Laser Video Fluorescence Diagnosis of Stomach Diseases
The aim of the study was to assess the efficiency of the method for registration of video fluorescence of 5-ALA-induced protoporphyrin IX in stomach and esophagus diseases, to adapt it for clinical conditions, i.e. for conducting differential diagnosis and detecting precancer conditions, and to formulate recommendations on the best photosensitizer doses and time of application in order to make the diagnostic procedure for these diseases more accurate.
Materials and Methods. Registration of fluorescence for diagnostic purposes was performed on 57 patients with gastropathology (mainly with stomach cancer) with the help of single-channel (n=50) and dual-channel (n=7) laser video fluorescence registration systems. The study was performed using 5-aminolevulinic acid (5-ALA) (Alasens). 39 endoscopic, 18 intraoperative/laparoscopic investigations, and 7 studies on the macropreparation have been performed.
Results. When both systems were used, no fluorescence was registered in cases of stomach ulcer, chronic gastritis, massive tumor necrosis and blood admixture in the stomach as well as in the patient with subcompensated stenosis and a stented output section of the stomach without serous membrane invasion and low 5-ALA concentration. In all other cases, a distinct fluorescence was recorded, the data of which may be used for establishing exact diagnosis and choosing further treatment tactics.
Conclusion. Laser video fluorescence technique is a promising method for differential diagnosing and definition of the tumor extension process in the stomach and esophagus which can be used as an express method in diagnostically complex cases.
- Marqués-Lespier J.M., González-Pons M., Cruz-Correa M. Current perspectives on gastric cancer. Gastroenterol Clin North Am 2016; 45(3): 413–428, https://doi.org/10.1016/j.gtc.2016.04.002.
- Waddingham W., Graham D., Banks M., Jansen M.F. The evolving role of endoscopy in the diagnosis of premalignant gastric lesions. F1000Res 2018; 7: 715, https://doi.org/10.12688/f1000research.12087.1.
- Sokolov V.V., Chissov V.I., Filonenko E.V., Telegina L.V., Trakhtenberg A.Kh., Frank G.A., Bulgakova N.N. Fluorescence detection of early central lung cancer. Pul’monologia 2005; 1: 107–116.
- Yagudaev D.M., Sorokaty A.E., Martov A.G., Heinits A.V., Markova M.V. Photodynamic therapy of prostatic adenoma. Urologia 2007; 4: 34–37.
- Tsyb A.F., Kaplan M.A., Molochkov V.A., Mironov A.F., Romanko Yu.S., Kapinus V.N., Tretyakova Ye.I., Sukhova T.Ye. Use of photodynamic therapy in the treatment of solitary and multiple basal-cell carcinomas. Rossijskij zurnal koznyh i venericeskih boleznej 2000; 4(10): 4–12.
- Novikova E.G., Trushina O.I., Sokolov V.V., Filonenko E.V. Fluorescent diagnosis and photodynamic therapy of pretumor pathology and an initial form of uterine cervix cancer. Rossijskij onkologiceskij zurnal 2005; 6: 28–33.
- Yagudajev D.M., Geinitz A.V., Martov A.G., Sorokatiy A.E. The first results of PDT used for urinary bladder cancer. Lazernaja medicina 2004; 8(3): 242.
- Loschenov V.B., Linkov K.G., Savelieva T.A., Loschenov M.V., Model S.S., Borodkin A.V. Hardware and tool equipment for fluorescence diagnostics and photodynamic therapy. Fotodinamicheskaya terapiya i fotodiagnostika 2013; 3: 17–25.
- Chen W.R., Jassemnejad B., Crull J., Knobbe E.T., Nordquist R.E. Detection and characterization of chemical-induced abnormal tissue and rat tumors at different stages using fluorescence spectroscopy. Proc. SPIE 2679, Advances in Laser and Light Spectroscopy to Diagnose Cancer and Other Diseases III: Optical
Biops 1996, https://doi.org/10.1117/12.237570. - Cheng C.W., Lau W.K., Tan P.H., Olivo M. Cystoscopic diagnosis of bladder cancer by intravesical instillation of 5-aminolevulinic acid induced porphyrin fluorescence — the Singapore experience. Ann Acad Med Singapore 2000; 29(2): 153–158.
- Curnow A., McIlroy B.W., Postle-Hacon M.J., Porter J.B., MacRobert A.J., Bown S.G. Enhancement of 5-aminolevulinic acid-induced photodynamic therapy in normal rat colon using
hydroxypyridinone iron-chelating agents. Br J Cancer 1998; 78(10): 1278–1282, https://doi.org/10.1038/bjc.1998.671. - Campbell D.L., Gudgin-Dickson E.F., Forkert P.G., Pottier R.H., Kennedy J.C. Detection of early stages of carcinogenesis in adenomas of
murine lung by 5-aminolevulinic acid-induced protoporphyrin IX fluorescence. Photochem Photobiol 1996; 64(4): 676–682, https://doi.org/10.1111/j.1751-1097.1996.tb03123.x. - Battersby A.R., Fookes C.J., Matcham G.W., McDonald E. Biosynthesis of the pigments of life: formation of the macrocycle. Nature 1980; 285(5759): 17–21, https://doi.org/10.1038/285017a0.
- Shemin D., Russell C.S. δ-aminolevulinic acid, its role in the biosynthesis of porphyrins and purines. J Am Chem Soc 1953; 75(19): 4873–4874, https://doi.org/10.1021/ja01115a546.
