title: Staging fluorescence laparoscopy for gastric cancer by using 5-aminolevulinic acid.
abstract: BACKGROUND
  Precise staging of gastric cancer is essential when selecting for the appropriate treatment approach. 5-Aminolevulinic acid (5-ALA) is metabolized and accumulated as protoporphyrin IX (PpIX), which is a photosensitizer. In this study, we evaluated the diagnostic usefulness of 5-ALA for demonstrating peritoneal dissemination in patients with gastric cancer.
  
  
  METHODS
  Fluorescence laparoscopy (FL) was performed in 13 patients with gastric cancer. All patients received preoperative oral administration of 5-ALA. Fluorescence-light laparoscopies were sequentially performed intraoperatively.
  
  
  RESULTS
  In four out of the 13 patients, primary tumors were detected by FL and demonstrated serosal invasion on histological examination. Five out of the 13 patients demonstrated peritoneal metastases, and one patient demonstrated superficial liver micrometastases, by FL. All of these lesions were diagnosed as metastatic lesions by hematoxylin and eosin staining.
  
  
  CONCLUSIONS
  These findings show that FL diagnosis with 5-ALA is accurate and suitable for the detection of peritoneal metastases and of superficial liver micrometastases in patients with gastric cancer.
authors.affiliation: Department of Surgery, Division of Digestive Surgery, Kyoto Prefectural University of Medicine Graduate School of Medical Science, 465 Kajii-cho Hirokoji Kawaramachi, Kamigyo-ku, Kyoto 602-8566, Japan. murayama@koto.kpu-m.ac.jp
authors.forename: Yasutoshi
authors.initials: Y
authors.lastname: Murayama
authors.forename: Daisuke
authors.initials: D
authors.lastname: Ichikawa
authors.forename: Noriaki
authors.initials: N
authors.lastname: Koizumi
authors.forename: Shuhei
authors.initials: S
authors.lastname: Komatsu
authors.forename: Atsushi
authors.initials: A
authors.lastname: Shiozaki
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Kuriu
authors.forename: Hisashi
authors.initials: H
authors.lastname: Ikoma
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kubota
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Nakanishi
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Harada
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Fujiwara
authors.forename: Kazuma
authors.initials: K
authors.lastname: Okamoto
authors.forename: Toshiya
authors.initials: T
authors.lastname: Ochiai
authors.forename: Yukihito
authors.initials: Y
authors.lastname: Kokuba
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Takamatsu
authors.forename: Eigo
authors.initials: E
authors.lastname: Otsuji
mesh_terms: D000284:Administration, Oral; D000368:Aged; D000369:Aged, 80 and over; D000622:Aminolevulinic Acid / Q000008:administration & dosage; D005260:Female; D005453:Fluorescence; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008113:Liver Neoplasms / Q000175:diagnosis / Q000556:secondary; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010534:Peritoneal Neoplasms / Q000175:diagnosis / Q000556:secondary; D013274:Stomach Neoplasms / Q000175:diagnosis* / Q000473:pathology
chemical_list: D000622:Aminolevulinic Acid