5-氨基酮戊酸光动力学诊断腹膜转移癌的研究进展

摘要

Peritoneal metastasis (PM) has long been regarded as the terminal stage or cancer spreading. Since the 1990s, an integrated treatment strategy combining cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) has been gradually developed by the surgical oncology community, and has definitely improved the survival in selected patients with PM. In such comprehensive treatment strategy, completeness of cytoreduction (CCR) is the most important independent prognostic factor for survival benefit. The current CRS technique, however, is inadequate to identify the minute tumor nodules hidden at less accessible sites in the abdomen and pelvis. Thus PM still accounts for the most frequent form of cancer recurrence after CRS + HIPEC. There is an urgent need to develop sharper techniques to identify the minute PM nodules. Among the emerging technologies, photodynamic diagnosis (PDD) attracts the increasing attention for PM diagnosis. This review summarizes the application of 5-aminolevulinic acid (5-ALA)-based PDD for the diagnosis and treatment of PM.%腹膜转移(peritoneal metastasis, PM)一直被视作癌症的终末阶段.20世纪90年代早期,外科肿瘤学界发展了细胞减灭术(cytoreductive surgery, CRS)加腹腔热灌注化学药物治疗(hyperthermic intraperitoneal chemotherapy, HIPEC)的综合治疗策略,可延长部分经谨慎选择的PM患者生存期.细胞减灭程度(completeness of cytoreduction, CCR)是该综合治疗后最重要的独立生存预测因子.然而,现行的手术技术容易遗漏肉眼难以发现的隐匿部位PM或微小癌灶,PM仍是常规CRS术后主要的复发形式.因此,近年来,光动力学诊断(photodynamic diagnosis,PDD)方法逐渐发展,并用于检测PM.本综述旨在总结5-氨基酮戊酸(5-aminolevulinic acid, 5-ALA)PDD技术在 PM中的应用进展.