A novel laparoscopic near-infrared fluorescence spectrum system for photodynamic diagnosis of peritoneal dissemination in pancreatic cancer
A novel laparoscopic near-infrared fluorescence spectrum system for photodynamic diagnosis of peritoneal dissemination in pancreatic cancer
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DOI：
10.1016/j.pdpdt.2020.102157
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发表时间：
2021-03-01
影响因子：
3.3
通讯作者：
Hirano, Satoshi
中科院分区：
文献类型：
--
作者：
Saito, Takahiro;Ebihara, Yuma;Hirano, Satoshi
背景：诊断腹膜播散对于为胰腺癌患者选择合适的治疗策略至关重要。术中腹腔镜诊断可以选择微创手术策略。尽管不易检测到微弱的荧光，但使用 5-氨基乙酰丙酸进行光动力诊断可以提高胃肠癌诊断的准确性。在这里，我们的目的是使用腹腔镜分光光度法来提高这种灵敏度。方法：使用原卟啉IX的系列稀释液进行光动力诊断，并将腹腔镜分光光度法的检测能力与肉眼观察的检测能力进行比较。对胰腺癌细胞系进行五氨基乙酰丙酸光动力诊断，建立小鼠腹膜播散性结节模型。我们比较了腹腔镜分光光度法和使用白光和荧光灯的肉眼观察结果，并将其与常规组织病理学检查结果进行比较。 2017年和2018年对8名胰腺癌患者进行了光动力诊断。结果：用分光光度法比肉眼观察更好地检测稀释原卟啉IX样品的较弱荧光。此外，通过分光光度法检测了多种细胞系中原卟啉 IX 的光谱。在小鼠模型中，白光、荧光和分光光度法肉眼观察的检出率分别为62%、78%和90%。有和无病理转移的荧光阴性腹膜的比较显示，前者的分光光度强度显着更高（P < 0.010）。在临床研究中，观察到三个荧光光阴性分光光度法阳性的病理转移病灶。结论：小鼠模型中的腹腔镜分光光度法和临床实践中使用分光光度法进行腹膜外光动力诊断是敏感的光动力诊断技术。
Background: Diagnosing peritoneal dissemination is essential for selecting the appropriate therapeutic strategy for patients with pancreatic cancer. Intraoperative laparoscopic diagnosis enables the selection of less invasive surgical strategies. Photodynamic diagnosis using 5-aminolevulinic acid may improve gastrointestinal cancer diagnostic accuracy, although weak fluorescence is not easily detected. Here we aimed to improve this sensitivity using laparoscopic spectrophotometry.Methods: Photodynamic diagnosis was performed using serial dilutions of protoporphyrin IX, and its detectability using laparoscopic spectrophotometry was compared with that using naked-eye observation. Five-aminolevulinic acid-photodynamic diagnosis was performed for pancreatic cancer cell lines, and a murine peritoneal disseminated nodule model was established. We compared laparoscopic spectrophotometry and naked-eye observation results using white and fluorescent lights and compared them to routine histopathological examination results. Photodynamic diagnoses were made in 2017 and 2018 in eight patients with pancreatic cancer.Results: Weaker fluorescence of the diluted protoporphyrin IX samples was better detected with spectrophotometry than with naked-eye observation. Moreover, a spectrograph of protoporphyrin IX in multiple cell lines was detected by spectrophotometry. In the murine model, the detection rates were 62 %, 78 %, and 90 % for naked-eye observation with white light, fluorescent light, and spectrophotometry, respectively. Comparisons of fluorescent light-negative peritonea with and without pathological metastases showed significantly higher spectrophotometric intensities in the former (P < 0.010). In clinical studies, three fluorescent light-negative spectrophotometry-positive pathologically metastatic lesions were observed.Conclusions: Laparoscopic spectrophotometry in the murine model and extraperitoneally photodynamic diagnoses using spectrophotometry in clinical practice are sensitive photodynamic diagnostic techniques.