Abstract
At the moment only early detection of lung cancer offers a good prognosis for the patients. Conventional white light endoscopy is mostly insufficient for early diagnosis. Therefore we developed a system of fluorescence diagnosis using 5-aminolaevulinic acid (ALA) exogeneously applied. As precursor of the heme synthesis it is metabolized to protoporphyrin IX – a red fluorescent substance. Therefore protoporphyrin IX accumulates in tumorous and premalignant tissue, and can be directly visualized by fluorescence bronchoscopy. Excitation with blue light (380–435 nm) causes a red fluorescence, which can be detected after filtering most of the blue component with the naked eye or a camera system. After earlier work with laser systems and cold light sources we now use the system D-Light AF for the fluorescence diagnosis using ALA-induced protoporphyrin IX fluorescence.
Highlights
Lung cancer is a very common disease throughout the world, which has a dismal prognosis
If 5-aminolaevulinic acid (ALA) is applied exogeneously, this negative feed-back mechanism is surpassed and protoporphyrin IX is synthesized during the heme biosynthesis
We examined the application of 5-ALA in three-dimensional miniorgans [26], which are derived from biopsies of the bronchial wall
Summary
Lung cancer is a very common disease throughout the world, which has a dismal prognosis. For non-invasive screening X-ray of the thorax and sputum cytology were applied [3,4,5,6,7] and got inconclusive results. These methods are reexamined [8]. Methods for improving the detection of early lesions are needed. The introduction of 5-aminolaevulinic acid (5-ALA) as an endogeneous photosensitizer [21] has changed the field and allows a very simple system for photodynamic detection of early tumorous or premalignant lesions in various organs such as the bladder [22] and the brain [23]
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