5-氨基乙酰丙酸荧光膀胱镜在膀胱肿瘤诊治中的应用评价(附56例报告)  

Value of 5-aminolevulinic acid-induced fluorescence cystoscopy in the diagnosis and treatment of bladder cancer (report of 56 cases)

作　　者：赵军[1] 何辉[1] 贺大林[1] 刘润明[1] 吴大鹏[1] 龙清志[1] 李旭东[1] 

机构地区：[1]西安交通大学医学院第一附属医院泌尿外科,陕西西安710061

出　　处：《现代泌尿外科杂志》2006年第3期158-160,共3页Journal of Modern Urology

基　　金：卫生部临床学科重点项目(No.20012029)

摘　　要：目的与普通膀胱镜相比较,评价5-氨基已酰丙酸荧光膀胱镜检查在膀胱肿瘤诊断和治疗中的价值。方法术前1.5h,1.4%的碳酸氢钠溶液50mL溶解1.5g的5-氨基乙酰丙酸(5-ALA),膀胱灌注。术中对普通光下及蓝光下的可疑部位取活检,并对活检部位电切和电灼,活检组织送病理检查。结果56例患者共取活检155处,平均2.8次/人。荧光膀胱镜的敏感性98.4%(63/64位点),特异性73.5%(61/83位点),两者有显著统计学差异(P<0.01)。蓝光下发现普通光下未发现的肿瘤位点14处。未发现5-ALA的局部和全身毒副作用。结论5-ALA荧光膀胱镜是一种高敏感的用于膀胱肿瘤诊断和治疗的有效方法,能够提高对膀胱原位癌的诊断敏感性及降低术中因未发现和切除不完全所带来的膀胱肿瘤复发危险性。Objective To assess the value of 5-aminolevulinic acid-induced fluorescence endoscopy in the diagnosis and treatment of bladder cancer. Methods One half an hours prior to cystoscopy, 1.5 g 5- aminolevulinic acid （5-ALA） was dissolved in 50 mL 1.4% NaHCO3 solution and instilled intravesically. For fluorescence excitation a blue light source （D-light, Karl Storz） was used. Under white and fluorescence light guidance, tumor locations were recorded, biopsies were taken and tumors were resected. Results 155 biopsies were taken from fluorescent and nonfluorcscent areas （2.8 per patient） to check the effectiveness of the new method. Compared with standard cystoscopy, 5-ALA cystoscopy had a sensitivity of 98.4% （63/64 sites）, specificity of 73.5% （61/83 sites）. There was significant difference between operation methods （P〈0.01）. The 5-ALA cystoscopy helped the diagnosis of tumor in 14 sites with negative standard cystoscopic findings. Neither local nor systemic side effects were noted. Conclusion 5-Aminolevulinic acid-induced fluorescence cystoscopy has proved to be a valua and treatment method with a high sensitivity for the bladder cancer, which improves the diagnostic sensitivity for situ and to reduce the risk of recurrence related to missed cancerous lesions or incomplete resection. ble detection carcinoma In

关 键 词：膀胱肿瘤 光动力学诊断 荧光膀胱镜 

分 类 号：R737.14[医药卫生—肿瘤]