| Budget Amount *help |
¥2,600,000 (Direct Cost: ¥2,000,000、Indirect Cost: ¥600,000)
Fiscal Year 2011: ¥650,000 (Direct Cost: ¥500,000、Indirect Cost: ¥150,000)
Fiscal Year 2010: ¥1,950,000 (Direct Cost: ¥1,500,000、Indirect Cost: ¥450,000)
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| Research Abstract |
We evaluated the feasibility of photodynamic diagnosis(PDD) using 5-aminolevulinic acid(ALA) for detecting of prostate cancer(PCa) cells in the urine obtained following prostate massage. Urine samples were collected from 138 men performed the prostate massage(attentive digital rectal examination) before prostate needle biopsy. Urine sediments were exposed to 5-ALA(1mM) for 3 hours and cytospun onto glass slides. Protoporphyrin IX(PPIX), which is the metabolite of 5-ALA in the heme biosynthetic pathway, was observed using the fluorescent microscope(excitation filter 380-420 nm, emission filter 630 nm) as a positive signal of cancer cell. Any fluorescent signal in the samples was evaluated as positive. After histological diagnosis, the results of 5-ALA-PDD were compared with the histological diagnosis. Prostate cancer cells were successfully visualized by the PPIX. Of the 81 cases with biopsy-proven prostate cancer, 60 were evaluated as positive by 5-ALA-PDD(sensitivity : 74%). Although 57 cases were diagnosed as no cancer with biopsy, 17 5-ALA-PDD positive cases were detected(specificity : 70%). The positive predictive value of 5-ALA cancer detection was 78%. The proportion of 5-ALA PDD positive in the patients biopsy-proven prostate cancer was increased to 68% in Gleason score(GS) 6, 74% in GS 7, and 83% in GS 8 to 10, respectively(p=0.07). We have successfully demonstrated that PPIX in urine sediments treated with 5-ALA could be detected in the PCa patients. Furthermore, pathologically, the higher Gleason score was associated with the larger incidence of 5-ALA-PDD positive. 5-ALA-PDD positive cells might indicate how malignant the prostate cancer cells in the urine obtained following prostate massage are. So this harmless cancer detecting system appears to have the useful clinical application.
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