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山东大学学报（医学版） ›› 2017, Vol. 55 ›› Issue (11): 32-37.doi: 10.6040/j.issn.1671-7554.0.2017.036

• 临床医学 • 上一篇    下一篇

荧光素钠“黄荧光”导航辅助高级别胶质瘤手术治疗的临床意义

王超超,田海龙,姜慧峰,郭文强,王志刚   

  1. 山东大学齐鲁医院(青岛)神经外科, 山东 青岛 266000
  • 收稿日期:2017-01-11 出版日期:2017-11-10 发布日期:2017-11-10
  • 通讯作者: 王志刚. E-mail:wzg1110@126.com E-mail:wzg1110@126.com

Clinical significance of sodium fluorescein-guided resection of high-grade glioma under “yellow fluorescence” mode

WANG Chaochao, TIAN Hailong, JIANG Huifeng, GUO Wenqiang, WANG Zhigang   

  1. Department of Neurosurgery, Qilu Hospital of Shandong University(Qingdao), Qingdao 266000, Shandong, China
  • Received:2017-01-11 Online:2017-11-10 Published:2017-11-10

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摘要： 目的 探讨荧光素钠在“黄荧光”模式下辅助高级别胶质瘤手术治疗的临床意义。 方法 回顾性分析2014年1月至2015年12月山东大学齐鲁医院(青岛)神经外科收治并经病理确诊为高级别胶质瘤患者21例,全麻后经静脉注射荧光素钠,在“黄荧光”模式下进行肿瘤切除,术中比较肿瘤不同部位的荧光显影程度,选取多点病理送检,术后计算肿瘤全切率并分析各自病理,对患者进行长期术后随访。 结果 “黄荧光”下肿瘤与周围脑组织分辨良好,17例全切,4例次全切。肿瘤实质的荧光程度强于肿瘤边界及瘤周水肿(P<0.05)。同一患者不同部位肿瘤的病理结果不同,显微镜自然白光下判定为水肿的脑组织可检出肿瘤成分。 结论 荧光素钠“黄荧光”导航有助于识别肿瘤与脑组织的边界,利于肿瘤全切。高级别胶质瘤不同部位的荧光程度及病理结果可有不同。

关键词: 黄荧光, 高级别胶质瘤, 全切, 荧光素钠, 多点病理

Abstract: Objective To explore the clinical significance of sodium fluorescein-guided resection of high-grade glioma(HGG)under “yellow fluorescence” mode. Methods The clinical data of 21 HGG confirmed by pathological examination and treated during Jan. 2014 and Dec. 2015 were retrospectively analyzed. All patients underwent intravenous injection of sodium fluorescein after general anesthesia. Tumors were removed under “yellow fluorescence” mode. Fluorescence degree of different regions of tumor was compared and multiple site biopsy was implemented during the operation. Total resection rate was calculated and pathological results were analyzed after operation. All patients were followed up for a long term. Results “Yellow fluorescence” mode allowed a good discrimination between tumor and peripheral brain tissues. Total resection was achieved in 17 patients and subtotal resection in 4 patients. The core of tumor had a stronger fluorescence imaging compared to the boundary and the peritumoral edema(P<0.05). The pathological results differed in different regions of tumor in the same patient. Tumor cells could be detected in the peritumoral edema under traditional white light illumination. Conclusion Sodium fluorescein-guided surgery under “yellow fluorescence” mode helps to distinguish tumor and peripheral brain tissue as well as to facilitate total resection of gliomas. The fluorescence degree and pathological results differ in different regions of HGG.

Key words: Yellow fluorescence, Multiple site biopsy, Total resection, Sodium fluorescein, High-grade glioma

中图分类号: 

  • R651.1
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