[Photodynamic diagnosis of vulvar precancerous conditions and invasive cancers using 5-aminolevulinic acid].

Abstract

BACKGROUND:

Photodynamic therapy (PDT), in particular Photodynamic diagnosis (PDD) is a modern, non-invasive technique using photosensitizer like 5-aminolevulinic acid (5-ALA) in detection of the vulvar diseases. Photodynamic therapy gives the possibilities to differentiate inflammatory diseases from precancerous lesions and invasive vulvar cancer.

OBJECTIVE:

To assess accuracy of the PDD in detection, localisation and differentiation of precancerous diseases and invasive cancer of the vulva.

MATERIAL AND METHODS:

This study included 107 patients with vulvar disorders, 30 patients with VIN I, 31 patients with VIN II, and 46 patients with VIN III and vulvar carcinoma. All women underwent a standard gynaecologic examination. 5-ALA was topically applied to the vulva. After 180-360 minutes the vulvar skin was illuminated by a short--are xenon lamp at 380-440 nm and an output of 200 mW (D-Light; Karl storz). A filter to select the emitted wavelength range 630-670 nm was used in order to achieve differentiation's of the fluorescence--positive and negative areas. After the PDD, biopsies were taken from patients with multifocal VIN lesions. Macroscopic appearance, fluorescence pattern in scale of three degrees (zero, +, ++) and histology of the lesions were compared.

RESULTS:

The sensitivity, specificity, positive and negative predictive value for the detection of VIN I were 85.7%, 81.2%, 80.0%, 86.6% respectively, for VIN II there were 93.3%, 93.7%, 93.3% and 93.7%, and for VIN III and invasive vulvar cancer there were 96.3%, 94.7%, 96.3% and 94.7% respectively. The sensitivity, specificity, positive and negative predictive value for the detection of all VIN and invasive vulvar cancer common were 92.9%, 90.2%, 91.2%, 92.0 respectively.

CONCLUSION:

The Photodynamic therapy becomes a valuable, non-invasive diagnostic tool that lowers the amount of false negative diagnosis in cases of VIN and vulvar cancer.

• Authors: Kindah Mo Akoel, Jakub Welfel, Leszek Gottwald, Jacek Suzin
• Journal: Ginekologia polska (Ginekol Pol) Vol. 74 Issue 9 Pg. 662-5 (Sep 2003) ISSN: 0017-0011 [Print] Poland
• Vernacular Title: Zastosowanie metody fotodynamicznej w diagnostyce zmian przednowotworowych i nowotworowych sromu.
• PMID: 14674104 (Publication Type: English Abstract, Journal Article)

Chemical References

• Photosensitizing Agents
• Aminolevulinic Acid

Topics

• Aminolevulinic Acid
• Carcinoma in Situ (diagnosis, pathology)
• Diagnostic Techniques, Obstetrical and Gynecological
• Female
• Humans
• Lasers
• Neoplasm Invasiveness
• Photosensitizing Agents
• Precancerous Conditions (diagnosis, pathology)
• Predictive Value of Tests
• Risk Factors
• Sensitivity and Specificity
• Spectrometry, Fluorescence (methods)
• Vulvar Neoplasms (diagnosis, pathology)