5-Aminolevulinic Acid (5-ALA)-Induced Protoporphyrin IX Fluorescence by Glioma Cells—A Fluorescence Microscopy Clinical Study

Cancers

卷:14

Maria Laura Falchetti¹  Stefano Giannetti²  Liverana Lauretti²  Roberto Pallini²  Valerio Maria Caccavella²  Simone Pacioni²  Martina Giordano²  Martina Offi²  Giuseppe Maria Della Pepa³  Quintino Giorgio D’Alessandris³ 

[1] CNR-Institute of Cell Biology and Neurobiology (IBCN), 00015 Rome, Italy;

[2] Department of Neuroscience, Università Cattolica del Sacro Cuore, 00168 Rome, Italy;

[3] Operative Unit of Neurosurgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy;

关键词: high-grade glioma;    low-grade glioma;    fluorescence-guided surgery;    5-ALA;    blood–brain barrier;   

DOI  :  10.3390/cancers14122844

来源: DOAJ

【 摘 要 】

5-aminolevulinic acid (5-ALA)-induced PpIX fluorescence is used by neurosurgeons to identify the tumor cells of high-grade gliomas during operation. However, the issue of whether 5-ALA-induced PpIX fluorescence consistently stains all the tumor cells is still debated. Here, we assessed the cytoplasmatic signal of 5-ALA by fluorescence microscopy in a series of human gliomas. As tumor markers, we used antibodies against collapsin response-mediated protein 5 (CRMP5), alpha thalassemia/mental retardation syndrome X-linked (ATRX), and anti-isocitrate dehydrogenase 1 (IDH1). In grade III–IV gliomas, the signal induced by 5-ALA was detected in 32.7–75.5 percent of CRMP5-expressing tumor cells. In low-grade gliomas (WHO grade II), the CRMP5-expressing tumor cells did not fluoresce following 5-ALA. Immunofluorescence with antibodies that stain various components of the blood–brain barrier (BBB) suggested that 5-ALA does not cross the un-breached BBB, in spite of its small dimension. To conclude, 5-ALA-induced PpIX fluorescence has an established role in high-grade glioma surgery, but it has limited usefulness in surgery for low-grade glioma, especially when the BBB is preserved.

【 授权许可】

Unknown