光动力技术介导膀胱癌精准诊疗的研究进展  

Research progress of photodynamic technology in precision diagnosis and treatment of bladder cancer

作　　者：康海明 闫鹏宇 杨晓峰[2] KANG Haiming;YAN Pengyu;YANG Xiaofeng(The First Clinical Medical College,Shanxi Medical University,Taiyuan 030000,China;Department of Urology,The First Hospital,Shanxi Medical University,Taiyuan 030000,China)

机构地区：[1]山西医科大学第一临床医学院,山西太原030000 [2]山西医科大学第一医院泌尿外科,山西太原030000

出　　处：《现代泌尿外科杂志》2024年第8期744-749,共6页Journal of Modern Urology

摘　　要：膀胱癌是泌尿系统常见的恶性肿瘤之一,现阶段常规诊疗手段取得的效果并不令人满意。近年来,光动力技术发展迅速,在膀胱癌的诊断与治疗中均得到应用,其效果在临床上得到了广泛认可:光动力学诊断(PDD)在膀胱癌的诊断中已经展现价值,与白光膀胱镜(WLC)相比,蓝光膀胱镜(BLC)灵敏度及特异度更高,更好地适用于微小病变及原位癌(CIS)等隐匿性病变的诊断,但昂贵且耗时。以尿液为样本的非侵入性靶向光动力诊断技术开始展现潜力;PDD引导的经尿道膀胱肿瘤切除术(TURBT)具有更好的诊断敏感性及手术精确性。同时,光动力学治疗(PDT)是膀胱癌理想的治疗方式。新型光敏剂的开发,双光子PDT技术、间断性和节律性PDT技术的应用,均有助于在提高疗效的同时减少PDT的操作次数,从而减少额外创伤;有学者尝试使用纳米技术结合PDT与化疗药物进一步改善肿瘤治疗效果;光动力技术与新型分子靶向技术相结合的靶向光动力技术是膀胱癌治疗领域新的热点,单克隆抗体、抗体片段、蛋白质支架、肽和小分子靶向分子示踪剂各自具备不同的特点,新的联合治疗手段正在被研究与开发,光动力技术为膀胱癌治疗带来了新的机遇。Bladder cancer is one of the common malignant tumors of the urinary system,and the results of conventional diagnosis and treatment methods are not satisfactory at this stage.In recent years,photodynamic technology has been applied in the diagnosis and treatment of bladder cancer due to its rapid development,and its effect has been widely recognized in clinical practice.Photodynamic diagnosis(PDD)has shown value in the diagnosis of bladder cancer,and compared with white light cystoscopy(WLC),blue light cystoscopy(BLC)has higher sensitivity and specificity,and is better suitable for the diagnosis of minor lesions and hidden lesions such as CIS,but it is expensive and time-consuming.Non-invasive targeted photodynamic diagnostic techniques using urine as a sample are beginning to show potential;PDD-guided TURBT has better diagnostic sensitivity and surgical precision.Photodynamic therapy(PDT)is an ideal treatment modality for bladder cancer.New photosensitizers have been developed,and two-photon PDT technology,intermittent and rhythmic PDT technology have been applied,which can help to reduce the number of PDT operations and reduce additional trauma while improving the efficacy.Some scholars have tried to use nanotechnology to combine PDT with chemotherapy drugs to further improve the efficacy.Monoclonal antibodies,antibody fragments,protein scaffolds,peptides and small molecule targeted molecular tracers have different characteristics,and new combination therapy methods are being researched and developed,bringing new opportunities for bladder cancer treatment.

关 键 词：膀胱癌 光动力技术 光动力学诊断 光动力学治疗 蓝光膀胱镜 光敏剂 纳米技术 靶向技术 靶向分子示踪剂 

分 类 号：R737.14[医药卫生—肿瘤]