Photodynamic diagnosis using 5‐aminolevulinic acid during gastrectomy for gastric cancer. Issue 3 (8th November 2013)

• Record Type: Journal Article
• Authors: Namikawa, Tsutomu; Inoue, Keiji; Uemura, Sunao; Shiga, Mai; Maeda, Hiromichi; Kitagawa, Hiroyuki; Fukuhara, Hideo; Kobayashi, Michiya; Shuin, Taro; Hanazaki, Kazuhiro
• Is Part Of: Journal of surgical oncology. Volume 109:Issue 3(2014:Mar. 01)
• Page Start: 213
• Page End: 217
• Publication Date: 2013-11-08
• Subjects: Cancer -- Surgery -- Periodicals; Neoplasms -- Periodicals; 616
• DOI: 10.1002/jso.23487
• Languages: English
• ISSNs: 0022-4790

Abstract

<abstract abstract-type="main" xml:lang="en"> <title>Abstract</title> <sec id="jso23487-sec-0001" sec-type="section"> <title>Background and Objectives</title> <p>Five‐aminolevulinic acid (ALA) has received much attention recently as a new‐generation photosensitive substance for photodynamic diagnosis (PDD). This study aimed to investigate the feasibility of intraoperative PDD using ALA to identify gastric cancer.</p> </sec> <sec id="jso23487-sec-0002" sec-type="section"> <title>Methods</title> <p>Intraoperative PDD was carried out in 26 lesions of 21 patients with gastric cancer. Before surgery, 1.0 g of ALA solution was given orally through a stomach tube. After tumor resection, resected specimens were investigated by an endoscopic PDD system, and red fluorescence‐positive lesions were compared with the pathological result.</p> </sec> <sec id="jso23487-sec-0003" sec-type="section"> <title>Results</title> <p>Red fluorescence was detected in 15 lesions of 11 patients. The sensitivity, specificity, and accuracy of PDD using ALA in detecting gastric cancer were 57.7, 100, and 66.7%, respectively. The incidence of laparoscopic surgery was significantly lower in the PDD‐positive group than in PDD‐negative cases (18.2% vs. 60.0%; <italic>P</italic> = 0.049), while that of intestinal type tumor was significantly higher in PDD‐positive compared to PDD‐negative patients (93.3% vs. 27.3%; <italic>P</italic> < 0.001).</p> </sec> <sec id="jso23487-sec-0004" sec-type="section"> <title>Conclusions</title> <p>Fluorescence navigation by PDD provides good visualization and detection of gastric cancer lesions, and might be particularly useful for intestinal type gastric cancer. Thus, PDD using ALA seems to be a promising diagnostic tool for gastric cancer. <italic>J. Surg. Oncol. 2014 109:213–217</italic>. © 2013 Wiley Periodicals, Inc.</p> </sec> </abstract>