Van Veelen C W, Rijksen G, Van Ketel B A, Staal G E
Department of Neurosurgery, University Hospital Utrecht, The Netherlands.
Br J Neurosurg. 1988;2(2):257-63. doi: 10.3109/02688698808992677.
In primary human brain tumours a shift occurs in the synthesis of isoenzymes of pyruvate kinase from the M towards the K-type. In astrocytomas, oligodendrogliomas and glioblastomas, which were localised in the cerebral hemispheres of adult patients over 20 years of age, the shift correlated well with histological grading and growth rate as observed in postoperative survival. Gliomas of adults, localised in midline structures, as well as childrens gliomas were characterised too by a strong shift from M towards the K type. However, in these tumours, less correlation with histological grading and growth rate was found. The isoenzyme shift can be rapidly demonstrated with an alanine inhibition test. The application of this assay may have a diagnostic value during operation for gliomas in grading of malignancy in adults as well as demarcation of the resection of gliomas in all age groups. The test can be performed within 10-15 min and can thus fit easily into a surgical procedure. A case report is presented for illustration.
在原发性人脑肿瘤中，丙酮酸激酶同工酶的合成发生了从M型向K型的转变。在位于20岁以上成年患者大脑半球的星形细胞瘤、少突胶质细胞瘤和胶质母细胞瘤中，这种转变与组织学分级以及术后生存观察到的生长速率密切相关。位于中线结构的成人大脑胶质瘤以及儿童胶质瘤的特征也是从M型向K型强烈转变。然而，在这些肿瘤中，与组织学分级和生长速率的相关性较小。通过丙氨酸抑制试验可以快速证明同工酶的转变。该检测方法在成人胶质瘤手术中对恶性程度分级以及所有年龄组胶质瘤切除范围的界定可能具有诊断价值。该检测可在10 - 15分钟内完成，因此很容易融入外科手术过程。现给出一个病例报告以作说明。
