Department of Urology, Central Hospital of Bolzano, Bolzano, Italy.
Curr Urol Rep. 2013 Apr;14(2):90-3. doi: 10.1007/s11934-013-0306-0.
Photodynamic Diagnosis (PDD), an adjunct to white light cystoscopy, has been shown to improve detection and thoroughness of resection of bladder cancer by enhancing visualisation of malign lesions during transurethral resection of bladder tumours (TURBT) compared to the sole use of standard white light cystoscopy. The PDD also has been shown to improve recurrence of free survival in non-muscle invasive bladder cancer. Little data on its impact on outcome in non-muscle invasive bladder cancer of high risk of progression is available however. The few trials and studies available demonstrate improved accuracy of diagnosis especially of flat malign lesions. In addition, improved recurrence rates have been suggested without an impact on progression rates in early invasive bladder cancer indicating little influence of thoroughness of resection on the tumour biology in those tumour stages. While no specific and larger data on impact of PDD on cancer specific survival exist to date and the few long-term data suggest little impact, improved accuracy of diagnosis is suggested to be beneficial for clinical decision making and thus a value of PDD is postulated in the management of high-risk non-muscle invasive bladder cancer.
光动力诊断(PDD)是白光膀胱镜检查的辅助手段,与单独使用标准白光膀胱镜检查相比,它通过增强经尿道膀胱肿瘤切除术(TURBT)过程中恶性病变的可视化程度,提高了膀胱癌的检测和彻底切除率。PDD 还显示可提高非肌肉浸润性膀胱癌的无复发生存率。然而,关于其对高进展风险非肌肉浸润性膀胱癌结局的影响的数据很少。目前可用的少数试验和研究表明,其诊断准确性得到了提高,尤其是对扁平恶性病变的诊断准确性。此外,早期浸润性膀胱癌的复发率有所改善,而进展率没有影响,这表明在这些肿瘤分期中,切除的彻底程度对肿瘤生物学的影响很小。虽然目前尚无关于 PDD 对癌症特异性生存率影响的具体且更大的数据,而且少数长期数据表明影响很小,但诊断准确性的提高被认为有助于临床决策,因此假设在高危非肌肉浸润性膀胱癌的管理中 PDD 具有价值。