Quantitative spectroscopic analysis of 5-aminolevulinic acid-induced protoporphyrin IX fluorescence intensity in diffusely infiltrating astrocytomas
Quantitative spectroscopic analysis of 5-aminolevulinic acid-induced protoporphyrin IX fluorescence intensity in diffusely infiltrating astrocytomas
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DOI：
10.2176/nmc.47.53
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发表时间：
2007-02-01
影响因子：
1.9
通讯作者：
Sakatani, Kaoru
中科院分区：
文献类型：
--
作者：
Ishihara, Ryutaro;Katayama, Yoichi;Sakatani, Kaoru
5-氨基乙酰丙酸（5-ALA）内源性诱导原卟啉IX （PpIX）的荧光最近被用于胶质瘤组织的术中可视化。为了提高光检测的灵敏度，我们在6例整体切除的弥漫性浸润星形细胞瘤（2例弥漫性星形细胞瘤、2例间变性星形细胞瘤和2例胶质母细胞瘤）的组织中定量测量5- ala诱导的PpIX荧光发射光谱，并评估荧光强度与组织学特征之间的相关性。共对65片进行了体外光谱分析。36个非肿瘤组织的峰值发射强度与反射激发强度或荧光强度之比均小于0.001。胶质母细胞瘤形态组织的荧光强度比大于0.090。光谱荧光强度与作为增殖活性指标的MIB-1标记指数、作为泛内皮标志物的cd31微血管密度、作为血管生成因子的血管内皮生长因子表达呈正相关。mb -1增殖指数是最强大的决定因素，表明较高的细胞增殖可能控制了胶质瘤细胞中PpIX的优先积累。这项初步研究表明，光谱分析可能有助于优化弥漫性胶质瘤的切除。
The fluorescence of protoporphyrin IX (PpIX) induced endogenously by 5-aminolevulinic acid (5-ALA) administration has recently been used for the intraoperative visualization of glioma tissues. To increase the sensitivity of photodetection, the emission spectra of 5-ALA-induced PpIX fluorescence was quantitatively measured in tissues taken from six cases of en bloc resected diffusely infiltrating astrocytomas (2 diffuse astrocytomas, 2 anaplastic astrocytomas, and 2 glioblastomas), and the correlation assessed between the fluorescence intensity and histological features. A total of 65 slices were analyzed by ex vivo spectroscopy. The ratio of the peak emission intensity to reflected excitation intensity or fluorescence intensity ratio was less than 0.001 for all 36 non-tumor tissues. The tissues with glioblastoma morphology had a fluorescence intensity ratio in excess of 0.090. The spectroscopic fluorescence intensity was positively correlated with the MIB-1 labeling index as an indicator of proliferation activity, the CD31-microvessel density as a pan-endothelial marker, and the vascular endothelial growth factor expression as an angiogenetic factor. The MIB-1 proliferation index was the most powerful determinant, suggesting that higher cell proliferation may govern preferential PpIX accumulation in glioma cells. This preliminary study suggests that spectroscopic analysis may be useful for optimizing the removal of diffuse gliomas.