Department of Urology, The Ohio State University, Suite 3000, 915 Olentangy River Rd, Columbus, OH, 43212, USA.
Curr Urol Rep. 2020 Apr 4;21(5):19. doi: 10.1007/s11934-020-0966-5.
It has been firmly established that hexaminolevulinate-assisted blue light cystoscopy (HAL-BLC) reduces cancer recurrence rates. This review explores the impact of HAL-BLC on other meaningful outcomes in patients with bladder cancer, including disease progression, and earlier detection of disease at the time of surveillance cystoscopy.
A randomized clinical trial confirmed earlier implementation of HAL-BLC at the time of surveillance cystoscopy increased identification of cancerous lesions, including those of high grade, when compared with white light cystoscopy. In addition, the evidence is evolving that the use of HAL-BLC at the time of endoscopic treatment of high-risk tumors may lead to lower rates of progression to muscle invasion, and this in part may be due to better risk stratification leading to changes in treatment plan. The clinical contexts for the use of HAL-BLC are broader than prior knowledge. It is also becoming more clear that the positive impact of HAL-BLC is likely more than just reducing cancer recurrence rates, and patients would benefit from the technology at many time points in the management and follow-up of their disease.
已明确证实，六亚甲基蓝辅助蓝光照相膀胱镜检查（HAL-BLC）可降低癌症复发率。本综述探讨了 HAL-BLC 对膀胱癌患者其他有意义的结果的影响，包括疾病进展以及在监测性膀胱镜检查时更早地发现疾病。
一项随机临床试验证实，与白光膀胱镜检查相比，在监测性膀胱镜检查时更早地实施 HAL-BLC 可更早地发现癌性病变，包括高级别病变。此外，证据表明，在高危肿瘤的内镜治疗时使用 HAL-BLC 可能会导致进展为肌肉浸润的比率降低，部分原因可能是更好的风险分层导致治疗计划的改变。HAL-BLC 的临床应用范围比之前的认识更广。越来越明显的是，HAL-BLC 的积极影响可能不仅仅是降低癌症复发率，而且患者在疾病的管理和随访的许多时间点都会受益于该技术。
