Hypericin-based fluorescence diagnosis of bladder carcinoma.
OBJECTIVE
To determine the use of hypericin instillation for the fluorescent detection of papillary bladder cancer and carcinoma in situ.


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
D'Hallewin
Marie-Ange
MA
Department of Urology, UZ Gasthuisberg, Herestraat 49, B-3000 Leuven, Belgium. marie-ange.dhallewin@uz.kuleuven.ac.be
Kamuhabwa
A R
AR
Roskams
T
T
De Witte
P A M
PA
Baert
L
L
D000873:Anthracenes; D002278:Carcinoma in Situ / Q000175:diagnosis*; D002291:Carcinoma, Papillary / Q000175:diagnosis*; D003558:Cystoscopy / Q000379:methods; D006801:Humans; D008856:Microscopy, Fluorescence / Q000379:methods; D010569:Perylene / Q000031:analogs & derivatives*; D011838:Radiation-Sensitizing Agents; D012680:Sensitivity and Specificity; D001749:Urinary Bladder Neoplasms / Q000175:diagnosis*
D000873:Anthracenes; D011838:Radiation-Sensitizing Agents; D010569:Perylene; C004965:hypericin