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Photodynamic Therapy in the Treatment of Bladder Cancer: Past Challenges and Current Innovations
摘要： There are limited treatment options for patients with recurrent non-muscle-invasive bladder cancer. In this report, we will talk about the history of photodynamic therapy; although it showed encouraging therapeutic results, it was largely abandoned due to toxicity or bystander effects on normal cells. Monoclonal antibody-conjugates represent an emerging therapeutic approach for malignancies that improves upon tumor specificity. The use of a monoclonal antibody-photosensitizer conjugate is a more selective method of delivering light therapy and has been termed 'photoimmunotherapy', which we will discuss in the last part of this report.
关键词： Hematoporphyrin,Urothelial cancer,Hexaminolevulinic acid,Photoimmunotherapy,PIT,BCG-refractory NMIBC,PDT,Bladder cancer,5-Aminolevulinic acid,Photodynamic therapy
更新于2025-09-23 15:23:52
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Efficacy of Hexaminolevulinate Photodynamic Diagnosis of Non-Muscle Invasive Bladder Cancer
摘要： Objective: This study evaluated the efficacy of hexaminolevulinate fluorescence cystoscopy as a diagnostic tool for bladder cancer. The study was a case series in the Department of Urology in Hippokratio General Hospital of Athens between October 2008 and May 2012. Methods: Fifty patients (43 males and 7 females) who were investigated for hematuria were included in the study. White light cystoscopy (WLC) was first performed in all patients and after was performed a fluorescence cystoscopy (BLC-blue light cystoscopy). Biopsies were collected from any suspicious area and resection of the tumors identified (TUR).Whenever no suspicious areas could be seen, a standard random mapping including 8 biopsies overall was completed. Results: Patients demographic data and clinical history are presented in Table 1. Two-hundred twenty specimens were extracted and bladder cancer was diagnosed in 137. There were 17 CIS lesions all diagnosed with BLC whereas only 11 with WLC. WLC correctly diagnosed 109/140 specimens and the positive and negative predictive values were 77.9% and 65% respectively. The sensitivity and specificity were 79.6% and 62.6% respectively. BLC diagnosed 125/169 specimens and the positive and negative predictive values were 73.9% and 76.5% respectively. The sensitivity of BLC was 91.2% and the specificity 46.9%. Conclusion: Hexaminolevulinate-guided cystoscopy is a valuable diagnostic method, with considerably improved accuracy and improvement in diagnosis of non-muscle-invasive bladder cancer and especially CIS.
关键词： Transurethral resection,Hexaminolevulinate-Guided cystoscopy,Bladder cancer
更新于2025-09-23 15:23:52
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Multifunctional nanoclusters of NaYF4:Yb3+,Er3+ upconversion nanoparticle and gold nanorod for simultaneous imaging and targeted chemotherapy of bladder cancer
摘要： This paper reports successful synthesis of multifunctional nanoclusters of upconversion nanoparticle (UCNP) and gold nanorod (AuNR) through a PEGylation process. UCNPs emit visible luminescence under near-infrared excitation, producing high-contrast images with no background fluorescence. When coupled with AuNRs, the resulting UCNP-AuNR multifunctional nanoclusters are capable of simultaneous detection and treatment of bladder cancer. These UCNP-AuNR nanoclusters are further functionalized with antibodies to epidermal growth factor receptor (EGFR) to target bladder cancer cells known to overexpress EGFRs. This paper demonstrates, for the first time, efficient targeting of bladder cancer cells with UCNP-AuNR nanoclusters. In addition to high-contrast imaging and consequently high sensitivity detection of bladder cancer cells, highly selective optoporation-assisted chemotherapy was accomplished using a dosage of chemotherapy agent significantly lower than any previous reports, within a clinically relevant incubation time window. These results are highly relevant to the eventual human application in which the nanoclusters and chemotherapy drugs will be directly instilled in bladder via urinary catheter.
关键词： Luminescence upconversion,Surface Plasmon,Bladder Cancer,Gold Nanorod,Optoporation
更新于2025-09-23 15:23:52
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Plasmoelectronic-Based Ultrasensitive Assay of Tumor Suppressor microRNAs Directly in Patient Plasma: Design of Highly Specific Early Cancer Diagnostic Technology
摘要： It is becoming understood that microRNAs hold great promise for non-invasive liquid biopsies for screening for different types of cancer, but current state-of-the-art RT-PCR and microarray techniques have sensitivity limitations that currently restrict their use. Herein, we report a new transduction mechanism involving delocalization of photoexcited conduction electrons wavefunction of gold triangular nanoprism (Au TNP) in the presence of -ssDNA/microRNA duplexes. This plasmoelectronic effect increases the electronic dimension of Au TNPs and substantially affects their localized surface plasmon resonance (LSPR) properties that together allow us to achieve a sensitivity for microRNA assay as low as 140 zeptomolar concentrations for our nanoplasmonic sensors. We show that the position of a single base-pair mismatch in the -ssDNA/microRNA duplex dramatically alters the LSPR properties and detection sensitivity. The unprecedentedly high sensitivity of nanoplasmonic sensors has allowed us to assay four different microRNAs (microRNA-10b, -182, -143 and -145) from bladder cancer patient plasma (50 μL/sample). For the first time, we demonstrate the utility of a label-free, nanoplasmonic sensor in quantification of tumor suppressor microRNAs - the level of tumor suppressor microRNAs goes down in cancer patient as compared to normal healthy individuals - in metastatic and non-metastatic bladder cancer patient plasma. Our statistical analysis of patient samples unequivocally suggests that the tumor suppressor microRNAs are more specific biomarkers (p-value of <0.0001) than oncogenic microRNAs for differentiation between metastatic and non-metastatic bladder cancer, and non-metastatic cancer from healthy individuals. This work demonstrating the electron wavefunctions delocalization dependent ultrasensitive LSPR properties of noble metal nanoparticles has a great potential for fabrication of miniaturized and extremely powerful sensors to investigate microRNA properties in other cancers (for example breast, lung, and pancreatic) through liquid biopsy.
关键词： nanoplasmonic sensors,ultrasensitive detection,microRNAs,LSPR,liquid biopsy,bladder cancer,plasmoelectronic effect
更新于2025-09-23 15:22:29
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Fulguración ambulatoria con láser Holmium: Un procedimiento seguro para el tratamiento de la recidiva del carcinoma vesical no músculo infiltrante
摘要： Background and Objective: Nonmuscle invasive bladder cancer has a high recurrence rate and a low progression rate. The aim of this study was to assess the effectiveness, safety and feasibility of Holmium laser fulguration in an outpatient regimen for selected tumours. Material and Method: A prospective, longitudinal cohort study was conducted between January 2009 and December 2016. Seventy-nine Holmium laser fulguration procedures with subsequent instillation of mitomycin C were performed in an outpatient regimen on 59 patients with a history of low-risk bladder cancer and recurrence of small papillary tumours. We performed a descriptive data analysis and analysed the relapse-free time using Kaplan-Meier curves. Results: All procedures were completed in one day, and only one patient required subsequent hospitalisation due to haematuria. Some 87.2% of the patients presented pain with a visual analogue score ≤3. Recurrence occurred after 49.4% of the procedures (27.3% at 12 months). The median follow-up time was 17 months (range, 2-65). The onset of recurrence was significantly earlier after the second fulguration than after the first (median, 10 months vs. 56 months). Conclusions: Holmium laser fulguration and subsequent mitomycin C instillation in an outpatient regimen is a safe and feasible alternative to transurethral resection of bladder tumours in selected patients. Transurethral resection of the bladder tumour is recommended for patients with recurrence after fulguration, given the possibly higher risk of progression in these patients.
关键词： Nonmuscle invasive bladder cancer,Outpatient fulguration,Holmium laser
更新于2025-09-23 15:22:29
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Dual-mode Au nanoprobe based on surface enhancement Raman scattering and colorimetry for sensitive determination of telomerase activity both in cell extracts and the urine of patients
摘要： Telomerase is a valuable biomarker, which is highly correlated to cancer diseases. However, single-mode probe for telomerase detection cannot satisfy the challenge of detection of telomerase activity rapidly, simply with high selectivity, sensitivity and accuracy both in preliminary diagnosis and point of care (POC) testing. Therefore, there is an urgent need to develop a robust approach with controllable assembly and high accuracy to consider both the simplification of preliminary diagnosis and POC testing and the quantification requirement for early clinical diagnosis and treatment. Herein, a novel dual-mode Au NPs probe was developed for determination of telomerase activity with controllable assembly and aggregation statement based on surface enhancement Raman scattering (SERS) and colorimetry. In this strategy, an Au dimer-based probe with high uniformity was assembled successfully, telomerase activity was reflected according to the color variations of solution and the Raman intensity of Raman reporter. Taking advantage of the uniformity of Au dimers and the combination of colorimetry and SERS techniques, our strategy determined the telomerase activity with high accuracy, sensitivity and wide range. The established probe possessed of high selectivity, sensitivity and accuracy, which was approved as a reliable, intuitional and convenient approach for detecting telomerase activity.
关键词： colorimetry,bladder cancer,surface enhanced Raman scattering,Au nanoparticles,telomerase activity
更新于2025-09-23 15:21:21
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The clinical study of en Bloc transurethral resection with 980a??nm Laser for treatment of primary non-muscle invasive bladder cancer
摘要： OBJECTIVE: To elevate safety and ef?cacy of en bloc transurethral resection with 980 nm laser as treatment for primary non-muscle-invasive bladder cancer (NMIBC). METHODS: Total 84 cases were enrolled in this study. Among them, 36 and 48 cases underwent treatment using the 980 nm laser and the traditional TUR-BT procedure, respectively. The peri-operative characteristics (tumor size, tumor multiplicity, tumor grade, etc.) and intra-operative complications (obturator nerve re?ex, bladder perforation, bladder irrigation, etc.) were recorded and compared between the two groups. RESULTS: There are no signi?cant difference in baseline characteristics between laser and TUR-Bt treatment groups. Operation time also has no signi?cant difference in two groups. Obturator nerve re?ex and bladder perforation were noted in 6 patients and in 3 patients during TUR-Bt group, respectively. No obturator nerve re?ex and bladder perforation were observed in the laser group. The patients who need bladder irrigation was lower in laser group than in TUR-Bt group. There were no signi?cant differences in catheterization time and hospitalization time between two groups. No signi?cant difference in the overall recurrence rate were observed among the two groups during the follow-up periods. CONCLUSION: En bloc transurethral resection using 980 nm laser is an effective and safe treatment option for non- muscle-invasive bladder cancer. Compared to the traditional TUR-Bt procedure, the procedure using 980 nm laser has fewer perioperative complications and similar oncological results.
关键词： 980 nm laser,en Bloc,non-muscle invasive bladder cancer
更新于2025-09-23 15:21:01
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Transurethral en bloc resection of non-muscle invasive bladder cancer with holmium:YAG laser in pediatric patients: cases series and review of literatures
摘要： Introduction Urothelial bladder carcinoma frequently occurs in adults over 60?years of age; yet it affects only 0.1–0.4% of patients before the first 2?decades of life. We present two cases of transitional cell carcinoma in two young patients treated with holmium:YAG laser to demonstrate the effectiveness of this technique in pediatrics. Cases and methods Case study 1 During a routine abdomen ultrasound, a 14-year-old female showed a endoluminal formation about 10 × 6 × 10?mm of size, in the left paramedian site. There was an absence of meaningful vascular signs during color-Doppler. Physical examination and laboratory exams were all normal. Case study 2 A 12-year-old female presented with acute macroscopic haematuria. No other symptoms were associated. Bladder ultrasound revealed an irregular 15?mm intravesical endophytic lesion in the posterior-superior area. In both cases, treatment commenced with an en bloc enucleation. For the resections, a 272?μm holmium:YAG fiber laser was used through the 12 Ch cystoscopy working channel with an energy of 0.8–1?J/pulse and a frequency of 8–10?Hz. Results There was no haematuria after the procedure and the transurethral catheter remained for 12?h. The histological diagnosis was papillary urothelial neoplasm of low malignant potential. Cystoscopy was performed 3 and 9?months after the surgery and an ultrasound every 6?months, which all came back normal. The follow-up continued for each patient with a cystoscopy once a year, according to EAU guidelines. Conclusion Based on the findings, holmium:YAG laser is a good alternative to treat superficial transitional cell carcinoma in pediatric patients.
关键词： Transurethral en bloc resection,Transitional cell carcinoma,PUNLMP,Holmium:YAG laser,Pediatric bladder cancer
更新于2025-09-23 15:21:01
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Can a second resection be avoided after initial thulium laser endoscopic en bloc resection for non-muscle invasive bladder cancer? A retrospective single-center study of 251 patients
摘要： Background: This study aimed to evaluate the efficacy of transurethral thulium laser en bloc resection of the bladder tumor (TmLRBT) in patients with non-muscle invasive bladder cancer (NMIBC) and to investigate whether a second resection can be avoided. Methods: From June 2012 to June 2018, 251 newly diagnosed patients with NMIBC were enrolled in this retrospective study; all patients received regular administration of pirarubicin after the initial resection. A second transurethral resection (TUR) was performed in patients within 2–6 weeks after the initial TmLRBT in group 1. Patients in group 2 only underwent cystoscopy at 3 months. Results: Second surgery results indicate that recurrence was detected histopathologically in 6/108 and 11/143 patients in group 1 and 2, respectively (P = 0.52); Progression was observed in 2 patients in each group (P = 0.34). The mean follow-up duration was 40.1 months, with no significant difference between the groups (P = 0.32). Recurrence was observed in 23 (21.3%) and 39 (27.3%) patients in groups 1 and 2 during the follow-up, respectively (P = 0.34); disease progression occurred in 4 (3.8%) patients in group 1 compared with 7 (4.0%) in group 2 (P = 0.20). Conclusion: Complete removal of tumors can be achieved by TmLRBT. This technique may decrease the number of second TURs.
关键词： Intravesical instillation,Transurethral thulium laser en bloc resection of bladder tumor,Second resection,Bladder cancer,Pirarubicin
更新于2025-09-23 15:19:57
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DaBlaCa-11: Photodynamic diagnosis in flexible cystoscopy - initial findings in a randomized controlled trial
摘要： Patients with non-muscle invasive bladder cancer (NMIBC) face the risk of having several transurethral resections of the bladder (TURBT) performed because of the high recurrence rate of the disease. Photodynamic diagnosis (PDD) is recommended in primary TURBTs because of a higher detection rate than white light (WL) cystoscopy. In the surveillance program, however, WL flexible cystoscopy is still the standard approach. The aim of this randomized controlled trial is to examine the potential benefits from a PDD guided flexible cystoscopy in the outpatient clinic in patients with previous NMIBC. From February 2016 to September 2017, 605 patients were enrolled from three urological department in Denmark. All patients were scheduled for a routine surveillance cystoscopy following a TURBT because of Ta bladder cancer (low or high grade) 4 months earlier. Patients were randomized 1:1 to either an intervention group where Hexaminolevulinate (Hexvix?Photocure, NO) was instilled in the bladder one hour before the cystoscopy with PDD video cystoscope (PDD 11272 VPI, D-Light C-Light Source; Karl Storz), or a control group where cystoscopy was performed with WL flexible cystoscope. In both patient groups, detection of multiple and large recurrences estimated > 1 cm were scheduled for a TURBT in general anesthesia whereas solitary or small multiple recurrences, as well as suspect mucosa, were biopsied or fulgurated directly in the flexible procedure. A total of 304 patients were allocated to the intervention group (flexible PDD) and 301 to the control group (flexible WL). Approximately half of all patients in both groups were recurrence free (control group, n= 150 and intervention group, n=157). The number of patients undergoing biopsy or fulguration because of suspect mucosa were higher in the intervention group compared to the control group (n=66 vs. n=36, p<0.05). Significantly more patients in the intervention group were treated in the outpatient clinic (n=95) compared to the control group (n=76) (n=95 vs n=76, p <0.05), whereas fewer patients were scheduled for a TURBT in the intervention group (n=52) than in the control group (n=75) (n=52 vs n=75, p<0.05). These initial results indicate that PDD guided flexible cystoscopy can reduce the need of TURBT when biopsy and fulguration of small tumors is possible in the outpatient clinic. Further follow-up data on recurrences in patients in the study will be needed to estimate the clinical impact on this regarding reduction of recurrence risk and repeated procedures.
关键词： randomized controlled trial,flexible cystoscopy,Photodynamic diagnosis,non-muscle invasive bladder cancer
更新于2025-09-23 15:19:57