摘要
目的本研究利用胶质瘤动物模型,在手术中采用荧光引导的方法以判定肿瘤的实际边界,旨在探讨5-氨基乙酰丙酸(5-AlA)荧光引导显微手术切除鼠脑胶质瘤的临床应用价值。方法建立C6/Wistar大鼠脑胶质瘤模型,静脉注射5-ALA后,在手术荧光显微镜下激发荧光,根据所提供的荧光影像判定肿瘤边界并切除肿瘤。切除后对肿瘤中心、边界和周边取材进行HE染色以检测手术切除情况。结果注射5-ALA的胶质瘤模型在荧光显微镜下激发出红色荧光,而正常脑组织不发光。荧光强度高的胶质瘤组织HE染色显示含有大量的肿瘤细胞,并可见血管内皮细胞增生。荧光强度较弱或者没有荧光的区域仅有少量的肿瘤细胞和血管内皮细胞增生。结论该方法能够有效的切除胶质瘤,并为手术者提供客观的肿瘤边界,提高了手术切除率,具有一定的临床应用价值,为临床选择性应用5-ALA荧光引导脑胶质瘤切除术提供有益的指导作用。
Objective The study was designed to evaluate the effectiveness of fluorescence- guided microsurgical resection after 5--ALA administration for the detection of C6 gliomas intraoperatively. Methods Rat C6 glioma model was established by implanting C6 glioblastoma cells into rat brain by means of stereotactic injection. The fluorescent regions of C6 glioma were resected through a fluorescein surgical microscope after administration o 5--ALA. To evaluate the effectiveness of the resection, operative findings were compared with histological findings from different areas of these C6 glioma. Resuits In the experimental study, the C6 glioma itself and the brain adjacent to the tumor （within 2--3 mm of the gross surface of the tumor） were well stained a brilliant red for a few hours. The normal brain was not stained. Our histological findings revealed a large number of tumor cells and a conspicuous vascular reaction such as proliferation of endothelial cells in the fluorescein-- positive area. On the other hand, the fluorescein--negative area showed necrosis, or only a small number of tumor cells; little vascular reaction was found there. Conclusions These results suggest that fluorescence--guided microsurgical technique by administrating 5--ALA may be practical and useful for complete removal of malignant glioma. By this method, surgeons can easily and rapidly gain objective standard to judge the surgical boundary of the tumor during operation.
出处
《齐齐哈尔医学院学报》
2008年第9期1027-1029,共3页
Journal of Qiqihar Medical University
关键词
5-氨基乙酰丙酸胶质瘤
荧光引导显微切除
手术边界
5 -- aminolevulinic acid Glioma Fluorescence-- guided microsurgical resection Surgical boundary
