Koizumi Noriaki, Harada Yoshinori, Minamikawa Takeo, Tanaka Hideo, Otsuji Eigo, Takamatsu Tetsuro
Noriaki Koizumi, Yoshinori Harada, Takeo Minamikawa, Hideo Tanaka, Tetsuro Takamatsu, Department of Pathology and Cell Regulation, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 6028566, Japan.
World J Gastroenterol. 2016 Jan 21;22(3):1289-96. doi: 10.3748/wjg.v22.i3.1289.
Photodynamic diagnosis based on 5-aminolevulinic acid-induced 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 real-time 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.
基于5-氨基乙酰丙酸诱导原卟啉IX的光动力诊断，凭借其已证实的疗效和足够的安全性，已在临床多个领域得到应用。为了建立针对胃癌患者的个性化医疗方法，术中快速检测恶性病变变得至关重要。已对使用5-氨基乙酰丙酸进行光动力诊断在胃癌患者中的可行性进行了研究，特别是用于检测腹膜播散和淋巴结转移。该方法能够在术中对腹膜播散进行实时荧光检测，与白光观察相比，在无需组织病理学检查的情况下具有更高的灵敏度。该方法还能够检测切除淋巴结内的转移灶，其诊断准确性与当前分子诊断技术相当。尽管仍有几个复杂问题需要解决，如组织自发荧光的影响和激发光穿透深度不足等，但这种简单快速的方法有潜力成为胃癌、膀胱癌和神经胶质瘤的有用诊断工具。
