Improving the efficiency of bladder cancer diagnostic cystoscopy with 5-ALA hexyl ester
This article presents the results of a clinical study that examined the diagnostic efficacy of fluorescent diagnostics (FD) of non-muscularinvasive bladder cancer using a photosensitizer of FD of malignant neoplasms – 5-aminolevulinic acid hexyl ester (5-ALA HE) compared with standard cystoscopy. Th...
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| Format: | Article |
| Language: | Russian |
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Non-profit partnership for development of domestic photodynamic therapy and photodiagnosis "Russian Photodynamic Association"
2019-04-01
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| Series: | Biomedical Photonics |
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| Online Access: | https://www.pdt-journal.com/jour/article/view/291 |
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| author | A. D. Kaprin A. A. Trushin M. P. Golovachenko V. I. Ivanova-Radkevich V. I. Chissov E. V. Filonenko |
| author_facet | A. D. Kaprin A. A. Trushin M. P. Golovachenko V. I. Ivanova-Radkevich V. I. Chissov E. V. Filonenko |
| author_sort | A. D. Kaprin |
| collection | DOAJ |
| description | This article presents the results of a clinical study that examined the diagnostic efficacy of fluorescent diagnostics (FD) of non-muscularinvasive bladder cancer using a photosensitizer of FD of malignant neoplasms – 5-aminolevulinic acid hexyl ester (5-ALA HE) compared with standard cystoscopy. The study involved 110 patients. The study began with intravesical administration of 50 ml of 0.2% solution of 5-ALA HE, the exposure time was 1 hour, after which the drug was removed from the organ. During the next hour, the mucous membranes were examined in two cystoscopy modes, followed by a standard transurethral resection of all urothelium sites with suspicion for tumor lesion based on white light and visible red fluorescence, and a control blind biopsy from the visually unchanged and non-fluorescent mucous tissue in each patient. The results of the study indicate the high effectiveness of the developed FD methodology with 5-ALA HE in detecting non-muscularinvasive bladder cancer during intravesical administration of the drug, due to selective accumulation of hexasens-induced PPIX in the tumor tissue compared with healthy mucosa. Compared with the results of standard cystoscopy, fluorescence diagnostics significantly increased diagnostic sensitivity by 24.4% (from 75.1% to 99.5%), diagnostic accuracy – by 15.8% (from 82.4% to 98.2%) and a negative predictive value – by 33.2% (from 65.8% to 99%) (p≤0.05). Additionally, a total of 37 (33.6%) patients was found to have 63 foci of fluorescence with a diameter of 2.5 to 3.0 mm. 59 of these were morphologically confirmed to contain cancer cells. |
| format | Article |
| id | doaj-art-93ed35e685d6493eac8cecf8d3695421 |
| institution | Kabale University |
| issn | 2413-9432 |
| language | Russian |
| publishDate | 2019-04-01 |
| publisher | Non-profit partnership for development of domestic photodynamic therapy and photodiagnosis "Russian Photodynamic Association" |
| record_format | Article |
| series | Biomedical Photonics |
| spelling | doaj-art-93ed35e685d6493eac8cecf8d36954212025-08-20T03:35:29ZrusNon-profit partnership for development of domestic photodynamic therapy and photodiagnosis "Russian Photodynamic Association"Biomedical Photonics2413-94322019-04-0181293710.24931/2413-9432-2019-8-1-29-37159Improving the efficiency of bladder cancer diagnostic cystoscopy with 5-ALA hexyl esterA. D. Kaprin0A. A. Trushin1M. P. Golovachenko2V. I. Ivanova-Radkevich3V. I. Chissov4E. V. Filonenko5P.A. Herzen Moscow Oncology Research Center – branch of FSBI NMRRC of the Ministry of Health of Russia, Moscow; Peoples’ Friendship University of Russia (RUDN University), MoscowSechenov First Moscow State Medical University, MoscowP.A. Herzen Moscow Oncology Research Center – branch of FSBI NMRRC of the Ministry of Health of Russia, MoscowPeoples’ Friendship University of Russia (RUDN University), MoscowSechenov First Moscow State Medical University, MoscowP.A. Herzen Moscow Oncology Research Center – branch of FSBI NMRRC of the Ministry of Health of Russia, MoscowThis article presents the results of a clinical study that examined the diagnostic efficacy of fluorescent diagnostics (FD) of non-muscularinvasive bladder cancer using a photosensitizer of FD of malignant neoplasms – 5-aminolevulinic acid hexyl ester (5-ALA HE) compared with standard cystoscopy. The study involved 110 patients. The study began with intravesical administration of 50 ml of 0.2% solution of 5-ALA HE, the exposure time was 1 hour, after which the drug was removed from the organ. During the next hour, the mucous membranes were examined in two cystoscopy modes, followed by a standard transurethral resection of all urothelium sites with suspicion for tumor lesion based on white light and visible red fluorescence, and a control blind biopsy from the visually unchanged and non-fluorescent mucous tissue in each patient. The results of the study indicate the high effectiveness of the developed FD methodology with 5-ALA HE in detecting non-muscularinvasive bladder cancer during intravesical administration of the drug, due to selective accumulation of hexasens-induced PPIX in the tumor tissue compared with healthy mucosa. Compared with the results of standard cystoscopy, fluorescence diagnostics significantly increased diagnostic sensitivity by 24.4% (from 75.1% to 99.5%), diagnostic accuracy – by 15.8% (from 82.4% to 98.2%) and a negative predictive value – by 33.2% (from 65.8% to 99%) (p≤0.05). Additionally, a total of 37 (33.6%) patients was found to have 63 foci of fluorescence with a diameter of 2.5 to 3.0 mm. 59 of these were morphologically confirmed to contain cancer cells.https://www.pdt-journal.com/jour/article/view/2915-aminolevulinic acid hexyl esterbladder cancerfluorescent diagnostics |
| spellingShingle | A. D. Kaprin A. A. Trushin M. P. Golovachenko V. I. Ivanova-Radkevich V. I. Chissov E. V. Filonenko Improving the efficiency of bladder cancer diagnostic cystoscopy with 5-ALA hexyl ester Biomedical Photonics 5-aminolevulinic acid hexyl ester bladder cancer fluorescent diagnostics |
| title | Improving the efficiency of bladder cancer diagnostic cystoscopy with 5-ALA hexyl ester |
| title_full | Improving the efficiency of bladder cancer diagnostic cystoscopy with 5-ALA hexyl ester |
| title_fullStr | Improving the efficiency of bladder cancer diagnostic cystoscopy with 5-ALA hexyl ester |
| title_full_unstemmed | Improving the efficiency of bladder cancer diagnostic cystoscopy with 5-ALA hexyl ester |
| title_short | Improving the efficiency of bladder cancer diagnostic cystoscopy with 5-ALA hexyl ester |
| title_sort | improving the efficiency of bladder cancer diagnostic cystoscopy with 5 ala hexyl ester |
| topic | 5-aminolevulinic acid hexyl ester bladder cancer fluorescent diagnostics |
| url | https://www.pdt-journal.com/jour/article/view/291 |
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