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首页> 外文期刊>Lung cancer: Journal of the International Association for the Study of Lung Cancer >Photodynamic therapy, Nd-YAG laser and electrocautery for treating early-stage intraluminal cancer: which to choose?
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Photodynamic therapy, Nd-YAG laser and electrocautery for treating early-stage intraluminal cancer: which to choose?

机译：光动力疗法，Nd-YAG激光和电灼治疗早期腔内癌：该选择哪一种？

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The degree of healing and damage of the bronchial wall after photodynamic therapy, Nd-YAG laser and electrocautery for intraluminal early-stage cancer have been analysed. Review of the bronchoscopy reports and follow-up histology specimens of twenty-nine patients treated bronchoscopically with curative intent for their intraluminal tumor have been performed. Seventeen patients had been treated with bronchoscopic electrocautery (BE) only, six with photodynamic therapy (PDT) and six with Nd-YAG laser. Bronchial wall scarring seen during follow-up bronchoscopy was scored and subepithelial fibrosis were histologically evaluated using Alcian blue staining, Azan staining and polarised light. After BE, prominent airway scarring was seen in five patients (29%), with significant stenosis (>50% lumen) in one of these cases. Prominent scarring and significant stenosis were found in four (67%), after PDT. In five (83%) after Nd-YAG laser prominent scarring was found, one patient had significant stenosis. In three cases, two after BE and one after PDT, subepithelial tissue in the follow-up biopsies was insufficient for proper histologic examination. In the remaining biopsy specimen only one (7%) showed a moderate or excessive amount of fibroblasts after BE, whereas for PDT and Nd-YAG this was found in three (60%) and four patients (67%), respectively. Excessive matrix was found in none of the biopsies after BE, in two (40%) after PDT and in three (50%) after Nd-YAG laser. Compact collagen formations were seen in two (12%) biopsies after BE, in two (40 and 33%) after PDT and Nd-YAG, respectively. Compared to electrocautery, more airway scarring and more subepithelial fibrosis were seen after treatment with PDT and Nd-YAG laser. These findings, especially regarding PDT, is in contrast to the assumption that PDT is selective and may be important in the choice of treatment for patients with early stage cancer.
机译：分析了光动力疗法，Nd-YAG激光和电灼术治疗腔内早期癌后支气管壁的愈合程度和损伤程度。回顾性分析了29例经管腔镜治疗腔内肿瘤的患者的支气管镜检查报告和随访组织学标本。仅对17例患者进行了支气管镜电灼（BE），对6例进行了光动力疗法（PDT），对6例进行了Nd-YAG激光治疗。对在后续支气管镜检查中观察到的支气管壁瘢痕进行评分，并使用阿尔辛蓝染色，阿赞染色和偏振光在组织学上评估上皮下纤维化。发生BE后，其中5例（29％）出现明显的气道瘢痕形成，其中1例出现明显狭窄（> 50％流明）。 PDT后有四个（67％）发现明显的疤痕和明显狭窄。在发现Nd-YAG激光明显瘢痕形成的患者中，有五名患者（83％）有明显的狭窄。在3例中，BE后2例，PDT后1例，随访活检中的上皮下组织不足以进行适当的组织学检查。在剩余的活检标本中，只有一个（7％）在BE后显示中度或过量的成纤维细胞，而对于PDT和Nd-YAG，分别在三名（60％）和四名（67％）患者中发现。在BE后，PDT后的两个（40％）和Nd-YAG激光后的三个（50％）的活检中均未发现过量的基质。在BE之后的两次（12％）活检中，在PDT和Nd-YAG之后的两次（40％和33％）中，可见致密的胶原蛋白形成。与电灼相比，PDT和Nd-YAG激光治疗后出现更多的气道瘢痕形成和上皮下纤维化。这些发现，特别是关于PDT的发现与PDT是选择性的，并且在选择早期癌症患者的治疗方法中可能重要的假设相反。

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