Фотодинамическая тераностика центрального рака легкого: возможности ранней диагностики и малоинвазивного лечения (обзор)

Цель исследования — оценка перспектив скрининга центрального рака легкого (ЦРЛ) с помощью флуоресцентной диагностики и его лечения методом эндобронхиальной фотодинамической терапии.

Проведение бронхоскопической флуоресцентной диагностики с использованием фотосенсибилизаторов хлоринового ряда и разработанной инструментальной системы позволяет выявить опухолевые изменения слизистой оболочки крупных бронхов на ранних стадиях, а разработанная технология выполнения фотодинамической терапии под флуоресцентным контролем — добиться персонализации лечения. Такой подход рассматривается как вариант тераностики — фотодинамическая тераностика.

Для решения задачи скрининга ЦРЛ нужен флуоресцирующий краситель, отличающийся большей доступностью и возможностью применения непосредственно во время проведения обследования. Таким красителем может служить индоцианин зеленый, особенностью использования которого является необходимость в возбуждении и регистрации флуоресценции в ближнем инфракрасном (БИK) диапазоне длин волн. Первые опыты с применением БИК-диапазона в диагностике бронхоскопической системы показали возможность выявления опухолевых участков методом OS-BPT (on-site bronchoscopic photodynamic theranostics), который заключается в БИК-визуализации опухолевых очагов при введении непосредственно во время обследования индоцианина зеленого в стандартной дозе.

Заключение. Дальнейший прогресс ранней диагностики и малоинвазивного лечения ЦРЛ будет определяться разработкой новых фотосенсибилизаторов, которые должны характеризоваться сильной полосой поглощения в БИК-области, быстрым накоплением в опухоли, высоким выходом синглетного кислорода при БИК-освещении, яркой флуоресценцией, высоким потенциалом в плане индукции противоопухолевого иммунного ответа.

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