Recent advances in photodynamic diagnosis of gastriccancer using 5-aminolevulinic acid

作     者：Noriaki Koizumi Yoshinori Harada Takeo Minamikawa Hideo Tanaka Eigo Otsuji Tetsuro Takamatsu 

作者机构：Department of Pathology and Cell RegulationGraduate School of Medical ScienceKyoto Prefectural University of MedicineKyoto 6028566Japan Division of Digestive SurgeryDepartment of SurgeryGraduate School of Medical ScienceKyoto Prefectural University of MedicineKyoto 6028566Japan Department of SurgeryNishijin HospitalKyoto 6028319Japan Department of Medical PhotonicsGraduate School of Medical ScienceKyoto Prefectural University of MedicineKyoto 6028566Japan 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2016年第22卷第3期

页      面：1289-1296页

核心收录：

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

基　　金：Japan Society for the Promotion of Science  JSPS  (15K08407) 

主　　题：Gastric cancer Photodynamic diagnosis 5-aminolevulinic acid Protoporphyrin IX Lymph nodemetastasis Personalized medicine Peritoneal dissemination 

摘      要：Photodynamic diagnosis based on 5-aminolevulinic acidinduced protoporphyrin IX has been clinically applied in many fields based upon its evidenced efficacy and adequate safety. In order to establish a personalized medicine approach for treating gastric cancer patients, rapid intraoperative detection of malignant lesions has become important. Feasibility of photodynamic diagnosis using 5-aminolevulinic acid for gastric cancer patients has been investigated, especially for the detection of peritoneal dissemination and lymph node metastasis. This method enables intraoperative realtime fluorescence detection of peritoneal dissemination, exhibiting higher sensitivity than white light observation without histopathological examination. The method also enables detection of metastatic foci within excised lymph nodes, exhibiting a diagnostic accuracy comparable to that of a current molecular diagnostics technique. Although several complicating issues still need to be resolved, such as the effect of tissue autofluorescence and the insufficient depth penetration of excitation light, this simple and rapid method has the potential to become a useful diagnostic tool for gastric cancer, as well as urinary bladder cancer and glioma.