biophBiomedical PhotonicsBiomedical Photonics2413-9432Non-profit partnership for development of domestic photodynamic therapy and photodiagnosis10.24931/2413-9432-2021-10-4-35-43bioph-516Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL ARTICLESФлуоресцентная диагностика с хлорином е6 в хирургии глиом низкой степени злокачественностиFluorescent diagnostics with chlorin e6 in surgery of low-grade gliomaРындаА. Ю.RyndaA. Yu.

Санкт-Петербург

Saint-Petersburg

artemii.rynda@mail.ruОлюшинВ. Е.OlyushinV. E.

Санкт-Петербург

Saint-Petersburg

РостовцевД. М.RostovtsevD. M.

Санкт-Петербург

Saint-Petersburg

ЗабродскаяЮ. М.ZabrodskayaY. M.

Санкт-Петербург

Saint-Petersburg

ПапаянГ. В.PapayanG. V.

Санкт-Петербург

Saint-Petersburg

Российский нейрохирургический институт имени профессора А.Л. Поленова – филиал ФГБУ «Национальный медицинский исследовательский центр имени В.А. Алмазова»РоссияPolenov Neurosurgical Institute – a branch of Almazov National Medical Research CenterRussian Federation2021040220221043543Copyright © Рында А.Ю., Олюшин В.Е., Ростовцев Д.М., Забродская Ю.М., Папаян Г.В., 20222022Рында А.Ю., Олюшин В.Е., Ростовцев Д.М., Забродская Ю.М., Папаян Г.В.Rynda A.Y., Olyushin V.E., Rostovtsev D.M., Zabrodskaya Y.M., Papayan G.V.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.pdt-journal.com/jour/article/view/516

Применение интраоперационной флуоресцентной диагностики для глиом высокой степени злокачественности широко используется в нейрохирургической практике. В работе проанализированы возможности флуоресцентной диагностики для глиом низкой степени злокачественности с использованием хлорина е6. В исследование были включены пациенты с впервые диагностированной глиомой низкой степени злокачественности (low-grade glioma, LGG), у которых с целью интраоперационного флуоресцентного контроля применен препарат хлорин е6 в дозе 1 мг/кг массы тела. В процессе операции анализировали интенсивность флуоресценции различных участков предполагаемой опухолевой ткани с использованием программного обеспечения RSS Cam – Endo 1.4.313. Образцы тканей различной степени интенсивности флуоресценции сопоставляли с результатами их гистопатологического анализа (диагностика опухоли ВОЗ, индекс Ki-67, P53, VEGF). Флуоресценция выявлена в более чем половине случаев, но в большинстве случаев имела очаговый характер и низкую интенсивность флуоресценции. Интенсивность флуоресценции напрямую коррелировала с данными гистопатологического исследования тканей опухоли: индекс Ki-67 (p=0,002), экспрессия P53 (p=0,0015), VEGF (p=0,001). Чувствительность метода для хирургии LGG составила 72%, специфичность 56,7%. Проведенное исследование подтвердило, что технология интраоперационной флуоресцентной диагностики с применением хлорина е6 может применяться в хирургии LGG, особенно для визуализации внутриопухолевых участков с более высокой степенью анаплазии.

Intraoperative fluorescence diagnostics of high-grade gliomas is widely used in neurosurgical practice. This work analyzes the possibilities of fluorescence diagnostics for low-grade gliomas (LGG) using chlorin e6 photosensitizer. The study included patients with newly diagnosed LGG, for whom chlorin e6 was used for intraoperative fluorescence control at a dose of 1 mg/kg. During the operation, the fluorescence intensity of various areas of the putative tumor tissue was analyzed using the RSS Cam – Endo 1.4.313 software. Tissue samples with various degrees of fluorescence intensity were compared with the results of their histopathological analysis (WHO tumor diagnosis, Ki-67 index, P53, VEGF). Fluorescence was detected in more than half of the cases, but in most cases had a focal character and low fluorescence intensity. The fluorescence intensity directly correlated with the data of histopathological examination of tumor tissues (Ki-67 index (p=0.002), expression of P53 (p=0.0015) and VEGF (p=0.001)). The sensitivity of the method for LGG surgery was 72%, the specificity was 56,7%. Intraoperative fluorescence diagnostics with chlorin e6 can be used in LGG surgery, especially to visualize intratumoral areas with a higher degree of anaplasia.

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The authors declare that there are no conflicts of interest present.