自发荧光光谱识别高级别胶质瘤边界的应用研究

目的通过内源性荧光团的荧光光谱对高级别胶质瘤肿瘤组织、瘤旁组织与正常脑白质进行鉴别。方法收集2021年8月—2022年1月在解放军总医院第一医学中心神经外科采用术中导航引导下手术切除的高级别胶质瘤患者的新鲜样本，通过405 nm激发光对各样本FAD、脂质、卟啉等内源性荧光团进行光谱测定，使用方差分析、多重比较对3类样本进行统计学分析及ROC曲线分析判断其敏感度与灵敏性。结果肿瘤组织、瘤旁组织与正常脑白质能够两两区分（P＜0.05），其中区分肿瘤与瘤旁灵敏度、特异性分别为87.5%~100%、75.0%~96.2%；肿瘤与白质的灵敏度、特异性分别为85.7%~100%、79.1%~100%；瘤旁与白质的灵敏度、特异性分别为85.7%、81.2%。结论自发荧光检测可区分高级别胶质瘤肿瘤组织、瘤旁组织与正常脑白质，是一种具有非侵入性、无需标记的方法，在术中实时识别高级别胶质瘤边界方面具有广泛的应用前景。

Objective To distinguish high-grade glioma tissue，peritumoral tissue and white matter by autofluorescence spectrum. Methods From August 2021 to January 2022, the fresh samples of high-grade glioma tissues by surgical resection under intraoperative navigation in the Department of Neurosurgery， The PLA General Hospital were collected. Autofluorescence spectrum of endogenous fluorophores such as FAD, lipid, porphyrin were determined by 405 nm excitation light. Anova and multiple comparison were used to conduct statistical analysis and ROC curve analysis was used to judge their sensitivity and specificity for the three types of samples. Results High-grade glioma tumor tissue, peritumoral tissue and white matter could be distinguished in pairs(P<0.05). The sensitivity and specificity of tumor and peritumoral tissue were 87.5%-100% and 75.0%-96.2% respectively. The sensitivity and specificity of tumor and white matter were 85.7%-100% and 79.1%-100% respectively. The sensitivity and specificity of peritumoral tissue and white matter were 85.7% and 81.2%. Conclusion Autofluorescence measurement can distinguish the above three types of tissues, which is a non-invasive and labeling free method, and has a wide application prospect in real-time intraoperative monitoring.