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Опыт применения флюоресцентной цистоскопии в диагностике поверхностного рака мочевого пузыря

Опыт применения флюоресцентной цистоскопии в диагностике поверхностного рака мочевого пузыря

Abstract

Experience of using fluorescence cystoscopy in the diagnosis of superficial bladder cancer. The study involved 103 patients of both sexes (mean age 58,7 ± 6,3 years) who underwent photodynamic diagnosis (PDD) of bladder cancer. For this purpose 5 mg of photoditazine were injected into the bladder dissolved in 20 ml of saline. The exposure time of the drug in the bladder was from 60 to 90 minutes. Then sequentially performed cystoscopy in white and blue light. For fluorescence diagnosis the light flux with a wavelength of 402 nm was used, which corresponded to the maximum peak of photoditazine absorption. The use of PDD revealed bladder cancer in all 103 patients, while in 69 (67 %) patients were identified in a total of 125 plots mucosa, fluorescent in blue light and unaltered in white light. Histological examination of these sites of mucosa in 52 (41.6 %) cases the tumor (transitional cell carcinoma) was morphologically confirmed, in 14 (11.2 %) cases of dysplasia was detected, in 15 (12 %) squamous metaplasia of the urothelium, in 31 (24.8 %) inflammatory changes in the urothelium, in 13 (10.4 %) leukoplakia of the bladder. Thus, the diagnostic sensitivity of the standard cystoscopy in white light was 62.3 %, and PDD with intravesical use of the drug photodithazine 96.7 %.

Под наблюдением находились 103 больных обоего пола (средний возраст 58,7 ± 6,3 года), которым проводили фотодинамическую диагностику (ФДД) рака мочевого пузыря. С этой целью в мочевой пузырь вводили 5 мг фотодитазина, растворенного в 20 мл физиологического раствора. Время экспозиции препарата в мочевом пузыре составляло от 60 до 90 минут. Затем последовательно выполняли цистоскопию в белом и синем свете. Для флюоресцентной диагностики использовали световой поток с длиной волны 402 нм, что соответствовало максимальному пику поглощения фотодитазина. Использование ФДД позволило выявить рак мочевого пузыря у всех 103 больных, при этом у 69 (67 %) больных было выявлено в общей сложности 125 участков слизистой, флюоресцирующих в синем свете и неизмененных в белом свете. При гистологическом исследовании этих участков слизистой в 52 (41,6 %) случаях морфологически подтверждена опухоль (переходно-клеточный рак), в 14 (11,2 %) случаях выявлена дисплазия, в 15 (12 %) плоскоклеточная метаплазия уротелия, в 31 (24,8 %) воспалительные изменения уротелия, в 13 (10,4 %) лейкоплакия мочевого пузыря. Таким образом, диагностическая чувствительность стандартной цистоскопии в белом свете составила 62,3 %, а ФДД с внутрипузырным применением препарата фотодитазин 96,7%.

Keywords

ПОВЕРХНОСТНЫЙ РАК МОЧЕВОГО ПУЗЫРЯ,SUPERFICIAL BLADDER CANCER,ФОТОДИНАМИЧЕСКАЯ ДИАГНОСТИКА,PHOTODYNAMIC DIAGNOSTICS,ФОТОДИТАЗИН,PHOTODITHAZINE

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
0
Average
Average
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