Performance of 5-aminolevulinic-acid-based photodynamic diagnosis for radical prostatectomy

BMC Urology

Research Article

Atsushi Kurabayashi¹  Mutsuo Furihata¹  Keiji Inoue²  Taro Shuin²  Hideo Fukuhara² 

[1] Department of Pathology, Kochi Medical School, Kohasu, Oko, 783-8505, Nankoku, Kochi, Japan;Department of Urology, Kochi Medical School, Kohasu, Oko, 783-8505, Nankoku, Kochi, Japan;

关键词: Prostate Cancer;    Radical Prostatectomy;    Surgical Margin;    Positive Surgical Margin;    Human Prostate Cancer Cell;   

DOI  :  10.1186/s12894-015-0073-y

 received in 2014-09-17, accepted in 2015-07-24,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundThe aim of this study was to investigate whether we could detect positive surgical margins during open and laparoscopic radical prostatectomy by 5-aminolevulinic acid (ALA) photodynamic diagnosis (PDD) and mapping of red fluorescence in human prostate cancer cells.MethodsAll 52 patients were diagnosed with prostate cancer by biopsy. They had a positive core in the apex or highly suspicious positive margins. Open and laparoscopic radical prostatectomy was performed in 18 and 34 cases, respectively. One gram of ALA solution was given intraoperatively, orally through a stomach tube. An endoscopic PDD system, including a D-Light C, CCU Tricam SLII/3CCD CH Tricam-P PDD, and HOPKINS II Straight Forward Telescope 0°, was used. The D-Light C light source was equipped with a band-pass filter. The CCU Tricam SLII/3CCD CHTricam-P PDD video camera system was equipped with a long-pass filter. The laparoscopy optic component was equipped with a yellow long-pass filter.ResultsOne of the 52 patients had a red-fluorescent-positive margin of the excised whole prostate and the positive surgical margin was histologically confirmed. In the section of excised prostate, we obtained 141 biopsied samples. The sensitivity and specificity were 75.0 % and 87.3 %, respectively.ConclusionsIntraoperative ALA-PDD is feasible. However, heat degeneration and length of positive surgical margin have crucial influences on red fluorescence. In future, a randomized clinical trial should be carried out.

【 授权许可】

Unknown   
© Fukuhara et al. 2015. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.