The sensitivity of malignant tissue detection was 97%, as well as the specificity was 100% regardless of pathological stage

The sensitivity of malignant tissue detection was 97%, as well as the specificity was 100% regardless of pathological stage. in the management of NMIBC. Although it plays a central role during conventional TURBT, white light cystoscopy (WLC) has some recognized limitations. First, small or occult tumor lesions, particularly CIS in the bladder, are not easy to visualize and diagnose.8 Phensuximide Second, the morphological characteristics of CIS under WLC appear as erythematous areas, and thus it is difficult to distinguish CIS from inflammatory lesions due to no histopathological information provided during an operation.9 Finally, the depth of tumor invasion and surgical margin status identified by two-dimensional cystoscopic images and the operators experience are often subjective and inaccurate, even among senior urologists.10 In a systematic review that involved 8,409 cases with high-grade (HG) Ta and T1 bladder tumor who accepted repeat transurethral resection (reTUR), residual tumors were found in 17%C67% of patients with stage Ta and in 20%C71% of patients with T1 bladder tumor, and 36%C86% of residual tumors were located in the initial resection site.11 Besides the quality of TURBT, it is verified that the number of tumors, tumor diameter, prior recurrence rate, concurrent CIS, pathological stage, and histologic grade also influence the recurrence and progression rate substantially.12 Thus, new imaging technologies that serve as auxiliary imaging modes for WLC have been developed recently to enhance visualization of tumor lesions and diagnostic accuracy, which will contribute to complete tumor resection and reduction of recurrence rate. 13 The procedure of piecemeal resection during conventional TURBT may cause dissemination and seeding of exfoliated tumor cells.14 Tailored intravesical chemotherapy or immunotherapy corresponding to the individual tumor risk stratification is recommended as an adjuvant treatment strategy.7 Many studies have evaluated the therapeutic effect of chemotherapeutic drugs, such as mitomycin C, epirubicin, pirarubicin, and gemcitabine. The results showed that patients with NMIBC benefit from Phensuximide intravesical therapy in terms of oncological outcomes.15, 16, 17 However, poor absorption of drug in tumor tissue due to its non-cancer-specific characteristic and related adverse effects (AEs) reduce the efficacy and safety of intravesical chemotherapy.18 Comparatively, bacillus Calmette-Gurin (BCG) immunotherapy has more AEs than does chemotherapy, and even some patients may not respond to this therapy.19,20 Meanwhile, due to the shortage of BCG, not every eligible patient has access to immunotherapy.21 PIT is a new molecular targeted therapeutic model that relies on a conjugate of tumor-specific monoclonal antibody with highly hydrophilic phthalocyanine dye, which targets malignant tissue and reduces nonspecific accumulation in normal tissue. Recently, a systematic review analyzed the latest developments in molecular targeted agents for fluorescence image-guided cancer surgery.22 This molecular imaging technology used in cancer surgery mainly focuses on breast Phensuximide and hollow viscus, such as the respiratory and gastrointestinal tracts.23, 24, 25 Optical molecular imaging can specifically show the pathological process related to tumorigenesis and provide real-time macroscopic imaging of tumor tissue molecular imaging study showed that the PLZ4-Cy5.5 conjugate selectively accumulated in Phensuximide tumor tissues of patient-derived xenograft mouse models after intravenous administration.41 Intratumor heterogeneity significantly compromises the diagnostic accuracy of optical molecular imaging.63 Many studies have confirmed that malignant cells, including bladder tumor cells, have an increased anaerobic glycolysis activity, which leads to an acidic tumor microenvironment.64,65 The pHLIPs first target the acidity on the cancer cell surfaces, and then cross through the membrane of cancer cells. This effect is triggered by the acidic tumor microenvironment.66,67 22 fresh intact bladder specimens were obtained after RC and incubated with ICG-pHLIP molecular probe, and then examined under near-infrared (NIR) imaging equipment. The sensitivity of malignant tissue detection was 97%, FST and the specificity was 100% regardless of pathological stage. However, when necrotic and previously chemotherapy-treated tissues were included, the number of false-positive results increased and the specificity was reduced to 80%.42 A series of molecular fluorescent tracers have been used in molecular imaging and have shown the potential to highlight bladder tumor lesions in animal models of urothelial cancer and tumor specimens from patients. Thus, we question how to choose the best molecular fluorescent tracer to perform endoscopic molecular imaging in a particular patient with BC. The.