Gross total resection of glioma with the intraoperative fluorescence-guidance of fluorescein sodium.
Gross total resection of glioma with the intraoperative fluorescence-guidance of fluorescein sodium.
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DOI：
10.7150/ijms.4843
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发表时间：
2012
影响因子：
3.6
通讯作者：
Chen D
中科院分区：
文献类型：
--
作者：
Chen B;Wang H;Ge P;Zhao J;Li W;Gu H;Wang G;Luo Y;Chen D
Objective.高剂量荧光素钠已被用于荧光引导的肿瘤切除术，关于该手术的有效性的报道相互矛盾。本研究的目的是重新评估使用荧光素钠治疗和切除胶质瘤脑肿瘤的实用性和临床局限性。方法.将诊断为胶质瘤的患者分为两组，共22例患者入组研究：1）研究组（n=10），接受荧光素钠静脉注射的患者; 2）对照组（n=12），手术切除期间未接受注射的患者。根据Karnofsky行为量表（KPS）评分和神经功能状态评估生活质量。按15- 20 mg/kg体重静脉注射黄绿素钠。术前和术后通过增强磁共振成像（MRI）评估胶质瘤切除情况。结果观察到两组患者的大体全切除率（GTR）存在显著差异（Fisher精确检验p=0.047）。与对照组和非GTR组相比，研究组（Student T检验p=0.033）和GTR组（Student T检验p=0.0001）的无进展生存期显著延长。研究组3例患者和对照组4例患者出现一过性神经功能恶化。对照组1例患者出现永久性偏瘫。结论术中使用荧光素钠可显著提高GTR率，且无明显恶化。此外，我们发现，对于术前MRI已增强的血脑屏障（BBB）破坏的病例，应用荧光素钠更好。
Objective. High dose fluorescein sodium has been utilized for fluorescence-guided tumor resection with conflicting reports on the efficacy of this procedure. The aim of this study was to reevaluate the utility and clinical limitations of using fluorescein sodium for the treatment and resection of glioma brain tumors. Methods. Patients diagnosed with glioma were divided into two groups with a total of 22 patients enrolled in the study: 1) the study group (n=10), patients that received intravenous injection of fluorescein sodium and 2) the control group (n=12), patients that did not receive injections during surgical resection. Quality of life was evaluated according to Karnofsky Performance Scale (KPS) score and neurological status. Fluorescein sodium was intravenously injected at a dose of 15-20mg/kg of body weight. Glioma resection was evaluated preoperative and postoperatively with enhanced Magnetic Resonance Imaging (MRI). Results. Significant differences in the gross total resection (GTR) rates were observed between the two patient groups (Fisher's Exact Test p=0.047). Progressive free survival was significantly longer in the study group (Student's T-Test p=0.033) as well as in the GTR group (Student's T-Test p=0.0001) compared to the control and non-GTR groups, respectively. Three patients in the study group and four patients in the control group had transient neurological deterioration. One patient in the control group had permanent hemiplegia. Conclusion. The intraoperative utility of using fluorescein sodium can significantly increase the GTR rate without obvious deterioration. In addition, we find that it is better to apply the fluorescein sodium in the cases with BBB (blood-brain barrier) disruption, which had been enhanced in preoperative MRI.
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影响因子：
3.9
作者：
Shinoda, J;Sakai, N;Funakoshi, T
通讯作者：
Funakoshi, T
影响因子：
--
作者：
Kuroiwa, T;Kajimoto, Y;Ohta, T
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Ohta, T
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4.1
作者：
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WALKER, WW
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1.1
作者：
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Ceylan, S.
影响因子：
4.1
作者：
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通讯作者：
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