Fluorescence guided tumor resection and expressive significance of molecular pathology in glioblastoma

Tian Hailong; He Wei; Jiang Huifeng; Yin Xin; Wang Chaochao; Wang Yihua; Guo Zhentao; Jiang bin; He Zheng; Wang Zhigang

doi:10.11850/j.issn.1009-122X.2016.06.004

Abstract：Objective To analyze the expression difference of molecular pathology in different fluorescence intensity regions in glioblastoma, and explore the clinical significance of fluorescence-guided technology in glioblastoma surgery. Methods Twenty-one cases of glioblastoma confirmed by pathology during the fluorescence-guided microsurgery were chose retrospectively. The fluorescence intensity and expression of molecular markers were compared between the different tumor regions. Results Total tumor resection was achieved in 19 patients and subtotal resection in 2. Glioblastoma fluorescence intensity in surgery was showed as follows: strong fluorescence imaging was seen in 18 patients and weak or no fluorescence imaging in 3 in the tumor parenchyma, strong fluorescence imaging in 14 and weak or no fluorescence imaging in 7 in the boundary of the tumor, strong fluorescence imaging in 2 and weak or no fluorescence imaging in 19 in the zone of peritumoral edema (P<0.05). Immunohistochemistry results indicated that no significant differences were found in the expression levels of P53, GFAP and CD28 between the different tumor regions (P>0.05), while significant differences were found in Ki-67 expression level betwen the different tumor regions and glioblastomas with different fluorescence intensity (P<0.05). Conclusions Labeling of glioblastoma with sodium fluorescein is helpful to identify the boundary of the tumor. The expression of molecular pathology would show difference between different tumor regions and fluorescence intensity of glioblastoma, which provide a pathological basis for more accurate analysis of tumor infiltration and for increasing safe resection range in fluorescence-guided surgery.