76.3% detected by white light endoscopy.
PDD has proved to be an effective detection device for superficial bladder cancer.
已证实使用5-氨基酮戊酸的光动力诊断（PDD）对检测膀胱移行细胞癌具有极高的敏感性，尤其是在检测扁平尿路上皮病变方面。我们报告了1995年3月至2002年3月期间875例患者（1713次PDD操作）的临床结果。
875例患者共进行了1713次PDD操作。通过非相干光源将50 mL 3%的5-氨基酮戊酸溶液注入膀胱后2至3小时进行荧光成像。总共采集了4630个病变的标本（每次PDD操作采集2.7个病变标本）。
在所有活检中，34.8%的组织学检查结果为恶性；其中23.7%的活检仅因荧光阳性而进行。在阳性活检中，28.5%发现了扁平病变。此外，原位癌的43.4%和Ⅱ级发育异常的30.7%仅通过荧光阳性检测到。在所有肿瘤病变中，PDD检测出92.0%，而白光内镜检测出76.3%。
PDD已被证明是一种检测浅表性膀胱癌的有效手段。
