FLUORESCENCE DETECTION OF FLAT BLADDER CARCINOMA IN SITU AFTER INTRAVESICAL INSTILLATION OF HYPERICIN
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Carcinoma in situ
To determine the use of hypericin instillation for the fluorescent detection of papillary bladder cancer and carcinoma in situ.Eighty-seven patients with papillary bladder cancer and/or carcinoma in situ received instillations with 40 mL of an 8 micromol/L hypericin solution for at least 2 h. Fluorescent excitation with blue light was effective for up to 16 h, and biopsies were examined by fluorescence microscopy.There were no side-effects reported, no photobleaching and all papillary lesions fluoresced red. The sensitivity and specificity for detecting carcinoma in situ was 94% and 95%, respectively. An interval of 4 months is recommended after BCG instillations before using this test. Fluorescence microscopy showed that hypericin was selectively localized in the epithelium.Hypericin-induced fluorescence has a high sensitivity and specificity for detecting bladder cancer. After 4 months there are few false-positive results in patients treated with BCG.
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OBJECTIVE To investigate the photodynamic therapy (PDT) antitumoral effect in vitro of Hypericin extract form Hypericum performatum L. on MDA231 human mammary carcinoma cell lines. METHODS The cellular uptake of Hypericin extract was investigated by detecting endocellular fluorescence, and the antitumoral effect of Hypericin extract was assessed by light microscopy, MTT assay and DNA ladder gel electrophoresis. RESULTS Light-activated Hypericin extract has an obvious inhibition effect against MDA231 cells in vitro, and its efficacy was correlated to the concentration of Hypericin extract and the light energy. CONCLUSION Hypericin extract can obviously decrease the growth of mammary carcinoma cells. Hypericin extract should be a powerful natural photosensitizer and have a good prospect for further investigation.
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A series of 81 cases of severe dysplasia or carcinoma in situ of the larynx was retrospectively analysed to evaluate the results of radiation therapy and repetitive stripping/biopsies. An average of almost five years elapsed between the diagnosis of severe dysplasia/carcinoma in situ and carcinoma. Of patients primarily treated with irradiation 19% developed invasive carcinoma compared to 15% in the group primarily treated with repetitive stripping/biopsies, and radiation therapy for failures. The mean age at diagnosis for patients in whom the epithelium normalized was 66.1 years, compared to 59.3 years for those in whom the process progressed to carcinoma (p less than 0.05). It thus appears that carcinoma in situ may comprise at least two different lesions with different biological behaviour.
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Introduction. About half of all new ipsilateral events after a primary ductal carcinoma in situ (DCIS) are invasive carcinoma. We studied tumor markers in the primary DCIS in relation to type of event (invasive versus in situ). Methods. Two hundred and sixty-six women with a primary DCIS from two source populations, all with a known ipsilateral event, were included. All new events were regarded as recurrences. Patient and primary tumor characteristics (estrogen receptor (ER), progesterone receptor (PR), HER2, EGFR, and Ki67) were evaluated. Logistic regression was used to calculate odd ratios and 95% confidence intervals in univariate and multivariate analyses. Results. One hundred and thirty-six of the recurrences were invasive carcinoma and 130 were in situ. The recurrence was more often invasive if the primary DCIS was ER+ (OR 2.5, 95% CI 1.2-5.1). Primary DCIS being HER2+ (OR 0.5, 95% CI 0.3-0.9), EGFR+ (OR 0.4, 95% CI 0.2-0.9), and ER95-/HER2+ (OR 0.2, 95% CI 0.1-0.6) had a lower risk of a recurrence being invasive. Conclusions. In this study, comparing type of recurrence after a DCIS showed that the ER-/HER2+ tumors were related to a recurrence being a new DCIS. And surprisingly, tumors being ER+, HER2-, and EGFR- were related to a recurrence being invasive cancer.
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Hypericin,used as a medicinal herb since ancient times,is a natural photosensitizer derived from the plant Hypericum perforantum.Hypericin would produce peroxides to induce apoptosis and inhibit the growth of oncocytes.Meanwhile,hypericin has a specific affinity with tumor pathology organization(underlying accumulation in pathology organization) which has been widely used in optical diagnosis.The present review gives a comprehensive summary of the anticancer effect based on photodynamic therapy,and photodynamic diagnosis of hypericin optical properties,with the purpose of making full use of the hypericin natural resources,and providing a basis for research and development of hypericin derivatives.
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The outcome of 75 patients with severe dysplasia or carcinoma in situ of the larynx has been reviewed. The patients were divided into three groups according to treatment; Group A (16 patients) had received irradiation. Group B (24 patients) had developed invasive carcinoma less than 1 year after the diagnosis of carcinoma in situ and Group C (41 patients) had been observed for more than 1 year, receiving no treatment other than repeat biopsies. Of the latter group, 46% developed invasive carcinoma of the vocal cords, with a mean observation time of 51 months. Mean age at the onset of the disease was 66 years in patients where the epithelium returned macroscopically to normal during observation compared to 59 years in patients who developed carcinoma (P less than 0.05). This may indicate that subgroups of carcinoma in situ exist with different biological behaviour. No extra benefit was seen for the patients who received irradiation for carcinoma in situ, and close follow-up with, eventually, stripping of the epithelium is therefore advocated. Both altered anatomical site during observation and an increase in area of the lesion should be regarded as a warning signal.
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