Koenig F, McGovern F J, Althausen A F, Deutsch T F, Schomacker K T
Wellman Laboratories of Photomedicine, Massachusetts General Hospital, Boston 02114, USA.
J Urol. 1996 Nov;156(5):1597-601.
We assessed the ability of laser induced autofluorescence to differentiate malignant from nonmalignant bladder lesions.
We studied 53 patients with bladder cancer undergoing mucosal biopsies or transurethral resection of a bladder tumor. A quartz optical fiber was advanced through the working channel of a cystoscope and placed in gentle contact with the bladder. Tissue fluorescence was excited by 337 nm. light pulses (nitrogen laser). One fiber was used for transmission of the excitation and emission (fluorescence) light. An optical multichannel analyzer system was used to record fluorescence spectra of the sites of interest.
We analyzed the fluorescence spectra of 114 bladder areas (1 carcinoma in situ as well as 28 malignant, 35 inflammatory, 7 dysplastic, 1 squamous metaplastic and 42 normal areas). These lesions included 44 difficult to diagnose suspicious tumors (11 malignant and 33 nonmalignant). We developed an algorithm that used the I385:I455 nm. fluorescence ratio to distinguish malignant from nonmalignant lesions, including inflammatory areas. By analyzing the data on all 114 lesions, we noted the sensitivity, specificity, and positive and negative predictive values of this method for differentiating malignant from nonmalignant bladder lesions to be 97, 98, 93 and 99%, respectively.
Under excitation with 337 nm. light a clear differentiation between malignant and nonmalignant bladder tissues can be made using the I385:I455 nm. autofluorescence ratio.
我们评估了激光诱导自体荧光区分膀胱恶性病变与非恶性病变的能力。
我们研究了53例接受膀胱肿瘤黏膜活检或经尿道膀胱肿瘤切除术的膀胱癌患者。将一根石英光纤通过膀胱镜的工作通道推进，并使其与膀胱轻轻接触。用337nm光脉冲（氮激光）激发组织荧光。一根光纤用于传输激发光和发射（荧光）光。使用光学多通道分析仪系统记录感兴趣部位的荧光光谱。
我们分析了114个膀胱区域的荧光光谱（1个原位癌以及28个恶性、35个炎症、7个发育异常、1个鳞状化生和42个正常区域）。这些病变包括44个难以诊断的可疑肿瘤（11个恶性和33个非恶性）。我们开发了一种算法，使用I385:I455nm荧光比率来区分恶性与非恶性病变，包括炎症区域。通过分析所有114个病变的数据，我们发现该方法区分膀胱恶性与非恶性病变的敏感性、特异性、阳性预测值和阴性预测值分别为97%、98%、93%和99%。
在337nm光激发下，使用I385:I455nm自体荧光比率可清晰区分膀胱恶性组织与非恶性组织。
