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中央型肺癌的光动力治疗:早期诊断和微创治疗的能力(综述)。

Photodynamic Theranostics of Central Lung Cancer: Capabilities of Early Diagnosis and Minimally Invasive Therapy (Review).

机构信息

Senior Researcher, Laser Medicine Center; Pavlov First Saint Petersburg State Medical University, 6-8 L'va Tolstogo St., Saint Petersburg, 197022, Russia; Senior Researcher, Research Department of Myocardial Microcirculation and Metabolism; Almazov National Medical Research Centre, 2 Akkuratova St., Saint Petersburg, 197341, Russia.

Professor, Head of Thoracic Surgery Department, Research Institute for Surgery and Emergency Medicine; Pavlov First Saint Petersburg State Medical University, 6-8 L'va Tolstogo St., Saint Petersburg, 197022, Russia.

出版信息

Sovrem Tekhnologii Med. 2021;13(6):78-86. doi: 10.17691/stm2021.13.6.09. Epub 2021 Dec 28.

Abstract

UNLABELLED

was to assess the prospects for central lung cancer (CLC) screening using fluorescent diagnostics and its treatment by endobronchial photodynamic therapy (PDT). Bronchoscopic fluorescent diagnostics using chlorin e6 photosensitizers and a developed instrumental system enable to reveal tumor changes in large bronchi mucosa at early stages, and a developed PDT technique performed under fluorescent control helps achieve personalized treatment. Such an approach is considered as a theranostic technique - photodynamic theranostics. central lung cancer screening requires a fluorescent dye characterized by availability and can be used directly within the examination. Indocyanine green can be used as a dye, its peculiarity is the necessity to excite and record fluorescence in the near-infrared (NIR) wavelength band. First experiments using NIR bands to diagnose a bronchoscopic system showed the detectability of tumor areas using on-site bronchoscopic photodynamic theranostics, which consists in NIR imaging of tumor foci when a standard dose of indocyanine green is administered during the examination.

CONCLUSION

Further progress of early diagnostics and minimally invasive CLC therapy will be determined by the development of new photosensitizers, which should be characterized by a high absorption band in NIR area, quick accumulation in a tumor, high yield of single oxygen in NIR illumination, bright fluorescence, high potential in terms of the induction of an anti-tumor immune response.

摘要

目的

评估使用荧光诊断学对中央型肺癌(CLC)进行筛查的前景,并采用支气管内光动力疗法(PDT)进行治疗。

支气管镜荧光诊断学使用氯乙酮光敏剂和开发的仪器系统,可以在早期发现大支气管黏膜的肿瘤变化,而在荧光控制下进行的开发 PDT 技术有助于实现个体化治疗。这种方法被认为是一种治疗诊断技术——光动力治疗诊断。

CLC 筛查需要一种具有可用性的荧光染料,可以在检查中直接使用。吲哚菁绿可用作染料,其特点是需要在近红外(NIR)波长带激发和记录荧光。使用 NIR 波段对支气管镜系统进行的首次实验表明,使用现场支气管镜光动力治疗诊断,即当在检查期间给予标准剂量的吲哚菁绿时,对肿瘤病灶进行 NIR 成像,可以检测到肿瘤区域。

结论

新光敏剂的开发将决定早期诊断和微创 CLC 治疗的进一步进展,这些光敏剂应具有以下特点:在 NIR 区域具有较高的吸收带,在肿瘤中快速积累,在 NIR 照射下产生高单重态氧,明亮的荧光,以及诱导抗肿瘤免疫反应的潜力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/41e8/8858399/9afb1dc17b29/STM-13-6-09-f1.jpg

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