Immuntherapie maligner Non-Hodgkin-Lymphome

Zusammenfassung Auch wenn in den vergangenen Jahren z. T. eine Verbesserung der Prognose von Non-Hodgkin-Lymphomen (NHL) bereits mit veränderten konventionellen und eskalierten Chemotherapieverfahren indolenter und aggressiver Lymphome erreicht werden konnte, verläuft für einen großen Teil der Patienten die Tumorerkrankung noch immer fatal. Da eine weitere Optimierung konventioneller Modalitäten schwer möglich erschien, stellte die Etablierung immuntherapeutischer Ansätze eine attraktive Option dar. Die erfolgreiche Einführung monoklonaler Antikörper in die Behandlung maligner Lymphome hat die Immuntherapie fest etabliert. Weiterentwicklungen dieses passiven Immuntherapieansatzes sind auf dem Weg in den klinischen Alltag. Daneben sind unterschiedliche Verfahren aktiver Immunisierung (Vakzinierung) in präklinischen und frühen klinischen Entwicklungen, deren Etablierung eine weitere Bereicherung des therapeutischen Armentariums darstellen kann. Zuletzt hat — insbesondere für Hochrisikopatienten — die allogene Stammzelltransplantation in der jüngsten Vergangenheit an Attraktivität gewonnen.     

Indirect fluorescence laryngoscopy in the diagnosis of precancerous and cancerous laryngeal lesions

Indirect fluorescence endoscopy of the larynx has proven to facilitate the detection and delineation of precancerous and cancerous lesion. The different methods are easy to handle and can be performed on an outpatient basis. Early diagnosis of laryngeal cancer and its precursor lesions is simplified. The aim of the present study is to compare indirect autofluorescence laryngoscopy to 5-ALA-induced PPIX fluorescence laryngoscopy. In a prospective study, 56 patients with suspected precancerous or cancerous lesions were primarily investigated by indirect autofluorescence laryngoscopy. In a second step 5-ALA-NaCl (0.6%) was topically applied to the larynx by inhalation, and indirect fluorescence laryngoscopy repeated 2 h after application. Autofluorescence as well as 5-ALA-induced fluorescence was induced by filtered light (375–440 nm) of a xenon short arc lamp and processed by a CCD camera system (D-light-AF System, Storz, Tuttlingen, Germany). White-light and fluorescence images were digitally recorded, immediately assessed for diagnosis and finally compared to pathohistological findings. Inconspicuous laryngeal mucosa presented a typical green fluorescence signal in autofluorescence endoscopy, which turned blue during 5-ALA-laryngoscopy. Precancerous and cancerous lesions displayed a loss of autofluorescence in autofluorescence endoscopy whereas increased protoporphyrin IX fluorescence could be observed in 5-ALA laryngoscopy. Both imaging techniques were suitable to distinguish benign from precancerous or cancerous lesions. In contrast PPIX fluorescence was easily recognized in scarred vocal folds. According to our results, both non-invasive fluorescence imaging techniques are useful in the early diagnosis of laryngeal cancer. Moreover autofluorescence can be used immediately without drug application and possible side effects. 5-ALA-induced fluorescence seems to be more suited for diagnostic examination of mucosal lesions in recurrent precancerous and cancerous lesions after surgery.     

Frühgeborenes mit massiv geblähtem Abdomen und ungewöhnlichem Ultraschallbefund

Monatsschrift Kinderheilkunde -     

Label‐free multiphoton excitation imaging as a promising diagnostic tool for breast cancer

Histopathological diagnosis is the ultimate method of attaining the final diagnosis; however, the observation range is limited to the two‐dimensional plane, and it requires thin slicing of the tissue, which limits diagnostic information. To seek solutions for these problems, we proposed a novel imaging‐based histopathological examination. We used the multiphoton excitation microscopy (MPM) technique to establish a method for visualizing unfixed/unstained human breast tissues. Under near‐infrared ray excitation, fresh human breast tissues emitted fluorescent signals with three major peaks, which enabled visualizing the breast tissue morphology without any fixation or dye staining. Our study using human breast tissue samples from 32 patients indicated that experienced pathologists can estimate normal or cancerous lesions using only these MPM images with a kappa coefficient of 1.0. Moreover, we developed an image classification algorithm with artificial intelligence that enabled us to automatically define cancer cells in small areas with a high sensitivity of ≥0.942. Taken together, label‐free MPM imaging is a promising method for the real‐time automatic diagnosis of breast cancer.     

Geschlechts-Krankheiten

Ohne Zusammenfassung     

Hautkrankheiten Akute und chronische Infektionskrankheiten

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