title: Porphyrins as urinary biomarkers for bladder cancer after 5-aminolevulinic acid (ALA) administration: the potential of photodynamic screening for tumors.
abstract: BACKGROUND
  Tumor biomarkers are commonly used for cancer screening and as indicators of treatment effects. We recently reported that urine porphyrin levels from tumor-bearing mice were elevated compared with those from normal mice after administration of 5-aminolevulinic acid (ALA). In the present study, we evaluated the use of urine samples from bladder cancer patients as tumor biomarkers.
  
  
  METHODS
  ALA, 1.0 g, was orally administered to 66 bladder cancer patients and 20 healthy adults. The urine concentrations of uroporphyrin I (UPI), uroporphyrin III (UPIII), coproporphyrin I (CPI), coproporphyrin III (CPIII), and total porphyrins were measured using High Performance Liquid Chromatography (HPLC) system.
  
  
  RESULTS
  Almost all of the urinary porphyrin concentrations from the patients with bladder cancer were higher than those from healthy adults. Moreover, 8h after ALA administration, urinary UPI and CPI showed high sensitivity (100 for UPI and CPI) and specificity (96.4 for UPI and 91.4 for CPI).
  
  
  CONCLUSIONS
  These results indicate that the presence of urinary porphyrins after administration of ALA may function as tumor biomarkers. This method represents a possible new tumor screening method called photodynamic screening (PDS) using ALA-induced porphyrins.
authors.affiliation: Department of Urology, Kochi Medical School, Nankoku, Kochi 783-8505, Japan.
authors.forename: Keiji
authors.initials: K
authors.lastname: Inoue
authors.forename: Urara
authors.initials: U
authors.lastname: Ota
authors.forename: Masahiro
authors.initials: M
authors.lastname: Ishizuka
authors.forename: Chiaki
authors.initials: C
authors.lastname: Kawada
authors.forename: Hideo
authors.initials: H
authors.lastname: Fukuhara
authors.forename: Taro
authors.initials: T
authors.lastname: Shuin
authors.forename: Ichiro
authors.initials: I
authors.lastname: Okura
authors.forename: Tohru
authors.initials: T
authors.lastname: Tanaka
authors.forename: Shun-ichiro
authors.initials: S
authors.lastname: Ogura
mesh_terms: D000328:Adult; D000368:Aged; D000622:Aminolevulinic Acid; D014408:Biomarkers, Tumor / Q000652:urine*; D002851:Chromatography, High Pressure Liquid / Q000379:methods; D055088:Early Detection of Cancer / Q000379:methods*; D005240:Feasibility Studies; D006801:Humans; D008875:Middle Aged; D017319:Photosensitizing Agents; D011166:Porphyrins / Q000652:urine*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D001749:Urinary Bladder Neoplasms / Q000175:diagnosis* / Q000652:urine*
chemical_list: D014408:Biomarkers, Tumor; D017319:Photosensitizing Agents; D011166:Porphyrins; D000622:Aminolevulinic Acid
keywords: 5-Aminolevulinic acid; Coproporphyrin; Tumor biomarker; Urine; Uroporphyrin