The Study Of Judging The Boundary Of Glioma Through Fluorescein Sodium

Objective: To explore the difference in the accuracy of judging tumor boundaries in gliomas of different cell sources during glioma resection assisted by sodium fluorescein.Methods:Methods: A diagnostic test was performed on glioma patients who used fluorescein sodium to assist in judging tumors from January 2020 to June 2020 in the Department of Neurosurgery,First Affiliated Hospital of Xinjiang Medical University.During the operation,take the yellow-stained area and the nearby non-yellow-stained area(about 5mm outside the yellow-stained area)under a fluorescence microscope for pathological examinations,perform statistical analysis and draw ROC curves to compare the use of gliomas of different pathological sources during the operation Judgment performance under sodium fluorescein.Results: 52 patients(31males 21females)were tested,average age 46±16 years old.Among the 52 patients,34 were tumors derived from astrocytes and 18 were tumors derived from oligodendrocytes.Diagnosis sensitivity of astrocyte-derived tumors: 84%,specificity 78%,Kappa value: 0.61,area under the ROC curve(AUC): 0.81;diagnostic sensitivity of oligodendrocyte-derived tumors: 57%,specificity: 83 %,Kappa value: 0.22,area under the ROC curve(AUC): 0.70.Conclusion: Using sodium fluorescein to determine the boundary of glioma derived from astrocytes is more accurate than determining the boundary of glioma derived from oligodendrocytes.Preoperative molecular MRI can be combined with rapid paraffin section during surgery to determine the type of tumor and guide the scope of tumor resection.When the tumor is derived from astrocytes,the yellow-stained area can be removed to achieve a good total resection rate;When the tumor is derived from oligodendrocytes,it is not accurate to judge the tumor boundary in the yellow-stained area,and the surgeon’s surgical experience is required to achieve a better total resection rate.