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首页> 外文会议>Optical methods for tumor treatment and detection: mechanisms and techniques in photodynamic therapy XX >Photody namic therapy of pancreatic cancer and elastic scattering spectroscopy of the duodenal mucosa for the detection of pancreaticobiliary malignancy
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Photody namic therapy of pancreatic cancer and elastic scattering spectroscopy of the duodenal mucosa for the detection of pancreaticobiliary malignancy

机译：胰腺癌的光动力疗法和十二指肠粘膜的弹性散射光谱检测胰腺胆道恶性肿瘤

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The diagnosis and treatment of pancreaticobiliary malignancy is of major interest to our group. Building on prior work, we undertook a phase I study of verteporfin photodynamic therapy in patients with locally advanced, unresectable, pancreatic cancer. We also initiated an optical diagnostic study using elastic scattering spectroscopy (ESS) of the normal-appearing periampullary duodenal mucosa in vivo to investigate the hypothesis of a field effect in pancreaticobiliary malignancy. In a phase I dose escalation study, patients were treated with interstitial verteporfin PDT via a single fibre, to determine its general safety profile and the optimum treatment parameters needed to achieve effective and safe necrosis of tumour, With increasing light doses, there was a linear increase in the extent of tumour necrosis around the fibre, without serious adverse events. Follow-on studies using multiple fibres are planned. In 30 patients with benign or malignant pancreaticobiliary disease undergoing clinically-indicated endoscopy, ESS spectra were collected from the normal-appearing duodenum and antrum and a diagnostic algorithm generated by principle component and linear discriminant analysis. Pooled data from duodenal sites distal to the ampulla gave a sensitivity of 86% and a specificity of'72% (82% AUC) for the detection of malignancy, whereas those from the periampullary region had a sensitivity of 77% and a specificity of 61% (72% AUC); antral measurements were not able to discriminate with such accuracy. These early results suggest that ESS of the duodenal mucosa could represent a novel minimally invasive diagnostic test for pancreaticobiliary malignancy.
机译：胰胆管恶性肿瘤的诊断和治疗是我们小组的主要兴趣。在先前工作的基础上，我们进行了Verteporfin光动力疗法在患有局部晚期不可切除的胰腺癌患者中的I期研究。我们还对体内正常出现的壶腹周围十二指肠粘膜使用弹性散射光谱法（ESS）进行了光学诊断研究，以研究胰腺胆道恶性肿瘤中场效应的假设。在I期剂量递增研究中，通过单纤维间质维替泊芬PDT治疗患者，以确定其总体安全性和实现有效，安全的肿瘤坏死所需的最佳治疗参数。随着光剂量的增加，线性增加纤维周围肿瘤坏死的程度，而没有严重的不良事件。计划使用多根光纤进行后续研究。在接受临床指示的内镜检查的30例胰胆管良性或恶性疾病患者中，从出现正常的十二指肠和胃腔收集ESS光谱，并通过主成分和线性判别分析生成诊断算法。来自壶腹远端十二指肠部位的汇总数据检测恶性肿瘤的敏感性为86％，特异性为'72％（AUC为82％），而壶腹周围区域的敏感性为77％，特异性为61 ％（72％AUC）；窦房测量结果不能以这种准确性加以区分。这些早期结果表明十二指肠粘膜的ESS可以代表胰腺胆道恶性肿瘤的新型微创诊断测试。

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