Department of Urology and Bio-X Program, Stanford University, Stanford, CA 94305, USA. Veterans Affairs Palo Alto Health Care System, Palo Alto, CA 94304, USA.
Institute for Stem Cell Biology and Regenerative Medicine, Stanford University, Stanford, CA 94305, USA.
Sci Transl Med. 2014 Oct 29;6(260):260ra148. doi: 10.1126/scitranslmed.3009457.
A combination of optical imaging technologies with cancer-specific molecular imaging agents is a potentially powerful strategy to improve cancer detection and enable image-guided surgery. Bladder cancer is primarily managed endoscopically by white light cystoscopy with suboptimal diagnostic accuracy. Emerging optical imaging technologies hold great potential for improved diagnostic accuracy but lack imaging agents for molecular specificity. Using fluorescently labeled CD47 antibody (anti-CD47) as molecular imaging agent, we demonstrated consistent identification of bladder cancer with clinical grade fluorescence imaging systems, confocal endomicroscopy, and blue light cystoscopy in fresh surgically removed human bladders. With blue light cystoscopy, the sensitivity and specificity for CD47-targeted imaging were 82.9 and 90.5%, respectively. We detected variants of bladder cancers, which are diagnostic challenges, including carcinoma in situ, residual carcinoma in tumor resection bed, recurrent carcinoma following prior intravesical immunotherapy with Bacillus Calmette-Guérin (BCG), and excluded cancer from benign but suspicious-appearing mucosa. CD47-targeted molecular imaging could improve diagnosis and resection thoroughness for bladder cancer.
光学成像技术与癌症特异性分子成像剂相结合，是提高癌症检测能力并实现图像引导手术的一种极具潜力的策略。膀胱癌主要通过白光膀胱镜进行内镜治疗，但诊断准确性不理想。新兴的光学成像技术具有提高诊断准确性的巨大潜力，但缺乏用于分子特异性的成像剂。我们使用荧光标记的 CD47 抗体（抗 CD47）作为分子成像剂，在新鲜切除的人类膀胱中，利用临床级荧光成像系统、共聚焦内镜和蓝光膀胱镜，一致地识别膀胱癌。对于 CD47 靶向成像，其灵敏度和特异性分别为 82.9%和 90.5%。我们检测到了膀胱癌的变体，这些变体是诊断上的挑战，包括原位癌、肿瘤切除床中的残留癌、卡介苗（BCG）膀胱内免疫治疗后的复发性癌，以及将良性但可疑的黏膜中的癌症排除在外。CD47 靶向分子成像可以提高膀胱癌的诊断和切除彻底性。
