Korean J Gastrointest Endosc.  2003 Feb;26(2):73-78.

Endoscopic Photodynamic Diagnosis (PDD) Using Oral 5-aminolevulinic Acid in Gastrointestinal Cancer and Dysplastic Lesions

• Cheon YK
• Cho YD
• Kim JO
• Cho JY
• Lee JS
• Kim YS
• Lee MS
• Shim CS

Abstract

BACKGROUND
/AIM: Endoscopic screening for the detection of premalignant high-grade dysplasia remains time consuming and is subject to sampling error. We performed this study to determine the clinical usefulness of laser endoscopic spectra analyzer (LESA-7) in gastrointestinal cancer and dysplastic lesions.
METHODS
Seventeen patients with histologically proven carcinoma or adenoma with or without high-grade dysplasia were treated with oral administration of 5-ALA (20 mg/kg). PDD was performed 4 hours later. The fluorescence was excited by a helium-neon laser with emission at 637 nm. The generated fluorescence light was collected and fed into a multi-channel analyzer and the full spectrum was displayed in real time (LESA-7).
RESULTS
In most of malignant tumors, a clear protoporphyrin IX-related dual-peaked fluorescence signal at about 635 and 700 nm was identified in the fluorescence spectra. However, it was not fully identified in bile duct cancers. In PDD of post-EMR in order to detect residual lesions (gastric flat adenoma 1, early gastric cancer 2), a dual spectra was not identified.
CONCLUSIONS
PDD with 5-ALA might be useful for the detection of dysplasia and carcinoma in the gastrointestinal tract.

Keyword

Gastrointestinal cancer; Dysplasia; Photosensitizer; 5-aminolevulinic acid; Photodynamic diagnosis

MeSH Terms

Adenoma
Administration, Oral
Bile Duct Neoplasms
Diagnosis*
Fluorescence
Gastrointestinal Neoplasms*
Gastrointestinal Tract
Humans
Mass Screening
Selection Bias
Stomach Neoplasms