Performance of 5-aminolevulinic-acid-based photodynamic diagnosis for radical prostatectomy.
Performance of 5-aminolevulinic-acid-based photodynamic diagnosis for radical prostatectomy.
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DOI：
10.1186/s12894-015-0073-y
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发表时间：
2015-08-01
期刊：
影响因子：
2
通讯作者：
Shuin T
中科院分区：
文献类型：
--
作者：
Fukuhara H;Inoue K;Kurabayashi A;Furihata M;Shuin T
本研究的目的是探讨5-氨基乙酰丙酸(ALA)光动力学诊断(PDD)和红色荧光标记法在开腹和腹腔镜行前列腺癌根治术中能否检出阳性手术切缘。52例患者均经活检确诊为前列腺癌。在顶端有一个阳性核心或高度可疑的阳性边缘。开腹前列腺癌根治术18例，腹腔镜根治术34例。术中经胃管口服1克ALA溶液。使用内窥镜PDD系统，包括D-Light C，CCU Tricam SLII/3CCDCH Tricam-P PDD和Hopkins II直线前进望远镜0°。D-Light C光源配备了带通滤光器。CCU Tricam SLII/3CHTricam-P PDD摄像机系统配备了长通滤光片。腹腔镜光学组件配有黄色长通滤光片。52例患者中有一例切除的整个前列腺边缘呈红色荧光阳性，手术边缘呈阳性，经组织学证实。在切除的前列腺切片中，我们获得了141例活检标本。敏感度为75.0%，特异度为87.3%。术中ALA-PDD是可行的。然而，热变性和阳性手术切缘的长度对红色荧光有重要影响。今后应进行随机临床试验。
The 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. All 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. One 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. Intraoperative 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.