Brielmaier Maria C, Reifenrath Johannes, Ganster Franziska, Pensel Nicolas, Gempt Jens, Meyer Bernhard, Schlegel Jürgen, Wagner Arthur
Department of Neurosurgery, Universitaetsklinikum Rechts der Isar, Technical University Munich, Munich, Germany.
Department of Neuropathology, Institute of Pathology, Technical University Munich, Munich, Germany.
Front Surg. 2025 Apr 28;12:1567711. doi: 10.3389/fsurg.2025.1567711. eCollection 2025.
Emerging digital biopsy technologies, such as confocal laser endomicroscopy (CLE), have shown how neuro-oncological surgery can be revolutionised with the help of rapid, intraoperative tissue assessment which offers a high diagnostic accuracy. For CLE of cerebral neoplasia, there is only one existing staining agent-Sodium-Fluorescein (SF)-approved for intravenous application. The staining characteristics of SF yet remain unclear.
In order to understand the dyeing behaviour of SF, we initiated a pilot study, comparing the staining pattern when incubating established tumour cell lines with SF to the distribution of intravenously applied SF -examined with CLE as well .
, the cell lines showed a hyperbolic, time-dependent cellular accumulation of SF. Carcinoma cell lines showed significantly more intracellular SF than glioma cell lines. This phenomenon could be observed when applying SF intravenously before tumour resection surgery. In gliomas and meningiomas, SF could only be detected in 14.3% and 16.1% of images per case, while in carcinoma metastases, SF would accumulate in 68.1% of images per case.
The concordant results from , and investigations could show that the cellular accumulation of the staining agent SF varies depending on the tumour entity. While primary brain tumours rarely show intracellular SF accumulation, carcinoma metastases display SF intracellularly more frequently. Therefore, SF allows for a better discrimination between brain tumours and brain metastases when performing CLE .
新兴的数字活检技术，如共聚焦激光内镜显微镜检查（CLE），已展示了神经肿瘤手术如何借助快速的术中组织评估实现变革，这种评估具有很高的诊断准确性。对于脑肿瘤的CLE检查，目前只有一种已获静脉应用批准的染色剂——荧光素钠（SF）。然而，SF的染色特性仍不清楚。
为了了解SF的染色行为，我们开展了一项初步研究，将已建立的肿瘤细胞系与SF孵育时的染色模式与静脉注射SF后的分布情况进行比较（同样通过CLE检查）。
细胞系显示出SF呈双曲线型、时间依赖性的细胞内蓄积。癌细胞系的细胞内SF明显多于胶质瘤细胞系。在肿瘤切除手术前静脉注射SF时可观察到这种现象。在胶质瘤和脑膜瘤中，每例图像中仅14.3%和16.1%能检测到SF，而在癌转移灶中，每例图像中有68.1%会有SF蓄积。
来自[此处可能有缺失信息]、[此处可能有缺失信息]和[此处可能有缺失信息]研究的一致结果表明，染色剂SF的细胞内蓄积因肿瘤类型而异。原发性脑肿瘤很少显示细胞内SF蓄积，而癌转移灶更频繁地在细胞内显示有SF。因此，在进行CLE检查时，SF有助于更好地区分脑肿瘤和脑转移瘤。
