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为了研究以5-氨基果糖酸(ALA)作为荧光物质的光动力学诊断系统(PDD)对膀胱微小乳头状癌、上皮的不典型增生和原位癌诊断的敏感性和特异性,对12例临床诊断为膀胱癌的患者,于术前用ALA1.5克+8.4％NaHCO_3 50ml行膀胱内灌注,2～4小时后进行常规膀胱镜检和荧光膀胱镜检(光源为λ=375～440nm蓝光),然后在有荧光部位行活检送病理检查。12例共69个活检标本,病理结果显示PDD对膀胱癌及不典型增生的诊断敏感性为100％,特异性为86.7％,假阳性率为13.3％,无假阴性。荧光膀胱镜检可以发现常规膀胱镜检难以发现的微小癌灶及不典型增生,指导电切,对减少肿瘤的遗漏和降低复发率有较大的临床意义。
In order to investigate the sensitivity and specificity of photodynamic diagnosis system (PDD) using 5-aminoglycolic acid (ALA) as a fluorescent substance in the diagnosis of bladder papillary carcinoma, epithelial dysplasia and carcinoma in situ, 12 patients Clinical diagnosis of bladder cancer in patients with preoperative ALA1.5 g + 8.4% NaHCO_3 50ml intravesical instillation, 2 to 4 hours after routine cystoscopy and fluorescence cystoscopy (light source for the λ = 375 ~ 440nm blue light ), And then biopsy in the fluorescent site to send pathological examination. A total of 69 biopsies were obtained from 12 patients. The pathological results showed that PDD had a sensitivity of 100%, a specificity of 86.7% and a false positive rate of 13.3% in bladder cancer and atypical hyperplasia without any false negative. Fluorescent cystoscopy can be found in conventional cystoscopy difficult to detect the tiny foci and dysplasia, guide the electrical incision, to reduce tumor omission and reduce the recurrence rate of greater clinical significance.