Enhanced expression of CPOX gene in glioblastoma with strong red fluorescence. (A) Comparison of the mRNA levels of PEPT1, PEPT2, ALAD, HMBS, UROS, UROD, ABCB6, CPOX, PPOX, ABCG2, FECH, HO-1, ALAS1, ALAS2, and HIF-1 genes between the “no fluorescence” and “strong fluorescence” groups. Gene names: PEPT1, oligopeptide transporter 1; PEPT2, oligopeptide transporter 2; ALAD, delta-aminolevulinate dehydratase; HMBS, hydroxymethylbilane synthase; UROS, uroporphyrinogen III synthase; UROD, uroporphyrinogen decarboxylase; ABCB6, ABC transporter B6; CPOX, coproporphyrinogen oxidase; PPOX, protoporphyrinogen oxidase; ABCG2, ABC transporter G2 (BCRP); FECH, ferrochelatase; HO-1, heme oxygenase 1; ALAS1, 5-aminolevulinate synthase 1; ALAS2, 5-aminolevulinate synthase 2; HIF-1, hypoxia inducible factor-1 alpha subunit. Total RNA was extracted from brain tumor areas, and the first strand cDNA was prepared from the extracted total RNA in a reverse transcriptase (RT) reaction. Quantitative PCR was performed as described previously [33]. The mRNA levels of these genes are normalized to the mRNA level of glyceraldehyde-3-phosphate dehydrogenase (GAPDH). Data are expressed as means ± SD (N = 10) [33]; (B) Statistical analysis of CPOX mRNA levels between the “no fluorescence” and the “strong fluorescence” groups. Data are expressed as means ± SD (N = 10) [33]. (C) HPLC elution profile of porphyrins in brain tumor samples with strong red fluorescence. HPLC analysis was performed as described previously [34]. As the standards, uroporphyrin 1 (UPI), Uroporphyrin III (UPIII), Coproprophyrin I (CPI), Coproprophyrin III (CPIII), and protoporphyrin IX (PpIX) were eluted at retention times of 7.3, 8.0, 20.0, 205, and 34.5 min, respectively.