Study of quantification by fluorescence guided surgery with malignant glioma

2020 Fiscal Year Final Research Report

• Project/Area Number: 17K10883
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Neurosurgery
• Research Institution: Asahikawa Medical College
• Principal Investigator: ANEI RYOGO 旭川医科大学, 医学部, 講師 (80301985)
• Co-Investigator(Kenkyū-buntansha): 田村 有希恵 旭川医科大学, 大学病院, 医員 (30723879) ; 鎌田 恭輔 旭川医科大学, 医学部, 教授 (80372374)
• Project Period (FY): 2017-04-01 – 2021-03-31
• Keywords: glioblastoma / fluorescence / quantification

Outline of Final Research Achievements

No correlation was found between FECH activity and PpIX content. This questioned the conventional hypothesis and suggested that FECH activation is unlikely to be an indicator of the grade of malignant glioma. Between the PpIX content and 5-ALA fluorescence intensity, y = 1.2332x + 18.626 x + 18.626, R2 = 0.5134 in 34 cases of whole brain tumor specimens, and y = 0.9664 in 20 cases of glioblastoma among malignant gliomas. A positive correlation was observed with x + 29.006 and R2 = 0.467. From this, it was found that the real-time fluorescence intensity quantification method developed by us reflects the content of PpIX in the tissue. It was suggested that there was a normal boundary with the tumor between the quantitative values 3-7.

Free Research Field

脳腫瘍

Academic Significance and Societal Importance of the Research Achievements

悪性神経膠腫は脳浸潤性腫瘍のため肉眼的には境界不明である。一般的に蛍光反応＝悪性腫瘍という概念が通っているが、腫瘍辺縁部でも蛍光反応を示すことが既にわかっている。本研究は、悪性神経膠腫の術中蛍光反応をリアルタイムに客観的に定量し、その病理組織およびPpⅨ蓄積経路に関与する酵素を測定することである。これにより蛍光強度に応じた腫瘍と非腫瘍の境界を術中リアルタイムで診断することが可能になり、摘出率の向上ならびに過剰切除による術後障害の回避に有用である。