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Abstract：
Bladder cancer (BC) possesses distinct molecular profiles that influence progression depending on its biological nature and delivered treatment intensity. Muscle-invasive BC (MIBC) and non-MIBC (NMIBC) demonstrate great intrinsic heterogeneity regarding different prognoses, survival, progression, and treatment outcomes. Transurethral resection of bladder tumor (TURBT) is the standard of care in treating NMIBC and serves both diagnostic and therapeutic purposes despite the prevalent recurrence and progression among many patients. In particular, flat urothelial carcinoma in situ and urothelial carcinoma with lamina propria invasion are the major precursors of MIBC. A new-generation photosensitizer, 5-Aminolevulinic acid (5-ALA), demonstrates high tumor specificity by illuminating the tumor lesion with a specific wavelength of light to produce fluorescence and has been studied for photodynamic diagnosis to detect precise tumor areas by TURBT. Additionally, it has been applied for treatment by producing its cytotoxic reactive oxygen species, as well as screening for urological carcinomas by excreting porphyrin in the blood and urine. Moreover, 5-ALA may contribute to screening before and after TURBT in NMIBC. Here, we summarize the updated evidence and ongoing research on photodynamic technology for NMIBC, providing insight into the potential for improving patient outcomes.
摘要：
膀胱癌(BC)具有不同的分子谱,其取决于其生物学性质和递送的治疗强度而影响进展。肌肉侵袭性BC（MIBC）和非MIBC（NMIBC）在不同预后方面表现出巨大的内在异质性，生存,programming,和治疗结果。经尿道膀胱肿瘤切除术（TURBT）是治疗NMIBC的标准护理，尽管许多患者普遍存在复发和进展，但仍可用于诊断和治疗目的。特别是,扁平尿路上皮原位癌和固有层浸润的尿路上皮癌是MIBC的主要前体。新一代光敏剂,5-氨基乙酰丙酸（5-ALA），通过用特定波长的光照射肿瘤病变以产生荧光，证明了高肿瘤特异性，并且已被研究用于光动力学诊断以通过TURBT检测精确的肿瘤区域。此外,它已被用于通过产生细胞毒性活性氧来治疗，以及通过排泄血液和尿液中的卟啉来筛查泌尿系统癌。此外，5-ALA可能有助于NMIBC中TURBT前后的筛查。这里,我们总结了NMIBC光动力技术的最新证据和正在进行的研究，深入了解改善患者预后的潜力。
