5-氨基酮戊酸在胶质瘤中的应用和研究进展

Research advances in the application of 5-aminolevulinic acid in glioma

摘要:

胶质瘤是中枢神经系统中最常见的恶性肿瘤，其预后通常不佳，主要受手术切除范围的限制。尽管荧光引导手术系统的引入已将胶质瘤的手术切除率提高至65%，但手术后复发仍然普遍，部分原因在于手术浸润边界处残留的具有高侵袭性的肿瘤细胞，包括神经胶质瘤干细胞（GSCs）。该综述旨在探讨5-氨基酮戊酸（5-ALA）在提高胶质瘤手术切除率中的应用现状、面临的挑战以及潜在的改进方法。笔者将分析5-ALA在荧光引导手术中的作用机制，探讨其对浸润边界肿瘤细胞的识别能力，以及如何通过荧光增敏技术提高其在手术中的效果。此外，该文还将讨论5-ALA对胶质瘤患者预后和个体化治疗策略的潜在影响。通过深入理解5-ALA的生物学行为和细胞生物学特性，笔者期望为胶质瘤的手术治疗提供更有效的方法，从而改善患者的生存率和生活质量。

Abstract:

Glioma is the most common malignant tumor of the central nervous system， with a generally poor prognosis mainly due to limitations of the extent of surgical resection. Although the introduction of fluorescence-guided surgical system has increased the surgical resection rate of glioma to 65%， postoperative recurrence remains prevalent， partly due to the presence of highly invasive tumor cells， including glioma stem cells， at infiltrated surgical margins. This article reviews the current status of the application of 5-aminolevulinic acid （5-ALA） in increasing the surgical resection rate of glioma， as well as related challenges and potential methods for improvement. This article also analyzes the mechanism of action of 5-ALA in fluorescence-guided surgery， discusses its ability to identify tumor cells at infiltrated margins， and explores how to improve the efficacy of 5-ALA through fluorescence enhancement techniques during surgery. Furthermore， this article discusses the potential impact of 5-ALA on the prognosis and individualized treatment strategies for glioma patients. Through a deeper understanding of the biological behavior and cellular characteristics of 5-ALA， it is hoped to provide more effective methods for the surgical treatment of glioma， thereby improving the survival rate and quality of life of patients.