摘要
胶质瘤是最常见的原发性中枢神经系统肿瘤,广义是指所有神经上皮来源的肿瘤,但人们习惯上狭义地指各类星形细胞、少突胶质细胞和室管膜来源的肿瘤,约占所有原发性神经系统肿瘤的50%,其中胶质母细胞瘤（GBM）和星形细胞瘤约占75%,其复发率和病死率极高。过去,胶质瘤的治疗主要依靠手术,预后极差。胶质瘤手术大约在19世纪后叶开始,而超声吸引器、手术显微镜和影像引导手术等设备是在1970年后才出现。脑肿瘤的外照射放疗始于1940年;而细胞毒化疗则于1952年才尝试,可选方案很少,同时因血脑屏障和多数肿瘤对化疗药物的耐药性,疗效很不理想。
Objective To study the safety and responsibility of the fluorescence mode microsurgical resection of glioma. Methods We used Zeiss Pentero 900 surgical microscope with fluorescence mode and normal mode in the resection of glioma. Resection of the glioma was based on identifying the fluorescein stained tissue,which intraoperatively reflected the range and boundary of the tumor. Fluorescein stained tissue was obtained for pathology. Postoperative MRI was performed within seventy- two hours,to evaluate the level of the glioma resection. Results Eleven patients with glioma were included. There were 4 patients with GBM（ WHO Ⅳ）,1 with anaplastic ependymoma（ WHO Ⅲ）,1 with anaplastic oligodendroglioma（ WHO Ⅲ）,2 with astrocytoma（ WHO Ⅱ）,1 had oligoastrocytomas（ WHO Ⅱ）,and 2 with pilocytic astrocytoma（ WHO Ⅰ）. Among them,there were 3 cases with recurrence glioma. All patients were followed- up for 18 month postoperatively. Recurrence occurred in 2 cases. The sensitivity of the fluorescein stained tissue in high grade glioma was 100%,with the specificity of 83. 3%. Conclusion The fluorescence- guided microsurgical technique can help surgeons easily and rapidly gain objective standard to judge the surgical boundary during operation. Strong fluorescence tissue in high grade glioma provides high specificity and sensitivity. However,the fluorescence- guided technique is not sensitive in low grade glioma.
出处
《广东医学》
CAS
北大核心
2017年第1期1-2,共2页
Guangdong Medical Journal
