Research Article

Photodynamic diagnosis using 5-aminolevulinic acid during gastrectomy for gastric cancer

Corresponding Author

Tsutomu Namikawa PhD, MD

Department of Surgery, Kochi Medical School, Kochi, Japan

Correspondence to: Tsutomu Namikawa, PhD, MD, Department of Surgery, Kochi Medical School, Kohasu, Oko-cho, Nankoku, Kochi 783-8505, Japan. Fax: +81-88-880-2371. E-mail: [email protected]Search for more papers by this author

Keiji Inoue PhD, MD,

Keiji Inoue PhD, MD

Department of Urology, Kochi Medical School, Kochi, Japan

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Sunao Uemura MD,

Sunao Uemura MD

Department of Surgery, Kochi Medical School, Kochi, Japan

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Mai Shiga MD,

Mai Shiga MD

Department of Surgery, Kochi Medical School, Kochi, Japan

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Hiromichi Maeda PhD, MD,

Hiromichi Maeda PhD, MD

Department of Surgery, Kochi Medical School, Kochi, Japan

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Hiroyuki Kitagawa PhD, MD,

Hiroyuki Kitagawa PhD, MD

Department of Surgery, Kochi Medical School, Kochi, Japan

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Hideo Fukuhara PhD, MD,

Hideo Fukuhara PhD, MD

Department of Urology, Kochi Medical School, Kochi, Japan

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Michiya Kobayashi PhD, MD,

Michiya Kobayashi PhD, MD

Department of Surgery, Kochi Medical School, Kochi, Japan

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Taro Shuin PhD, MD,

Taro Shuin PhD, MD

Department of Urology, Kochi Medical School, Kochi, Japan

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Kazuhiro Hanazaki PhD, MD,

Kazuhiro Hanazaki PhD, MD

Department of Surgery, Kochi Medical School, Kochi, Japan

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Tsutomu Namikawa PhD, MD,

Corresponding Author

Tsutomu Namikawa PhD, MD

Department of Surgery, Kochi Medical School, Kochi, Japan

Keiji Inoue PhD, MD,

Keiji Inoue PhD, MD

Department of Urology, Kochi Medical School, Kochi, Japan

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Sunao Uemura MD,

Sunao Uemura MD

Department of Surgery, Kochi Medical School, Kochi, Japan

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Mai Shiga MD,

Mai Shiga MD

Department of Surgery, Kochi Medical School, Kochi, Japan

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Hiromichi Maeda PhD, MD,

Hiromichi Maeda PhD, MD

Department of Surgery, Kochi Medical School, Kochi, Japan

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Hiroyuki Kitagawa PhD, MD,

Hiroyuki Kitagawa PhD, MD

Department of Surgery, Kochi Medical School, Kochi, Japan

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Hideo Fukuhara PhD, MD,

Hideo Fukuhara PhD, MD

Department of Urology, Kochi Medical School, Kochi, Japan

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Michiya Kobayashi PhD, MD,

Michiya Kobayashi PhD, MD

Department of Surgery, Kochi Medical School, Kochi, Japan

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Taro Shuin PhD, MD,

Taro Shuin PhD, MD

Department of Urology, Kochi Medical School, Kochi, Japan

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Kazuhiro Hanazaki PhD, MD,

Kazuhiro Hanazaki PhD, MD

Department of Surgery, Kochi Medical School, Kochi, Japan

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First published: 08 November 2013

https://doi.org/10.1002/jso.23487

Citations: 38

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Abstract

Background and Objectives

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.

Methods

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.

Results

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%; P = 0.049), while that of intestinal type tumor was significantly higher in PDD-positive compared to PDD-negative patients (93.3% vs. 27.3%; P < 0.001).

Conclusions

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. J. Surg. Oncol. 2014 109:213–217. © 2013 Wiley Periodicals, Inc.

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Volume109, Issue3

March 1, 2014

Pages 213-217

Photodynamic diagnosis using 5-aminolevulinic acid during gastrectomy for gastric cancer

Abstract

Background and Objectives

Methods

Results

Conclusions

REFERENCES

Citing Literature

References

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Photodynamic diagnosis using 5-aminolevulinic acid during gastrectomy for gastric cancer

Abstract

Background and Objectives

Methods

Results

Conclusions

REFERENCES

Citing Literature

References

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