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中华神经创伤外科电子杂志 ›› 2022, Vol. 08 ›› Issue (02) : 111 -116. doi: 10.3877/cma.j.issn.2095-9141.2022.02.010

综述

术中荧光在神经肿瘤手术中的临床应用
陈立华1, 夏勇1, 徐如祥1,()   
  1. 1. 610072 成都,四川省医学科学院·四川省人民医院神经外科
  • 收稿日期:2021-05-10 出版日期:2022-04-15
  • 通信作者: 徐如祥

Clinical application of intraoperative fluorescence in nerve tumor surgery

Lihua Chen1, Yong Xia1, Ruxiang Xu1,()   

  1. 1. Department of Neurosurgery, Sichuan Academy of Medical Sciences and Sichuan Provincial People’s Hospital, Chengdu 610072, China
  • Received:2021-05-10 Published:2022-04-15
  • Corresponding author: Ruxiang Xu
引用本文:

陈立华, 夏勇, 徐如祥. 术中荧光在神经肿瘤手术中的临床应用[J]. 中华神经创伤外科电子杂志, 2022, 08(02): 111-116.

Lihua Chen, Yong Xia, Ruxiang Xu. Clinical application of intraoperative fluorescence in nerve tumor surgery[J]. Chinese Journal of Neurotraumatic Surgery(Electronic Edition), 2022, 08(02): 111-116.

荧光引导神经肿瘤切除是近年来的发展方向。肿瘤荧光剂的应用,改变了肿瘤神经外科的手术模式和理念。肿瘤荧光定位技术可以定位肿瘤、标记肿瘤边界,引导安全、最大限度地切除肿瘤,从而提高肿瘤全切率和神经血管保护率,延长无进展生存期。5-氨基乙酰丙酸(5-ALA)、荧光素钠(FLS)、吲哚菁绿(ICG)是神经肿瘤切除术中常用的荧光剂。5-ALA诱导荧光原卟啉IX的生存,引导肿瘤切除。尽管FLS不是肿瘤细胞特异性的荧光剂,但由于其安全性、有效性和使用方便的特点,已成为一种新的神经肿瘤替代荧光引导切除技术。ICG对血管性肿瘤,如血管母细胞瘤有很好的应用前景。本文主要针对荧光引导技术在神经肿瘤术中的应用作一综述,围绕荧光定位技术和临床应用等方面进行讨论,以期为临床提供参考。

Fluorescence guided resection of nerve tumors is the development direction in recent years. The application of tumor fluorescent agent has changed the operation mode and concept of tumor neurosurgery. Tumor fluorescence localization technology can locate the tumor, mark the tumor boundary, guide the safe and maximum resection of the tumor, so as to improve the total resection rate and neurovascular protection rate, and prolong the progression free survival time. 5-aminolevulinic acid (5-ALA), fluorescein sodium (FLS) and indocyanine green (ICG) are commonly used fluorescent agents in the resection of nerve tumors. 5-ALA induces the survival of fluorescent protoporphyrin IX and guides tumor resection. Although FLS is not a tumor cell specific fluorescent agent, it has become a new alternative to fluorescence guided resection of nerve tumors because of its safety, effectiveness and convenience. ICG has a good application prospect for vascular tumors, such as hemangioblastoma. This article mainly reviews the application of fluorescence guided technology in neurooncology, and discusses the fluorescence localization technology and clinical application, in order to provide reference for clinic.

表1 5-ALA与FLS治疗恶性胶质瘤的疗效比较
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