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Fluorescence staining of human ovarian cancer tissue following application of 5‐aminolevulinic acid: Fluorescence microscopy studies
Author(s) -
Löning Martin C.,
Diddens Heyke C.,
HollUlrich Konstanze,
Löning Uta,
Küpker Wolfgang,
Diedrich Klaus,
Hüttmann Gereon
Publication year - 2006
Publication title -
lasers in surgery and medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.888
H-Index - 112
eISSN - 1096-9101
pISSN - 0196-8092
DOI - 10.1002/lsm.20302
Subject(s) - fluorescence microscope , fluorescence , staining , pathology , fluorescent staining , microscopy , ovarian cancer , chemistry , biology , cancer , biochemistry , medicine , genetics , optics , physics
Background and Objectives Application of 5‐aminolevulinic acid (ALA) for fluorescence‐guided second‐look laparoscopy has been shown to be a promising new procedure in the early diagnosis of ovarian carcinoma metastases. However, for assessing the reliability of this method, information on the microscopic distribution of protoporphyrin IX (PP IX) in the tissue is needed. Additionally, the selectivity of PP IX uptake is essential for a potential photodynamic therapy (PDT) of ovarian cancer metastases. Study Design/Materials and Methods Thirty‐six patients with epithelial ovarian cancer and two patients suffering from fallopian tube carcinoma underwent a laparoscopic second‐look procedure 5 hours after the application of ALA. In 17 patients 36 fluorescence‐guided biopsies were taken from fluorescing and non‐fluorescing tissues for further evaluation. Fluorescence microscopy and digital image processing were utilized to determine the presence of PP IX fluorescence. Results A specificity of 88% and a sensitivity of 100% with a negative predictive value of 100% and a positive predictive value of 91% were calculated for PP IX fluorescence on a microscopic level as marker for ovarian cancer metastases. Conclusions On a microscopic scale, ALA‐induced PP IX fluorescence is confined to ovarian cancer tumor tissue sparing stromal tissues. Lasers Surg. Med. © 2006 Wiley‐Liss, Inc.