Pathological characterization of the glioblastoma border as shown during surgery using 5-aminolevulinic acid-induced fluorescence
Pathological characterization of the glioblastoma border as shown during surgery using 5-aminolevulinic acid-induced fluorescence
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DOI：
10.1111/j.1440-1789.2011.01202.x
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发表时间：
2011-12-01
期刊：
影响因子：
2.3
通讯作者：
Tejada, Sonia
中科院分区：
文献类型：
--
作者：
Angel Idoate, Miguel;Diez Valle, Ricardo;Tejada, Sonia
连续30例胶质母细胞瘤手术患者，使用5-氨基乙酰丙酸诱导的荧光作为指导。组织的荧光质量被用来从肿瘤中心，周围的侵袭性区域和邻近的正常组织进行活检。用HE、Ki-67和nestin进行分析。将胶质母细胞瘤病例周围组织中的巢蛋白表达与血管病变、转移和海马硬化周围组织进行比较。通过容积MRI评估的大体全切除率为83%。以HE检查为金标准，荧光检测实体瘤阳性预测值为100%，浸润区阳性预测值为97%，正常组织阴性预测值为67%。Ki 67在肿瘤周围69%的非荧光样品中染色了一些细胞。nestin在肿瘤周围始终有强表达，但在非胶质瘤病变伴亚急性扩张中与对照组相似。5-氨基乙酰丙酸荧光引导是非常可靠的，可以帮助研究肿瘤-脑界面。巢蛋白在肿瘤周围组织中表达强烈且恒定，但主要是急性神经胶质反应，而不是肿瘤特异性的。巢蛋白染色不推荐作为肿瘤干细胞标记物。
Thirty consecutive surgical patients with glioblastoma, were operated upon using fluorescence induced by 5-aminolevulinic acid as guidance. The fluorescent quality of the tissue was used to take biopsies from the tumor center, from the invasive area around it and from adjacent normal-looking tissue. These samples were analyzed with HE, Ki-67 and nestin. Nestin expression in tissue surrounding glioblastoma cases was compared to tissue surrounding vascular lesions, metastasis and hippocampal sclerosis. The rate of gross total resection assessed by volumetric MRI was 83%. Using HE examination as the gold standard, fluorescence identified solid tumor with 100% positive predictive value, invasive areas with 97%, and normal tissue with 67% negative predictive value. Ki67 stained some cells in 69% of the non-fluorescent samples around the tumor. There was always strong nestin expression around the tumor but it was similar to control cases in non-glioma lesions with subacute expansion. 5-aminolevulinic acid fluorescence guidance is very reliable and can help to study the tumor-brain interface. Nestin expression is strong and constant in the tissue around the tumor, but is mostly an acute glial reaction, not specific of the neoplasm. Nestin staining is not recommended as a tumor stem cell marker.