BACKGROUND: Recently, photodynamic diagnosis using 5-aminolevulinic acid (5-ALA) has gained attention for the diagnosis of neoplastic diseases. In the present study, an in vitro method of photodynamic cytodiagnosis (PDCD) performed using the reagent 5-ALA in the cytodiagnosis of solid pancreatic tumors was developed. Here, we assess the accuracy of PDCD for malignancy. MATERIALS AND METHODS: EUS-FNA was performed from September 2015 to March 2018 in patients with solid pancreatic tumors at Osaka Rosai Hospital. Samples were diagnosed independently by an expert pathologist and a medical doctor with conventional cytology and PDCD. RESULTS: A total of 53 patients (35 males, average age: 70.2 years old) were enrolled. The definitive diagnoses were 7 benign lesions and 46 malignant lesions. Using the in vitro PDCD method, the detection of reddish fluorescence in cell samples indicated cancer cells. PDCD had a sensitivity of 91.3% (42/46) and a specificity of 100% (7/7), while conventional cytology had a sensitivity of 93.5% (43/46) and a specificity of 85.7% (6/7). Two patients were successfully diagnosed with malignancy only by the PDCD method. CONCLUSIONS: In vitro PDCD performed using the 5-ALA method can effectively and safely identify a diagnosis of pancreatic cancer without requiring an expert pathologist. The sensitivity of this technique could be increased in the diagnosis of pancreatic malignancy by combining it with the conventional method.
BACKGROUND: Recently, photodynamic diagnosis using 5-aminolevulinic acid (5-ALA) has gained attention for the diagnosis of neoplastic diseases. In the present study, an in vitro method of photodynamic cytodiagnosis (PDCD) performed using the reagent 5-ALA in the cytodiagnosis of solid pancreatic tumors was developed. Here, we assess the accuracy of PDCD for malignancy. MATERIALS AND METHODS: EUS-FNA was performed from September 2015 to March 2018 in patients with solid pancreatic tumors at Osaka Rosai Hospital. Samples were diagnosed independently by an expert pathologist and a medical doctor with conventional cytology and PDCD. RESULTS: A total of 53 patients (35 males, average age: 70.2 years old) were enrolled. The definitive diagnoses were 7 benign lesions and 46 malignant lesions. Using the in vitro PDCD method, the detection of reddish fluorescence in cell samples indicated cancer cells. PDCD had a sensitivity of 91.3% (42/46) and a specificity of 100% (7/7), while conventional cytology had a sensitivity of 93.5% (43/46) and a specificity of 85.7% (6/7). Two patients were successfully diagnosed with malignancy only by the PDCD method. CONCLUSIONS: In vitro PDCD performed using the 5-ALA method can effectively and safely identify a diagnosis of pancreatic cancer without requiring an expert pathologist. The sensitivity of this technique could be increased in the diagnosis of pancreatic malignancy by combining it with the conventional method.