Background

To evaluate the surgical safety of en bloc resection of bladder tumor (ERBT) and the effectiveness of ERBT combined with near-infrared (NIR) imaging technique in the diagnosis and treatment of non-muscle invasive bladder cancer (NMIBC).

Methods

From October 2017 to June 2018, 26 patients newly diagnosed with single NMIBC were included in this retrospectively trial. All patients received ERBT with monopolar current. After surgery, the fresh specimen was incubated with anti-CD47-Alexa Fluor 790, and then imaged under NIR imaging technique. Operative details, intraoperative and postoperative complications of ERBT regarded as safety outcomes, the mean fluorescence intensity (MFI) of tumor tissue and adjacent normal background tissue, and 12 months follow-up data were analyzed.

Results

Of 26 collected patients, obturator nerve reflex was occurred in six patients during tumor resection, and only one patient was observed with bladder perforation. In NIR gray image, the gray scale of MFI of tumor tissue were 132.31 ± 6.67 and the adjacent normal background tissue were 52.27 ± 12.09. The result showed a significantly higher MFI signals in tumor tissue compared to adjacent normal background tissue (P < 0.001). The recurrence-free survival rate at 12 month was 96.15%.

Conclusions

ERBT with monopolar current is a safe and feasible technique to treat patients with NMIBC. A integrated bladder tumor tissue-bound anti-CD47-Alexa Fluor 790 was detected under NIR light, and the NIR image indicates that higher MFI signals in surgical margin is a predictive factor for residual tumor in patients with NMIBC after ERBT.

中文翻译：

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整体切除结合近红外分子成像技术在膀胱癌诊治中的初步研究

背景

目的评估整块膀胱肿瘤切除术（ERBT）的手术安全性以及ERBT结合近红外（NIR）成像技术在非肌肉浸润性膀胱癌（NMIBC）的诊断和治疗中的有效性。

方法

从2017年10月到2018年6月，该回顾性研究纳入了26名新诊断为单NMIBC的患者。所有患者均接受单极电流ERBT治疗。手术后，将新鲜标本与抗CD47-Alexa Fluor 790孵育，然后在NIR成像技术下成像。分析手术细节，ERBT的术中和术后并发症为安全性结果，肿瘤组织和邻近正常背景组织的平均荧光强度（MFI）以及12个月的随访数据。

结果

在收集的26例患者中，有6例在肿瘤切除过程中发生了闭孔神经反射，只有1例患者出现了膀胱穿孔。在NIR灰度图像中，肿瘤组织的MFI灰度为132.31±6.67，相邻的正常背景组织为52.27±12.09。结果显示，与邻近的正常背景组织相比，肿瘤组织中的MFI信号明显更高（P <0.001）。12个月时无复发生存率为96.15％。

结论

ERBT单极电流治疗NMIBC患者是一种安全可行的技术。在NIR光下检测到整合的膀胱肿瘤组织结合抗CD47-Alexa Fluor 790，NIR图像表明手术边缘的MFI信号较高是ERBT后NMIBC患者残余肿瘤的预测因素。