Moesta K T, Ebert B, Handke T, Nolte D, Nowak C, Haensch W E, Pandey R K, Dougherty T J, Rinneberg H, Schlag P M
Robert-Roessle-Hospital at the Max-Delbrueck-Center for Molecular Medicine, Charité, Humboldt-University at Berlin, Germany.
Cancer Res. 2001 Feb 1;61(3):991-9.
Colorectal cancers exhibit a red fluorescence. The nature of the responsible fluorophore and its eventual diagnostic potential were investigated. Thirty-three consecutive colorectal resection specimen, 32 of which with histologically confirmed cancer, and a total of 1053 palpable mesenteric nodes were fluorimetrically characterized ex vivo. Furthermore, frozen material from 28 patients was analyzed, selected for the availability of primary tumor material and metastatic tissue, e.g., lymphatic and liver metastases from the same patient. Biochemical characterization was carried out through chemical extraction and reversed phase high-performance liquid chromatography. The fluorescence spectra of tissues, tissue extracts, and standard solutions of porphyrins were determined using a pulsed solid-state laser system for excitation and an imaging polychromator, together with an intensified CCD camera for time-delayed observation. Protoporphyrin IX (PpIX) was identified as the predominant fluorophore in primary tumors and their metastases. The fluorophore occurred in the absence of necrosis and in sterile locations. In untreated cases (n = 24), PpIX fluorescence discriminates metastatically involved lymph nodes from all other palpable nodes with a sensitivity of 62% at a specificity of 78% (P < 0.0001). After neoadjuvant treatment of rectal cancer, the PpIX fluorescence level of the primary tumors was reduced and a discrimination of lymph nodes based on PpIX-fluorescence was impossible. We conclude that colorectal cancer metastases accumulate diagnostic levels of endogenous PpIX as a result of a tumor-specific metabolic alteration.
结直肠癌呈现红色荧光。对其相关荧光团的性质及其最终的诊断潜力进行了研究。对33例连续的结直肠切除标本（其中32例经组织学确诊为癌症）以及总共1053个可触及的肠系膜淋巴结进行了离体荧光特征分析。此外，分析了28例患者的冷冻材料，这些患者因有原发性肿瘤材料和转移组织（如同一个患者的淋巴转移和肝转移）而被选中。通过化学提取和反相高效液相色谱法进行生化特征分析。使用脉冲固态激光系统进行激发，并结合成像多色仪以及增强型电荷耦合器件相机进行延时观察，测定组织、组织提取物和卟啉标准溶液的荧光光谱。原卟啉IX（PpIX）被确定为原发性肿瘤及其转移灶中的主要荧光团。该荧光团出现在无坏死且无菌的部位。在未经治疗的病例（n = 24）中，PpIX荧光可将转移累及的淋巴结与所有其他可触及的淋巴结区分开来，灵敏度为62%，特异性为78%（P < 0.0001）。直肠癌新辅助治疗后，原发性肿瘤的PpIX荧光水平降低，基于PpIX荧光对淋巴结进行区分变得不可能。我们得出结论，结直肠癌转移灶由于肿瘤特异性代谢改变而积累了具有诊断水平的内源性PpIX。
