腎細胞癌における5-アミノレブリン酸（5-ALA）を用いた光力学診断および5-ALA投与後の尿中ポルフィリン測定の有用性の検討
5-アミノレブリン酸（ALA）の代謝産物であるプロトポルフィリンIX（PPIX）は正常組織に比べ腫瘍組織に高濃度に集積し，青色光で赤色の蛍光を発する．この特性を利用した癌の蛍光診断を光力学診断（Photodynamic Diagnosis: PDD）と呼ぶ．膀胱癌においては，5-ALA投与後の腫瘍の発光程度と悪性度に相関関係があることや，5-ALA投与後の尿中ポルフィリン値がその診断に有用であると報告されている．しかし，腎細胞癌においては，そのような研究報告はない．本研究においては，腎細胞癌における5-ALAの診断に関する有用性について検討したので報告する．...
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| Published in | 日本レーザー医学会誌 Vol. 40; no. 1; pp. 93 - 103 |
|---|---|
| Main Authors | , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
特定非営利活動法人 日本レーザー医学会
15.04.2019
|
| Subjects | |
| Online Access | Get full text |
| ISSN | 0288-6200 1881-1639 |
| DOI | 10.2530/jslsm.jslsm-40_0014 |
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| Abstract | 5-アミノレブリン酸（ALA）の代謝産物であるプロトポルフィリンIX（PPIX）は正常組織に比べ腫瘍組織に高濃度に集積し，青色光で赤色の蛍光を発する．この特性を利用した癌の蛍光診断を光力学診断（Photodynamic Diagnosis: PDD）と呼ぶ．膀胱癌においては，5-ALA投与後の腫瘍の発光程度と悪性度に相関関係があることや，5-ALA投与後の尿中ポルフィリン値がその診断に有用であると報告されている．しかし，腎細胞癌においては，そのような研究報告はない．本研究においては，腎細胞癌における5-ALAの診断に関する有用性について検討したので報告する． |
|---|---|
| AbstractList | 5-アミノレブリン酸（ALA）の代謝産物であるプロトポルフィリンIX（PPIX）は正常組織に比べ腫瘍組織に高濃度に集積し，青色光で赤色の蛍光を発する．この特性を利用した癌の蛍光診断を光力学診断（Photodynamic Diagnosis: PDD）と呼ぶ．膀胱癌においては，5-ALA投与後の腫瘍の発光程度と悪性度に相関関係があることや，5-ALA投与後の尿中ポルフィリン値がその診断に有用であると報告されている．しかし，腎細胞癌においては，そのような研究報告はない．本研究においては，腎細胞癌における5-ALAの診断に関する有用性について検討したので報告する． |
| Author | 安田, 政実 城武, 卓 岡部, 尚志 小山, 政史 西本, 紘嗣郎 |
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| References | 1) 小山, 政史，朝倉 博孝，上野 宗久．5-アミノレブリン酸を用いた光線力学的診断・治療．臨床泌尿器科．2010; 64: 967-977. 7) Nakai Y, Anai S, Onishi S, Masaomi K, Tatsumi Y, Miyake M, Chihara Y, Tanaka N, Hirao Y, Fujimoto K. Protoporphyrin IX induced by 5-aminolevulinic acid in bladder cancer cells in voided urine can be extracorporeally quantified using a spectrophotometer. Photodiagnosis Photodyn Ther. 2015; 12: 282-288. 3) Schoenfeld N, Mamet R, Leibovici L, Epstein O, Teitz Y, Atsmon A. Growth rate determines activity of porphobilinogen deaminase both in nonmalignant and malignant cell lines. Biochem Med Metab Biol. 1988; 40: 213-217. 5) Nakai Y, Tatsumi Y, Miyake M, Anai S, Kuwada M, Onishi S, Chihara Y, Tanaka N, Hirao Y, Fujimoto K. Expression of ferrochelatase has a strong correlation in protoporphyrin IX accumulation with photodynamic detection of bladder cancer. Photodiagnosis Photodyn Ther. 2016; 13: 225-232. 14) Peng C, Li Y, Liang H, Cheng J, Li Q, Sun X, Li Z, Wang F, Guo Y, Tian Z, Yang L, Tian Y, Zhang Z, Cao W. Detection and photodynamic therapy of inflamed atherosclerotic plaques in the carotid artery of rabbits. J Photochem Photobiol B. 2011; 102: 26-31. 4) Kennedy JC, Pottier RH. Endogenous protoporphyrin IX, a clinically useful photosensitizer for photodynamic therapy. J Photochem Photobiol B. 1992; 14: 275-292. 11) Kondo H, Shirotake S, Okabe T, Makino S, Nishimoto K, Oyama M. Clinical Impact of Consolidative and Salvage Radiotherapy for Lymph Node Metastasis in Upper Urinary Tract Urothelial Carcinoma. Case Rep Urol. 2018; 2018: 1471839. 10) Endo Y, Okayama A, Endo G, Ueda T, Nakazono N, Horiguchi S. Improvement of urinary delta-aminolevulinic acid determination by HPLC and fluorescence detection using condensing reaction with acetylacetone and formaldehyde. Sangyo Igaku. 1994; 36: 49-56. 15) Kirdaite G, Lange N, Busso N, Van Den Bergh H, Kucera P, So A. Protoporphyrin IX photodynamic therapy for synovitis. Arthritis Rheum. 2002; 46: 1371-1378. 6) Inoue K, Ota U, Ishizuka M, Kawada C, Fukuhara H, Shuin T, Okura I, Tanaka T, Ogura S. Porphyrins as urinary biomarkers for bladder cancer after 5-aminolevulinic acid (ALA) administration: the potential of photodynamic screening for tumors. Photodiagnosis Photodyn Ther. 2013; 10: 484-489. 8) Hoda MR, Popken G. Surgical outcomes of fluorescence-guided laparoscopic partial nephrectomy using 5-aminolevulinic acid-induced protoporphyrin IX. J Surg Res. 2009; 154: 220-225. 12) Heng DY, Xie W, Regan MM, Warren MA, Golshayan AR, Sahi C, Eigl BJ, Ruether JD, Cheng T, North S, Venner P, Knox JJ, Chi KN, Kollmannsberger C, McDermott DF, Oh WK, Atkins MB, Bukowski RM, Rini BI, Choueiri TK. Prognostic factors for overall survival in patients with metastatic renal cell carcinoma treated with vascular endothelial growth factor-targeted agents: results from a large, multicenter study. J Clin Oncol. 2009; 27: 5794-5799. 2) 西本, 紘嗣郎，城 武卓，小山, 政史．5-アミノレブリン酸を用いた診断への取り組み（第45回尿路悪性腫瘍研究会講演スライド，2018年7月21日）．2018. Available from: https://figshare.com/articles/5-________/7075235. 13) Tickoo SK, Lee MW, Eble JN, Amin M, Christopherson T, Zarbo RJ, Amin MB. Ultrastructural observations on mitochondria and microvesicles in renal oncocytoma, chromophobe renal cell carcinoma, and eosinophilic variant of conventional (clear cell) renal cell carcinoma. Am J Surg Pathol. 2000; 24: 1247-1256. 9) Kamada Y, Murayama Y, Ota U, Takahashi K, Arita T, Kosuga T, Konishi H, Morimura R, Komatsu S, Shiozaki A, Kuriu Y, Ikoma H, Nakanishi M, Ichikawa D, Fujiwara H, Okamoto K, Tanaka T, Otsuji E. Urinary 5-Aminolevulinic Acid Concentrations as a Potential Tumor Marker for Colorectal Cancer Screening and Recurrence. Anticancer Res. 2016; 36: 2445-2450. |
| References_xml | – reference: 12) Heng DY, Xie W, Regan MM, Warren MA, Golshayan AR, Sahi C, Eigl BJ, Ruether JD, Cheng T, North S, Venner P, Knox JJ, Chi KN, Kollmannsberger C, McDermott DF, Oh WK, Atkins MB, Bukowski RM, Rini BI, Choueiri TK. Prognostic factors for overall survival in patients with metastatic renal cell carcinoma treated with vascular endothelial growth factor-targeted agents: results from a large, multicenter study. J Clin Oncol. 2009; 27: 5794-5799. – reference: 1) 小山, 政史，朝倉 博孝，上野 宗久．5-アミノレブリン酸を用いた光線力学的診断・治療．臨床泌尿器科．2010; 64: 967-977. – reference: 3) Schoenfeld N, Mamet R, Leibovici L, Epstein O, Teitz Y, Atsmon A. Growth rate determines activity of porphobilinogen deaminase both in nonmalignant and malignant cell lines. Biochem Med Metab Biol. 1988; 40: 213-217. – reference: 15) Kirdaite G, Lange N, Busso N, Van Den Bergh H, Kucera P, So A. Protoporphyrin IX photodynamic therapy for synovitis. Arthritis Rheum. 2002; 46: 1371-1378. – reference: 11) Kondo H, Shirotake S, Okabe T, Makino S, Nishimoto K, Oyama M. Clinical Impact of Consolidative and Salvage Radiotherapy for Lymph Node Metastasis in Upper Urinary Tract Urothelial Carcinoma. Case Rep Urol. 2018; 2018: 1471839. – reference: 9) Kamada Y, Murayama Y, Ota U, Takahashi K, Arita T, Kosuga T, Konishi H, Morimura R, Komatsu S, Shiozaki A, Kuriu Y, Ikoma H, Nakanishi M, Ichikawa D, Fujiwara H, Okamoto K, Tanaka T, Otsuji E. Urinary 5-Aminolevulinic Acid Concentrations as a Potential Tumor Marker for Colorectal Cancer Screening and Recurrence. Anticancer Res. 2016; 36: 2445-2450. – reference: 8) Hoda MR, Popken G. Surgical outcomes of fluorescence-guided laparoscopic partial nephrectomy using 5-aminolevulinic acid-induced protoporphyrin IX. J Surg Res. 2009; 154: 220-225. – reference: 14) Peng C, Li Y, Liang H, Cheng J, Li Q, Sun X, Li Z, Wang F, Guo Y, Tian Z, Yang L, Tian Y, Zhang Z, Cao W. Detection and photodynamic therapy of inflamed atherosclerotic plaques in the carotid artery of rabbits. J Photochem Photobiol B. 2011; 102: 26-31. – reference: 6) Inoue K, Ota U, Ishizuka M, Kawada C, Fukuhara H, Shuin T, Okura I, Tanaka T, Ogura S. Porphyrins as urinary biomarkers for bladder cancer after 5-aminolevulinic acid (ALA) administration: the potential of photodynamic screening for tumors. Photodiagnosis Photodyn Ther. 2013; 10: 484-489. – reference: 5) Nakai Y, Tatsumi Y, Miyake M, Anai S, Kuwada M, Onishi S, Chihara Y, Tanaka N, Hirao Y, Fujimoto K. Expression of ferrochelatase has a strong correlation in protoporphyrin IX accumulation with photodynamic detection of bladder cancer. Photodiagnosis Photodyn Ther. 2016; 13: 225-232. – reference: 10) Endo Y, Okayama A, Endo G, Ueda T, Nakazono N, Horiguchi S. Improvement of urinary delta-aminolevulinic acid determination by HPLC and fluorescence detection using condensing reaction with acetylacetone and formaldehyde. Sangyo Igaku. 1994; 36: 49-56. – reference: 13) Tickoo SK, Lee MW, Eble JN, Amin M, Christopherson T, Zarbo RJ, Amin MB. Ultrastructural observations on mitochondria and microvesicles in renal oncocytoma, chromophobe renal cell carcinoma, and eosinophilic variant of conventional (clear cell) renal cell carcinoma. Am J Surg Pathol. 2000; 24: 1247-1256. – reference: 2) 西本, 紘嗣郎，城 武卓，小山, 政史．5-アミノレブリン酸を用いた診断への取り組み（第45回尿路悪性腫瘍研究会講演スライド，2018年7月21日）．2018. Available from: https://figshare.com/articles/5-________/7075235. – reference: 7) Nakai Y, Anai S, Onishi S, Masaomi K, Tatsumi Y, Miyake M, Chihara Y, Tanaka N, Hirao Y, Fujimoto K. Protoporphyrin IX induced by 5-aminolevulinic acid in bladder cancer cells in voided urine can be extracorporeally quantified using a spectrophotometer. Photodiagnosis Photodyn Ther. 2015; 12: 282-288. – reference: 4) Kennedy JC, Pottier RH. Endogenous protoporphyrin IX, a clinically useful photosensitizer for photodynamic therapy. J Photochem Photobiol B. 1992; 14: 275-292. |
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| SubjectTerms | 5-アミノレブリン酸 光力学診断 尿中ポルフィリン 腎細胞癌 腫瘍マーカー |
| Title | 腎細胞癌における5-アミノレブリン酸（5-ALA）を用いた光力学診断および5-ALA投与後の尿中ポルフィリン測定の有用性の検討 |
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