University of Southern California, 1441 Eastlake Avenue, Suite 7416, Los Angeles, CA 90089, USA.
Memorial Sloan-Kettering Cancer Center, USA.
Nat Rev Urol. 2014 Oct;11(10):589-96. doi: 10.1038/nrurol.2014.245. Epub 2014 Sep 23.
Hexaminolevulinate (HAL) is a tumour photosensitizer that is used in combination with blue-light cystoscopy (BLC) as an adjunct to white-light cystoscopy (WLC) in the diagnosis and management of non-muscle-invasive bladder cancer (NMIBC). Since being licensed in Europe in 2005, HAL has been used in >200,000 procedures, with consistent evidence that it improves detection compared with WLC alone. Current data support an additional role in the reduction of recurrence of NMIBC. Since the approval of HAL by the FDA in 2010, experience of HAL-BLC in the USA continues to expand. To define areas of need and to identify the benefits of HAL-BLC in clinical practice, a focus group of expert urologists specializing in the management of patients with bladder cancer convened to review the clinical evidence, share their experiences and reach a consensus regarding the optimal use of HAL-BLC in the USA. The focus group concluded that HAL-BLC should be considered for initial assessment of NMIBC, surveillance for recurrent tumours, diagnosis in patients with positive urine cytology but negative WLC findings, and for tumour staging.
氨基酮戊酸（HAL）是一种肿瘤光敏剂，与蓝光照相膀胱镜检查（BLC）联合使用，作为白光膀胱镜检查（WLC）的辅助手段，用于诊断和治疗非肌肉浸润性膀胱癌（NMIBC）。自 2005 年在欧洲获得许可以来，已有超过 20 万例手术使用了 HAL，有一致的证据表明，与单独使用 WLC 相比，它可以提高检测率。目前的数据支持其在降低 NMIBC 复发方面的额外作用。自 2010 年 FDA 批准 HAL 以来，美国使用 HAL-BLC 的经验不断扩大。为了确定需求领域，并确定 HAL-BLC 在临床实践中的益处，一个专门从事膀胱癌患者管理的专家泌尿科医生焦点小组召开会议，审查临床证据，分享他们的经验，并就 HAL-BLC 在美 国的最佳使用达成共识。专家组得出的结论是，应考虑将 HAL-BLC 用于 NMIBC 的初始评估、复发性肿瘤的监测、尿液细胞学阳性但 WLC 检查结果阴性的患者的诊断，以及肿瘤分期。
