腎細胞癌に対するPDDの応用

  • 小山 政史
    埼玉医科大学国際医療センター泌尿器腫瘍科
  • 上野 宗久
    埼玉医科大学国際医療センター泌尿器腫瘍科

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  • ジンサイボウガン ニ タイスル PDD ノ オウヨウ

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  Photodynamic diagnosis(PDD)using 5-aminolevulinic acid(5-ALA)has been described as an innovative technique for the intraoperative detection of malignant tissue, especially for the identification of surgical margin. There have been two reports in which photodynamic detection after oral administration of 5-ALA was assessed for the identification of surgical margins in nephron-sparing surgery. During the operation, the bottom of the resection site and the outer tumor border were inspected for fluorescence under blue light. Residual carcinoma was confirmed in the areas of positive PDD findings. Surgical margin is usually evaluated by means of frozen section analysis(FSA), which is a time-consuming procedure with a limited reliability and certain probability of false negative results. PDD using orally administered 5-ALA may offer the advantage of real-time assessment of resection status and reduction of operation time. In two reports introduced here, no side effects of systemic 5-ALA administrations were observed.

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