{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T14:00:36Z","timestamp":1774274436725,"version":"3.50.1"},"reference-count":47,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,5,2]],"date-time":"2022-05-02T00:00:00Z","timestamp":1651449600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:p>Gastric cancer is the second most common cancer in Japan. The incidence of gastric cancer remains high owing to the increase in the elderly population. Endoscopy outperforms radiography in identifying early gastric cancer (EGC). Furthermore, image-enhanced endoscopy (IEE) has been developed and implemented worldwide in clinical practice. Magnifying IEE images can help to visualize the microvascular pattern and microstructure architecture, which is used for the characterization of EGC. However, accurate endoscopic diagnosis requires the experience and skill of endoscopists, making an objective and simple diagnostic method desirable. In this retrospective study, we investigated the diagnostic yield of 5-aminolevulinic acid (5-ALA)-mediated photodynamic diagnosis (PDD) for identifying gastric cancers and high-grade adenomas. In total, 52 lesions from 43 patients were ultimately included in the study. We detected 5-ALA-mediated protoporphyrin IX fluorescence in 45 of the 52 lesions that were initially intended for PDD, resulting in a detection rate of 86.5%, whereas each signet ring cell carcinoma was negative using 5-ALA PDD. In eight of the patients with multiple lesions, 17 lesions were identified using 5-ALA PDD. Again, we took biopsies from six areas that we suspected as new lesions. While 4 lesions were gastric neoplasms resected by endoscopic submucosal dissection, two other lesions were normal. Preoperative 5-ALA-PDD could provide additional diagnostic yields to detect such multiple lesions simultaneously. No severe adverse events were observed. Prospective multicenter studies are warranted to confirm the usefulness of 5-ALA PDD for EGC identification.<\/jats:p>","DOI":"10.3389\/fonc.2022.861868","type":"journal-article","created":{"date-parts":[[2022,5,2]],"date-time":"2022-05-02T05:37:01Z","timestamp":1651469821000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["Photodynamic Diagnosis for the Identification of Intestinal-Type Gastric Cancers and High-Grade Adenomas"],"prefix":"10.3389","volume":"12","author":[{"given":"Hiroki","family":"Kurumi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takuki","family":"Sakaguchi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keiichi","family":"Hashiguchi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Taro","family":"Yamashita","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masashi","family":"Fujii","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuichiro","family":"Ikebuchi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akira","family":"Yoshida","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hajime","family":"Isomoto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2022,5,2]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21660","article-title":"Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries","volume":"71","author":"Sung","year":"2021","journal-title":"CA Cancer J Clin"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.2910600502","article-title":"Working Group Report on Schistosomes, Liver Flukes and Helicobacter pylori","volume":"60","author":"M\u00f8ller","year":"1995","journal-title":"Int J Cancer"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa001999","article-title":"Helicobacter Pylori Infection and the Development of Gastric Cancer","volume":"345","author":"Uemura","year":"2001","journal-title":"N Engl J Med"},{"key":"B4","unstructured":"Center for Cancer Control and Information Services2021"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1111\/den.13684","article-title":"Guidelines for Endoscopic Diagnosis of Early Gastric Cancer","volume":"32","author":"Yao","year":"2020","journal-title":"Dig Endosc"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.3390\/jcm10132918","article-title":"Fundamentals, Diagnostic Capabilities and Perspective of Narrow Band Imaging for Early Gastric Cancer","volume":"10","author":"Kurumi","year":"2021","journal-title":"J Clin Med"},{"key":"B7","doi-asserted-by":"publisher","first-page":"193","DOI":"10.1016\/j.pdpdt.2015.03.008","article-title":"Oral 5-Aminolevulinic Acid Mediated Photodynamic Diagnosis Using Fluorescence Cystoscopy for non-Muscle-Invasive Bladder Cancer: A Randomized, Double-Blind, Multicentre Phase II\/III Study","volume":"12","author":"Inoue","year":"2015","journal-title":"Photodiagn Photodyn Ther"},{"key":"B8","doi-asserted-by":"publisher","first-page":"179","DOI":"10.1186\/s12957-017-1239-8","article-title":"Intraoperative 5-Aminolevulinic Acid-Induced Photodynamic Diagnosis of Metastatic Brain Tumors With Histopathological Analysis","volume":"15","author":"Yagi","year":"2017","journal-title":"World J Surg Oncol"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics11111967","article-title":"Current Status of Photodynamic Diagnosis for Gastric Tumors","volume":"11","author":"Kurumi","year":"2021","journal-title":"Diagnostics (Basel)"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1055\/s-0034-1365524","article-title":"How Commonly is Upper Gastrointestinal Cancer Missed at Endoscopy? 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