Effectiveness of Photodynamic Screening Using 5-Aminolevulinic Acid for the Diagnosis of Pancreatic Cancer

Anticancer Res. 2020 Jun;40(6):3571-3577. doi: 10.21873/anticanres.14347.

Abstract

Background/aim: We evaluated urinary levels of porphyrin metabolites, such as uroporphyrin (UP) and coproporphyrin (CP), after 5-Aminolevulinic acid (ALA) administration in patients with or without pancreatic cancer (PaC).

Patients and methods: Sixty-seven subjects with PaC, 11 with pancreatitis, and 9 with normal pancreas (NP) were enrolled. Urine samples from all subjects were collected prior to ALA administration and at more than 4 hours after ALA administration. We measured the urinary levels of UP and CP by high-performance liquid chromatography analysis.

Results: The PaC group showed significantly higher UP levels compared to NP groups (104.9 nmol/g Cre vs. 53.4 nmol/g Cre, p=0.014). Moreover, PaC patients with long-term survival had significantly lower urinary levels of UP at diagnosis (98.8 nmol/gCre) than the short-term survival group (125.2 nmol/gCre) (p=0.042).

Conclusion: The urinary levels of UP after ALA administration might serve as a promising biomarker for diagnosis and prognosis prediction of PaC.

Keywords: 5-aminolevulinic acid; Pancreatic cancer; biomarker; photodynamic screening.

MeSH terms

  • Aged
  • Aminolevulinic Acid
  • Biomarkers
  • Biomarkers, Tumor
  • Early Detection of Cancer
  • Female
  • Humans
  • Levulinic Acids* / metabolism
  • Light*
  • Male
  • Mass Screening
  • Middle Aged
  • Molecular Imaging* / methods
  • Molecular Imaging* / standards
  • Pancreatic Neoplasms / diagnosis*
  • Pancreatic Neoplasms / metabolism
  • Photosensitizing Agents* / metabolism
  • Porphyrins
  • Sensitivity and Specificity

Substances

  • Biomarkers
  • Biomarkers, Tumor
  • Levulinic Acids
  • Photosensitizing Agents
  • Porphyrins