Waqas Muhammad, Khan Inamullah, Shamim Muhammad Shahzad
Aga Khan University Hospital, Karachi.
J Pak Med Assoc. 2017 Oct;67(10):1630-1632.
Goal of surgery for patients with Glioblastoma Multiforme (GBM) is gross total resection with no new neurological deficits. Surgical resection is often restricted due the difficulty in differentiating the tumour from surrounding normal brain using either naked eye, or standard intra-operative white light microscopy. GBM uptakes orally administered 5-ALA becomes fluorescent when viewed by a special light, and this property has been used to improve intra-operative tumour identification. This technique should therefore allow better extent of tumour resection. The hypothesis has been tested through several studies and even though most studies are of low quality, they strongly favour the use of 5- ALA in improving the extent of resection when compared to white light microscopy. A systematic review on the topic had a similar conclusion. Few studies have also hinted on a high false negative rate with the use of this technique..
多形性胶质母细胞瘤（GBM）患者的手术目标是实现肿瘤全切除且不产生新的神经功能缺损。由于使用肉眼或标准术中白光显微镜难以区分肿瘤与周围正常脑组织，手术切除往往受到限制。GBM摄取口服给予的5-氨基乙酰丙酸（5-ALA）后，在特殊光线下会发出荧光，这一特性已被用于改善术中肿瘤识别。因此，该技术应能实现更大范围的肿瘤切除。这一假说已通过多项研究进行了验证，尽管大多数研究质量较低，但与白光显微镜相比，它们强烈支持使用5-ALA来提高切除范围。关于该主题的一项系统评价也得出了类似结论。也有少数研究暗示该技术存在较高的假阴性率。
