Algorithm for intraoperative study of the peritumoral zone, taking into account the mechanisms of glioma growth

INTRODUCTION. The progression of the tumor process begins with the activation of angiogenesis. The proven fact of the primacy of vascular growth with continued growth of gliomas is important for intraoperative determination of the scope of surgical intervention.

AIM OF THE STUDY: to study the possibilities of intraoperative diagnosis of the peritumoral zone, taking into account the mechanisms of glioma growth.

MATERIALS AND METHODS. Archival biopsies of 748 glioma patients aged 18 to 80 years old, operated at the Republican Scientific and Practical Center of Neurology and Neurosurgery (Minsk). To detect herpes simplex virus (HSV) in tumors, an immunohistochemical (IHC) study was performed with antibodies to the HSV antigen type I and II, the number of vessels was counted under the control of monoclonal antibodies to CD 34, to identify inflammatory infiltration, monoclonal antibodies CD 45 (total leukocyte factor), CD 8 (T-lymphocytes), CD 20 (B-lymphocytes), Р53. We used data from a comprehensive study of 6 deceased with glioblastoma using post-mortem MRI (Russian Research Institute. prof. A. L. Polenova).

RESULTS. Tumor growth was accompanied by the appearance of a large number of vessels and round cell infiltrates not only in the tumor tissue, but also in the peritumoral zone, which can become a diagnostic criterion for determining the extent of surgical intervention when removing high-grade gliomas. At the same time, independent studies conducted with MRI of tumors during autopsy showed that around tumors of different histostructure, both in vivo and postmortem, a zone with histological signs of inflammation and proliferating vessels is determined.

CONCLUSION. When performing surgery for the removal of high-grade gliomas, along with the use of photofluorescence methods, intraoperative morphological diagnostics will improve the rate of radicalness of the operation due to the detailing of processes in the peritumoral zone.

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