Korean Journal of Gastrointestinal Endoscopy 2003;26(2): 73-78.
소화관 암 및 이형성 병변에서 경구용 Aminolevulinic Acid를 이용한 내시경적 광역동 진단의 유용성 -예비 보고-
천영국·조영덕·김진오·조주영·이준성·김연수·이문성·심찬섭
순천향대학교 의과대학 내과학교실·소화기연구소
Endoscopic Photodynamic Diagnosis (PDD) Using Oral 5-aminolevulinic Acid in Gastrointestinal Cancer and Dysplastic Lesions
Young Koog Cheon, M.D., Young Deok Cho, M.D., Jin Oh Kim, M.D., Joo Yong Cho, M.D. Joon Seong Lee, M.D., Yun Soo Kim, M.D., Moon Sung Lee, M.D. and Chan Sup Shim, M.D.
Digestive Disease Center, Institute for Digestive Research, Soon Chun Hyang University College of Medicine, Seoul, Korea
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. Conclusion: PDD with 5-ALA might be useful for the detection of dysplasia and carcinoma in the gastrointestinal tract. (Korean J Gastrointest Endosc 2003;26:7378)
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