Laparoscopic fluorescence diagnosis for intraabdominal fluorescence targeting of peritoneal carcinosis experimental studies
Laparoscopic fluorescence diagnosis for intraabdominal fluorescence targeting of peritoneal carcinosis experimental studies
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DOI：
10.1097/00000658-200202000-00014
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发表时间：
2002-02-01
影响因子：
9
通讯作者：
Herfarth, C
中科院分区：
文献类型：
--
作者：
Gahlen, J;Prosst, RL;Herfarth, C
目的评估5-氨基乙酰丙酸（ALA）诱导的原卟啉IX在腹膜结肠癌转移灶中的积聚和荧光，以及其对腹腔镜荧光诊断的益处。腹腔镜荧光诊断允许检测这些病变后，腹腔灌洗ALA和随后的荧光诱导蓝光excitation.Methods腹腔镜下种植结肠癌细胞（CC 531）在55 WAG/Rij大鼠腹膜引起的腹膜播散性癌。肿瘤生长12天后，将动物随机分为11组，每组具有不同的光敏参数。除一个对照组外，用1.5%或3.0%ALA溶液进行腹膜灌洗。光敏化时间为0.5、1、2、4或8小时。使用光学多通道分析仪进行光谱分析。ALA和原卟啉IX血清水平测定高效液相色谱法，以确定systemic load.Results原卟啉IX肿瘤蓄积和荧光峰值后2至4小时ALA应用在两个主要组，1.5%和3.0% ALA。1.5%ALA组的肿瘤检出率最高。结论腹腔镜荧光诊断可提高腹腔镜诊断分期的敏感性和特异性。它可以确定腹膜癌的程度。改进的术前评估有助于避免不必要的剖腹手术和根治性切除术。
Objective To assess 5-aminolevulinic acid (ALA)-induced protoporphyrin IX accumulation and fluorescence in peritoneal colon carcinoma metastases and its benefits for laparoscopic fluorescence diagnosis.Summary Background Data Occult, macroscopically nonvisible peritoneal micrometastases; can be missed in laparoscopy or open surgery. Laparoscopic fluorescence diagnosis allows detection of these lesions after intraperitoneal lavage with ALA and subsequent fluorescence induction by blue-light excitation.Methods A disseminated peritoneal carcinosis was induced by laparoscopic implantation of colon carcinoma cells (CC531) in the peritoneum of 55 WAG/Rij rats. After 12 days of tumor growth the animals were randomized into 11 groups with different photosensitization parameters. Peritoneal lavage was performed either with 1.5% or 3.0% ALA solution, except for one control group. Photosensitization times were 0.5, 1, 2, 4, or 8 hours. Spectrometry was performed using an optical multichannel analyser. ALA and protoporphyrin IX serum levels were measured by high-performance liquid chromatography to determine systemic load.Results Protoporphyrin IX tumor accumulation and fluorescence peaked 2 to 4 hours after ALA application in both main groups, 1.5% and 3.0% ALA. Tumor detection rate was most effective in the 1.5% ALA group. Compared with conventional white-light laparoscopy alone, blue-light excitation detected 35% additional intraabdominal tumor foci.Conclusions Laparoscopic fluorescence diagnosis can increase the sensitivity and specificity of diagnostic staging laparoscopy. It allows determination of the extent of peritoneal carcinosis. Improved preoperative assessment helps to avoid unnecessary laparotomies and radical resections.