Issues
Fluorescent diagnostics of keratoacanthoma
«Radiation and Risk», 2016, vol. 25, No. 3, pp.66-72
DOI: 10.21870/0131-3878-2016-25-3-66-72
Authors
Dibirova S.D. – Postgraduate Student. I.M. Sechenov First Moscow State Medical University, Moscow, Russia. Contacts: 8/2 Trubetskaya St., Moscow, Russia, 119991. Tel.: +79037263820; e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it. .
Abstract
Keratoacanthoma (KA) is common benign epithelial tumor, in typical cases it spontaneously regresses, while in atypical cases it is transformed into squamous cells carcinoma with a frequency of up to 19%. Usually keratoacanthoma is removed surgically, by cryoablation, administration of interferon-alpha, and by other methods. In recent years for treatment of KA photodynamic therapy (PDT) is used, however, it does not prevent the relapse of the tumor. The preliminary fluorescent diagnostics (FD) that is non-invasive method without damaging tumors for obtaining more objective information improves the effectiveness of PDT. The purpose of the study was to develop new method for fluorescent diagnostics of the tumor with radachlorine photosensitizer. Patients with keratoacanthoma (30 persons) aged from 44 to 79 years, average age was 63 years, underwent FD. The clinical diagnosis of KA was confirmed by cytological and/or histological diagnoses. For fluorescence excitation Russian device for fluorescence imaging Biospec and diode laser source λ 400-405 nm were used. Accumulation of Radachlorin in the tumor was monitored spectroscopically, therapeutic amount of the photosensitizer in the tumor exceeded its amount in the skin by 1.6-4.0 times. Fluorescence imaging with Radachlorin allows a physician to determine tumor boarders, evaluate accumulation of the photosensitizer in tissues and monitor performance of photodynamic therapy. In addition to that, simultaneous analysis of fluorescent tumor image and its spectrometry allows a physician to obtain more objective diagnosis because spectrometry gives quantitative parameters of fluorescence intensity, which can be used as diagnostic criterion and differential diagnosis.
Key words
fluorescent diagnostics, oncology, dermatology, skin diseases, skin tumors,
keratoacanthoma, photosensitizer, laser radiation, intravenous injection of photosensitizer, local
injection of photosensitizer.
References
1. Molochkov V.A., Kazantseva I.A., Kuntsevich Zh.S., Bochkareva E.V. Keratoakantoma. Klinika, diagnostika, lechenie, transformatsiya v rak [Keratoacanthoma. Clinic, diagnostics, treatment, transformation into cancer]. Moscow, Binom, 2006. 176 p.
2. Filonenko E.V. Flyuorestsentnaya diagnostika s alasensom u bol'nykh rakom kozhi [Fluorescence diagnosis with alasens in patients with skin cancer]. Fotodinamicheskaya terapiya i fotodiagnostika – Photodynamic Therapy and Photodiagnosis, 2015, no. 1, pp. 4-7.
3. Kuznetsov V.V. Ispol'zovanie fotodinamicheskoy terapii v otechestvennoy onkologii (obzor literatury) [The use of photodynamic therapy in the domestic oncology. (Review of the literature)]. Issledovaniya i praktika v meditsine – Research’n Practical Medicine Journal, 2015, vol. 2, no. 4, pp. 98-105.
4. Sukhova T.E., Molochkov V.A., Romanko Yu.S., Matveeva O.V., Reshetnikov A.V. Lechenie bazal'nokletochnogo raka kozhi na sovremennom etape [The present day therapy of cutaneous basal cell carcinoma]. Al'manah klinicheskoj mediciny – Digest of Clinical Medicine, 2008, no. 18, pp. 14-21.
5. Kaplan M.A., Nikitina R.G., Malygina A.I., Romanko Ju.S., Bozadzhiev L.L., Drozhzhina V.V. Arkhipova L.M., Deev V.V., Smakhtin L.A. Vozmozhnosti primenenija bengal roz dlja fotodinamicheskoj terapii opuholej [The potential of rose bengal treatment for photodynamic therapy of tumors]. Voprosy onkologii – Problems in Oncology, 1999, vol. 45, no. 5, pp. 557-559.
6. Kaplan M.A., Romanko Yu.S., Popuchiev V.V., Yuzhakov V.V., Bandurko L.N. Morfofunktsional'nye osobennosti sarkomy M-1 pri fotodinamicheskoy terapii s ispol'zovaniem fotosensibilizatora fotoditazin [Morphological and functional features sarcoma M-1 in photodynamic therapy using a photosensitizer Photoditazin]. Rossiyskiy bioterapevticheskiy zhurnal – Russian Biotherapeutic Journal, 2004, vol. 3, no. 2, p. 53.
7. Yaroslavtseva-Isaeva E.V., Kaplan M.A., Romanko Yu.S., Sokol N.I. Razrabotka metodiki fotodinamicheskoy terapii eksperimental'noy opukholi (sarkoma M-1) pri lokal'nom vvedenii fotosensibilizatora [Method of photodynamic therapy of experimental tumor (sarcoma M-1) with local administration of photosensitizer]. Rossiyskiy bioterapevticheskiy zhurnal – Russian Biotherapeutic Journal, 2003, vol. 2, no. 4, pp. 19-22.
8. Kapinus V.K., Romanko Yu.S., Kaplan M.A., Ponomarev G.V., Sokol N.I. Effektivnost' flyuorestsentnoy diagnostiki i fotodinamicheskoy terapii s fotosensibilizatorom fotoditazin u bol'nykh rakom kozhi [The effectiveness of fluorescence diagnosis and photodynamic therapy photosensitizer photodithazine in patients with skin cancer]. Rossiyskiy bioterapevticheskiy zhurnal – Russian Biotherapeutic Journal, 2005, vol. 4, no 3, pp. 69-75.
9. Katsalap S.N., Romanko Yu.S. Vybor varianta fotodinamicheskoy terapii retsidivnoy bazaliomy [The choice of photodynamic therapy against recurrent basal cell carcinoma]. Vestnik esteticheskoy meditsiny – Vestnik of Aesthetic Medicine, 2012, vol. 11, no 1, pp. 44-48.
10. Kaplan M.A., Kapinus V.N., Romanko Yu.S., Yaroslavtseva-Isaeva E.V. Fotoditazin-effektivnyy fotosensibilizator dlya fotodinamicheskoy terapii [Photoditazin-efficient photosensitizers for photodynamic therapy]. Rossiyskiy bioterapevticheskiy zhurnal – Russian Biotherapeutic Journal, 2004, vol. 3, no. 2, p. 50.
11. Sukhova T.E., Romanko Yu.S., Matveeva O.V. Fotodinamicheskaya terapiya bazal'no-kletochnogo raka kozhi s lokal'nym primeneniem radakhlorina [Photodynamic therapy for basal-cell carcinoma with the local application of radachlorine]. Rossijskij zhurnal kozhnyh i venericheskih boleznej – Russian Journal of Skin and Sexually Transmitted Diseases, 2008, no. 4, pp. 41-44.
12. Sukhova T.E., Romanko Yu.S., Yaroslavtseva-Isaeva E.V., Korenev S.V., Prokof'ev A.A. Vnutritkanevoy variant vvedeniya fotosensibilizatora pri fotodinamicheskoy terapii bazal'no-kletochnogo raka kozhi (soobshchenie 1) [Interstitial options for introducing of a photosensitizer in photodynamic therapy of basal cell skin cancer (report 1)]. Rossijskij zhurnal kozhnyh i venericheskih boleznej – Russian Journal of Skin and Sexually Transmitted Diseases, 2010, no. 2, pp. 4-10.
13. Molochkov A.V., Sukhova T.E., Tret'yakova E.I., Akopova K.V., Koroleva L.P., Prokof'ev A.A., Rumyantsev S.A., Alieva P.M., Romanko Yu.S., Molochkov V.A. Sravnitel'nye rezul'taty effektivnosti lazeroindutsirovannoy termoterapii i fotodinamicheskoy terapii poverkhnostnoy i mikronodulyarnoy bazaliom [Comparative evaluation of the efficiency of laser-induced and photodynamic therapy for surface and micronodular basaloma]. Rossijskij zhurnal kozhnyh i venericheskih boleznej – Russian Journal of Skin and Sexually Transmitted Diseases, 2012, no. 4, pp. 30-36.
14. Taranets T.A., Sukhova T.E., Romanko Yu.S. Fotodinamicheskaya terapiya bazal'no-kletochnogo raka kozhi s lokal'nym i vnutrivennym ispol'zovaniem fotosensibilizatora khlorinovogo ryada «Fotolon» [Photodynamic therapy basal cell skin cancer with local and intravenous use chlorine series «Photolon»]. Al'manah klinicheskoj mediciny – Digest of Clinical Medicine, 2007, no. 15, pp. 283-288.
15. Katz O.O., Trifonov F.A., Kuznetsov V.V. Mesto fototerapii i fotodinamicheskoy terapii v lechenii ekstragenital'nogo skleroatroficheskogo likhena [Phototherapy and photodynamic therapy in the treatment of extragenital lichen sclerosus]. Issledovaniya i praktika v meditsine – Research’n Practical Medicine Journal, 2015, vol. 2, no. 3, pp. 51-58.
16. Kaplan M.A., Romanko Yu.S. Lazernaya fotodinamicheskaya terapiya (obzor, sostoyanie problemy i perspektivy) [Laser photodynamic therapy]. Voprosy onkologii – Problems in Oncology, 2004, no. 1, pp. 43-48.
17. Sukhova T.E., Molochkov V.A., Romanko Yu.S., Changlyan K.A., Tret'yakova E.I. Fotodinamicheskaya terapiya aktinicheskogo keratoza s applikatsionnym primeneniem «Fotoditazina» [Photodynamic therapy of actinic keratoses with applicator using «Photoditazin»]. Rossijskij zhurnal kozhnyh i venericheskih boleznej – Russian Journal of Skin and Sexually Transmitted Diseases, 2010, no. 5, pp. 4-8.
18. Galkin V.N., Kaplan M.A., Romanko Yu.S. Effektivnost' fotodinamicheskoy terapii bazal'nokletochnoy kartsinomy s ispol'zovaniem fotosensibilizatorov razlichnykh klassov [The effectiveness of photodynamic therapy of basal cell carcinoma using photosensitizer different classes]. Fotodinamicheskaya terapiya i fotodiagnostika – Photodynamic Therapy and Photodiagnosis, 2015, no. S1, p. 72.
19. Molochkov V.A., Molochkov A.V., Sukhova T.E., Khlebnikova A.N., Kuntsevich Zh.S., Romanko Yu.S., Dibirova S.D., Bochkareva E.V. Mestnaya fotodinamicheskaya terapiya keratoakantomy [Local photodynamic therapy for keratoacanthoma]. Rossiyskiy zhurnal kozhnykh i venericheskikh bolezney – Russian Journal of Skin and Sexually Transmitted Diseases, 2012, no. 4, pp. 21-24.
20. Molochkova Yu.V., Kuntsevich Zh.S., Sukhova T.E., Dibirova S.D., Galkin V.N., Ivanov S.A., Romanko Yu.S. Fotodinamicheskaya terapiya tipichnoy i atipichnoy keratoakantomy [Fluorescent diagnosis of keratoacanthomas]. Al'manakh klinicheskoy meditsiny – Almanac of Clinical Medicine, 2016, vol. 44, no 1, pp. 64-70.
Full-text article (in Russian)