Objectives: Ea rly cance r d e tection is the best way to improve the prognosis of patie nts with oral cancer. Ther efore this study presents qua ntita tive fluorescence m ea sure ments and r esults in the visualization of cancerous oral mucosa with 5-aminolevulinic acid (5-ALA)-induced protoporphyrin IX (PPOO. Methods: Time progression and type of porphyrin accumulation were analyzed in n eoplastic and surrounding h ealthy ti ssu e of 58 p a tients with a suspected cancer of the oral ca vity by measuring emission spectra of 5-ALA-induced PPIX fluore ce nce. Fluorescen ce im· a ges in the r ed and green spectral range from the tumor tissu e wer e r ecorded with a charge-coupled d evice camera. R esults: After topical application of 0.4% 5-ALA and incubation for 1 to 2.5 hours, all patients r evealed high er inten sities of r ed fluoresce nce in n eoplastic tissu e compared with the surrounding normal tissu e. Maximum contrast w as r eached after 1.5 hours of incuba tion. In 13.8% (n = 8) of the patie nts, additional findings like dysplasia, carcinoma in situ, primary tumor, secondary carcinomas, and tumor branch es w er e found by means of fluorescence marking in contrast to white light examination. An evaluation of the biopsy specimen s r esulted in a sp ecificity of 60% and a sens itivity of 99o/o. Conclusions: As a fluorescent m ark er, PPIX could r epresent a possible n ew dia gnostic tool to det ect early malignant and s condary lesions in the oral cavity. In addition, 5-ALA-induced PPIX fluorescen ce is promising a s a u sefuJ intraoperative tool for d etermining ad equate Pres nted in port at the Fourth International Symposium on Predictive Oncology and Therapy, Nie , Fronce, 0 tobcr 24 -27, 1998.From the D partmcnt ofOtorhinolaryngology-Head and Neck Surg ry (A.L., c.B ., o.o.l, the Laser R s~a rch. Labo reto~ (H.s. , ~~.M., R.B.), and th e In stitute of Pathology (S.A.)

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