Diagnosing the Location of Carcinoma in situ (CIS) of the Urinary Bladder Using Pirarubicin Hydrochloride

Abstract

Introduction: No established technique for locating solitary carcinoma in situ (CIS) of the urinary bladder or CIS accompanying bladder cancer has been determined. Here we investigated whether the location of CIS of the urinary bladder can be macroscopically ascertained by instilling pirarubicin hydrochloride (THP) into the urinary bladder. Patients and Methods: We dissolved 50 mg of THP in 50 ml of distilled water, and instilled the resulting solution into the urinary bladder. After 5 min, the urinary bladder is examined using a cystoscope. The study group consisted of 30 subjects (23 men and 7 women). Results: THP uptake was seen in 19 flat (nontumorous) areas of the bladder mucosa in 13 patients. Of these, 11 lesions in 6 patients were confirmed to be CIS. THP uptake was also seen in flat malignant lesions such as bladder cancer invasion into the prostatic urethra, and in benign lesions such as chronic cystitis and urothelial hyperplasia. Conclusions: The present method can be useful to find easily and macroscopically the location of flat malignant lesions such as CIS.

Application of pirarubicin photosensitizer fluorescence cystoscopy in early detection of bladder cancer

“…This drug was successfully developed in Japan in 1979 ( 17 ). THP could quickly get into bladder tumor cells, and bladder tissues spread with high selection, little whole-body absorption and relatively high level of safety ( 18 ). Results obtained from other studies ( 19 ) suggested that anthracene ring revealed fluorescence, and THP was quickly absorbed by bladder tumor tissues after bladder pouring, and the drug concentration inside the tumor was 4-fold higher than that in normal bladder tissues.…”

In vitro and in vivo studies of pirarubicin-loaded SWNT for the treatment of bladder cancer

“…Therefore, intravesical therapy, which includes intravesical chemotherapy and immunotherapy (1), has become an important part of bladder tumor treatment. The drugs commonly used in intravesical chemotherapy include mitomycin, doxorubicin, epirubicin, and THP (17-20), while the drugs used for intravesical immunotherapy are bacillus Calmette-Guérin vaccines. We selected THP for the present study because its prophylactic effect is greater than that of mitomycin and epirubicin (21,22).…”

Improved Detection of Nonmuscle Invasive Urothelial Carcinoma of the Bladder Using Pirarubicin Endoscopy: A Prospective, Single-Center Preliminary Study

“…The sensitivity and specificity of THP uptake for malignant mucosal lesions in our study was 96% and 74.7%, respectively, which is identical to that of previously documented photodynamic diagnosis. 21 Uchikoba and colleagues 14 reported sensitivity and specificity of up to 100% and 97.5%, respectively, using THP for malignant mucosal lesions; however, this difference may be attributed to different samples, diagnostic instruments, and THP dosage and retention time.…”

“…THP is pigmented and selectively absorbed by bladder tumor cells. In a preliminary study, Uchikoba and associates 14 reported the utility of intravesical instillation of THP in the macroscopic detection of flat malignant lesions, such as CIS. THP is similar to the color of the bladder mucosa, however, which can make discrimination of targeted cells difficult, especially when bleeding or cystitis is present.…”