神经导航联合荧光素钠引导显微手术治疗成人高级别胶质瘤患者预后的影响因素

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Abstract Objective To investigate the prognostic factors of neuronavigation combined with fluorescein sodium guided microsurgery in the treatment of adult patients with high-grade gliomas. Methods The clinical data of 35 adult patients with high-grade gliomas treated in the Department of Neurosurgery of the Inner Mongolia People’s Hospital from March 2016 to October 2020 were analyzed retrospectively. All patients underwent glioma resection with Brain lab neuronavigation system combined with fluorescein sodium (1.5-2.0 mg/kg) guided intraoperative adjuvant technology. Prognostic analysis of clinical factors affecting postoperative survival time was carried out. Results There were 14 cases of world health organization grade Ⅲ and 21 cases of world health organization grade Ⅳ. Total tumor resection was performed in 24 cases, and partial tumor resection in 11 cases. The follow-up time was 6-60 months, with 22 cases recurred and 20 cases died. The 1-year, 2-year, and 3-year survival rates were 76.4%, 44.4%, and 23.8%, respectively. There were statistically significant differences in survival rate among patients with different gender, tumor site, resection degree, pathological grade, Ki-67 index range, treatment mode, with or without epilepsy, and with or without complications (P ＜ 0.05). Postoperative complications and Ki-67 positive indicators were independent risk factors affecting prognosis of patients (RR = 7.406, P = 0.026; RR = 3.524, P = 0.028). Conclusion Postoperative with or without complications, Ki-67 positive expression level, and the tumor site can be used as important factors to assess the prognosis.

Key words： Glioma High-grade Neuronavigation Fluorescein sodium Microsurgery Prognosis

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	ZHANG Yisong ZHANG Xiaojun SUN Peng WANG Zhong ZHANG Ruijian

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ZHANG Yisong ZHANG Xiaojun SUN Peng WANG Zhong ZHANG Ruijian. Prognostic factors of neuronavigation combined with fluorescein sodium guided microsurgery in adult patients with high-grade gliomas[J]. 中国医药导报, 2022, 19(17): 123-126,146.

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https://www.yiyaodaobao.com.cn/EN/ OR https://www.yiyaodaobao.com.cn/EN/Y2022/V19/I17/123

[1] 国家卫生健康委员会医政医管局.脑胶质瘤诊疗规范（2018年版）[J].中华神经外科杂志，2019，35（3）：217-239.
[2] 《中国中枢神经系统胶质瘤诊断和治疗指南》编写组.中国中枢神经系统胶质瘤诊断与治疗指南（2015）[J].中华医学杂志，2016，96（7）：485-509.
[3] Fuller GN，Scheithauer BW. The 2007 Revised World Health Organization（WHO）Classification of Tumours of the Central Nervous System：newly codified entities [J]. Brain Pathol，2007，17（3）：304-307.
[4] Ostrom QT，Patil N，Cioffi G，et al. CBTRUS statistical report：Primary brain and other central nervous system tumors diagnosed in the united states in 2013-2017 [J]. Neuro Oncol，2020，22（Suppl 2）：1-96.
[5] Hervey-Jumper SL，Berger MS. Maximizing safe resection of low- and high-grade glioma [J]. J Neurooncol，2016， 130（2）：269-282.
[6] Hervey-Jumper SL，Berger MS. Role of surgical resection in low- and high-grade gliomas [J]. Curr Treat Options Neurol，2014，16（4）：284.
[7] Fountas KN. Fluorescent guided surgery in the surgical management of glioma：the dawn of a new era [J]. Brain Sci，2020，10（4）：237.
[8] 张义松，张晓军，韩志桐，等.小剂量荧光素钠引导下恶性胶质瘤切除的临床应用[J].现代肿瘤医学，2017，25（12）： 1888-1890.
[9] Mahmoudi K，Garvey KL，Bouras A，et al. 5-aminolevulinic acid photodynamic therapy for the treatment of high-grade gliomas [J]. J Neurooncol，2019，141（3）：595-607.
[10] 张义松.荧光引导下恶性胶质瘤切除的临床研究进展[J].中国微侵袭神经外科杂志，2017，22（6）：284-286.
[11] Raffa G，Scibilia A，Conti A，et al. Multimodal surgical treatment of high-grade gliomas in the motor area：The impact of the combination of navigated transcranial magnetic stimulation and fluorescein-guided resection [J]. World Neurosurg，2019，128：e378-390.
[12] Panciani PP，Fontanella M，Schatlo B，et al. Fluorescence and image guided resection in high grade glioma [J]. Clin Neurol Neurosurg，2012，114（1）：37-41.
[13] 杨泽浩.荧光引导手术治疗颅内胶质瘤的研究进展[J].中国微侵袭神经外科杂志，2021，26（2）：90-93.
[14] 余钻标，诸葛启钏.手术切除神经胶质瘤的辅助技术应用进展[J].中华神经外科杂志，2016，32（5）：528-530.
[15] 杨蔚然，王忠，张义松.荧光素钠在高级别脑胶质瘤显微切除术中的临床研究进展[J].中国医药导报，2021， 18（9）：48-51，55.
[16] Zhang YS，Pan CC，Zhang P，et al. Prognostic indicators of adult medullary gliomas after microsurgical treatment - A retrospective analysis of 54 patients [J]. J Clin Neurosci，2017，44（10）：122-127.
[17] 石易鑫，马文斌，王裕.基于美国SEER数据库的儿童胶质瘤临床特点和预后分析[J].中国现代神经疾病杂志，2021，21（3）：147-155.
[18] 葛明，杨伟，李少武.儿童脑干胶质瘤的临床特点及预后分析[J].中华神经外科杂志，2021，37（7）：679-683.
[19] 徐恒周，金贵善，米蕊芳.FASN在脑胶质瘤组织中的表达及其临床意义[J].中华神经医学杂志，2017，16（3）：217-221.
[20] Chen WJ，He DS，Tang RX，et al. Ki-67 is a valuable prognostic factor in gliomas：evidence from a systematic review and meta-analysis [J]. Asian Pac J Cancer Prev，2015，16（2）：411-420.
[21] 张慧，范月超，陈洪福.胶质瘤组织中GRK5和Ki-67的表达情况及临床意义[J].现代肿瘤医学，2021，29（2）：215-219.
[22] 赵伟，张旭，岳芳倩.microRNA-128在胶质瘤中的表达及其临床意义[J].临床神经外科杂志，2021，18（1）：53-57.
[23] 中国脑胶质瘤协作组，中国医师协会脑胶质瘤专业委员会.唤醒状态下切除脑功能区胶质瘤手术技术指南（2018版）[J].中国微侵袭神经外科杂志，2018，23（8）：383-384.
[24] Zur I，Tzuk-Shina T，Guriel M，et al. Survival impact of the time gap between surgery and chemo-radiotherapy in glioblastoma patients [J]. Sci Rep，2020，10（1）：9595.
[25] 胡峻龙.替莫唑胺治疗脑胶质瘤的新进展[J].中国临床神经外科杂志，2021，26（8）：647-649.