Hypericin‐based fluorescence diagnosis of bladder carcinoma

Objective To determine the use of hypericin instillation for the fluorescent detection of papillary bladder cancer and carcinoma in situ . Patients and methods Eighty‐seven patients with papillary bladder cancer and/or carcinoma in situ received instillations with 40 mL of an 8 µmol/L hypericin solution for at least 2 h. Fluorescent excitation with blue light was effective for up to 16 h, and biopsies were examined by fluorescence microscopy. Results There were no side‐effects reported, no photobleaching and all papillary lesions fluoresced red. The sensitivity and specificity for detecting carcinoma in situ was 94% and 95%, respectively. An interval of 4 months is recommended after BCG instillations before using this test. Fluorescence microscopy showed that hypericin was selectively localized in the epithelium. Conclusions Hypericin‐induced fluorescence has a high sensitivity and specificity for detecting bladder cancer. After 4 months there are few false‐positive results in patients treated with BCG.