荧光显像剂在胶质瘤荧光显像技术中的应用概况  

Application of fluorescent imaging agent in fluorescence imaging of glioma

作　　者：陈哲[1] 卢晓闻 许烈鹏[1] 李钦喜 涂艳阳[2] 袁军[1] 

机构地区：[1]汕头大学医学院第一附属医院神经外科,广东汕头515041 [2]第四军医大学唐都医院试验外科,陕西西安710038

出　　处：《转化医学电子杂志》2017年第7期86-92,共7页E-Journal of Translational Medicine

基　　金：广东省科技计划项目(2016ZC0167)

摘　　要：胶质瘤是中枢神经系统最常见的恶性肿瘤.大部分胶质瘤呈浸润性生长,治疗预后差.目前除了手术、放化疗等传统治疗手段,越来越多针对胶质瘤的诊疗技术,如伽马刀、超声刀、术中磁共振、光动力治疗,包括目前最前沿的各种基因、免疫治疗等已被应用到胶质瘤诊疗的临床实践中.相关研究证实,更广泛、精确的手术切除可以延长低级别胶质瘤和高级别胶质瘤患者的预期寿命.但由于肿瘤特殊生长的部位及肿瘤生长特性,临床上往往很难单纯依靠手术就可以将肿瘤细胞完全切除干净.因此越来越多的证据表明,更广泛,精确的手术切除可以延长胶质瘤患者的预期寿命.然而,目前神经外科导航技术在弥漫性胶质瘤的边缘缺乏相对灵敏性与特异性,想要通过现有的影像学辅助技术下完全切除肿瘤较为困难.目前已有越来越多的证据支持对手术范围最大化切除所带来的益处.许多神经胶质瘤的研究也都致力于改善长期预后的新手术方法.荧光引导手术(FGS)是一项在胶质瘤术中用来增强肿瘤边缘可视化以提高脑胶质瘤手术切除范围的技术.各种荧光剂,包括5-氨基乙酰丙酸(5-ALA)、荧光素钠、ICG、纳米荧光技术等已在临床以及临床前研究中被广泛应用.本文主要对各种荧光剂在胶质瘤荧光显像技术中的应用概况进行介绍.Glioma is the most common malignant tumor of the central nervous system. Most of gliomas are invasive, and with poor prognosis. In addition to surgery, radiotherapy, chemotherapy and other traditional treatments, more and more diagnosis and treatment techniques, such as gamma knife, ultrasound knife, intraoperative magnetic resonance, photodynamic therapy, and the most cutting-edge gene therapy and immunotherapy, and so on, have been applied to the clinical practice of glioma diagnosis and treatment. Relevant studies have confirmed that a more extensive and accurate surgical resection can extend the life expectancy of patients both with low grade and high grade gliomas. However, due to the special gro^h sites and growth characteristics of gliomas, it is difficult to entirely remove the tumor merely relying on surgery. There is increasing evidence that a wider and more accurate surgical resection can extend the life expectancy of patients with gliomas. However, the neurosurgical guidance techniques relatively lack sensitivity and specificity at the margins of diffuse gliomas, and it is difficult to completely remove tumors by existing imaging-assisted techniques. There is growing evidence to support the benefits of maximizing resection. Many studies of gliomas are also committed to improving the long-term prognosis with new surgical methods. Fluorescence-guided surgery （FGS） is a technique used in glioma surgery, which can enhance the visualization of tumor margins and improve the surgical resection of gliomas. Various fluorescent agents, including 5-aminolevulinic acid （5-ALA）, fluorescein sodium, ICG and nanofluorescence techniques, have been widely used in clinical and preclinical studies. This paper gives an introduction of the application of various fluorescent agents in glioma fluorescence imaging technology.

关 键 词：胶质瘤 荧光素 荧光引导手术 5-氨基乙酰丙酸 

分 类 号：R739.41[医药卫生—肿瘤]