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The value of photodynamic diagnosis (PDD) in identifying carcinoma in situ (Cis) of urinary bladder

Marek Lipiński, Michał Markowski, Waldemar Różański

Med Sci Tech 2008; 49(1): RA55-57

ID: 881587


Introduction: PDD is the method of the most precise way of picturing neoplastic tissue in urinary bladder. Urinary bladder is an organ which can be observed from inside in white and ultraviolet light, what allows controlling whole epithelial layer. The aim of this study was to evaluate photodynamic diagnosis in patients with suspicion of Cis. Material and methods: From 2005 to 2006 PDD was performed in 29 patients (21 men and 8 women) with superficial bladder tumor is stage Ta low and high grade and T1 low and high grade. All patients were treated by transurethral resection (TURBT). 6 patients had additional intravesical chemotherapy (Mitomicic C) and 23 had inravesical immunotherapy (BCG). After 3 months from TURBT all patients had cystoscopy in white and ultraviolet light. PDD was performed after instillation of 5 aminolevulinic acid solution (90 to 120 minutes before cystoscopy). To compare the images, both - light xenon lamp D Light Stroz and UV light were used. Results: In white light cystoscopy neoplasmatic changes were observed in 4 patients (3 PUNLMP and 1 T1 high grade). In PDD neoplasmatic changes were observed in 9 patients. Cis was detected in 7 patients (1 PUNLMP + Cis, T1 high grade + Cis, 5 Cis). All patients were treated by TURBT. 3 patients had instillations of Mitomycin C and then immuotherapthy with BCG. In 5 cases (4 men and 1 woman) cystectomies were performed. 1 patient (T1 high grade + Cis) who hadn’t agreed for cystectomy were treated with photodynamic therapy (PDT). Conclusions: Limited number of patients can not lead to ultimate conclusions. However PDD allows for correct estimation and detection Cis in urinary bladder which enable to perform appropriate way of treatment. (Clin Exp Med Lett 2008; 49(1): 55-57)

Keywords: bladder tumor, cis (carcinoma in situ), Diagnosis

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