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纸质出版:2013
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方升,熊伟茗,但炜,王超,詹彦,谢延风,石全红.幕上胶质瘤继发癫痫患者皮层脑电异常放电脑组织的病理学研究[J].陆军军医大学学报(原第三军医大学学报),2013,35(01):54-56.
Fang Sheng,Xiong Weiming,Dan Wei,Wang Chao,Zhan Yan,Xie Yanfeng,Shi Quanhong.Pathological features of brain tissues with electrocorticographic abnormalities on secondary epilepsy in patients with supratentorial glioma[J].J Amry Med Univ (J Third Mil Med Univ),2013,35(01):54-56.
方升,熊伟茗,但炜,王超,詹彦,谢延风,石全红.幕上胶质瘤继发癫痫患者皮层脑电异常放电脑组织的病理学研究[J].陆军军医大学学报(原第三军医大学学报),2013,35(01):54-56. DOI:
Fang Sheng,Xiong Weiming,Dan Wei,Wang Chao,Zhan Yan,Xie Yanfeng,Shi Quanhong.Pathological features of brain tissues with electrocorticographic abnormalities on secondary epilepsy in patients with supratentorial glioma[J].J Amry Med Univ (J Third Mil Med Univ),2013,35(01):54-56. DOI:
目的 探讨幕上胶质瘤继发癫痫患者皮层脑电异常放电脑组织的病理学改变。 方法 选择28例首次以癫痫发作入院的非功能区胶质瘤患者,在术中皮层脑电(electrocorticography,ECoG)监护下行肿瘤切除+痫样放电切除术。将切除有癫痫样放电的脑皮质作为试验组,无痫样放电的显微镜下显示肿瘤周边正常的哑区组织(胶质瘤切除附带)或内减压脑组织作为对照组。分析比较试验组与对照组术后病理检查的结果及试验组ECoG波型特点。 结果 ①病理特点:28例试验组中15例(53.57%)发现胶质瘤细胞,7例(25.00%)单纯胶质细胞增生
6例(21.43%)患者示脑组织充血水肿。13例对照组中3例(23.08%)出现胶质细胞增生,6例(46.15%)单纯充血水肿,4例(30.77%)为正常脑组织。术后病理检查结果显示,试验组胶质瘤或胶质增生明显高于对照组(P0.05)。②ECoG波型特点:试验组28例中22例术后病检显示胶质瘤或胶质增生者,ECoG显示17例(77.27%)为反复出现的单个极高幅棘波、多棘慢波,5例(22.72%)为高幅尖波节律;6例脑组织充血水肿者ECoG显示1例(16.67%)为高幅尖波节律,4例(66.67%)呈多灶性间隙性成簇出现的中高幅多棘波/多棘尖波,1例(16.67%)为散在于背景中单个棘尖波/棘尖慢波。 结论 幕上胶质瘤继发癫痫患者ECoG异常放电脑组织的病理学改变多表现为胶质瘤细胞和胶质细胞增生;胶质瘤周围ECoG反复出现极高幅棘波、棘尖波和尖波节律放电的脑皮质区应积极处理。
Objective To explore the pathological features of brain tissues with electrocorticography (ECoG) abnormalities on the secondary epilepsy in patients with supratentorial glioma. Methods Twenty-eight patients with nonfunctional areas glioma who were admitted by seizures for the first time were enrolled. By the ECoG monitoring
the patients underwent the resection of tumor and epileptic discharge tissues. The resected brain cortices with epileptic discharges were collected as an experimental group (n=28)
and normal dumb tissues (parenthesis of glioma resection) or decompression brain tissues in tumor surrounding area observed by microscopy without epileptic discharges were collected as a control group (n=13). The postoperative pathologic results were analyzed and compared between the experimental group and control group
and the characteristics of specific ECoG wave were analyzed in the experimental group. Results ①Pathological features: In the experimental group
glioma cells were found in 15 cases (53.57%)
simple glial cell proliferation was found in 7 cases (25.00%)
and brain congestion and edema was found in 6 cases (21.43%). In the control group
focal gliosis was found in 3 cases (23.08%)
simple congestion and edema was found in 6 cases (46.15%)
and normal brain tissue was found in 4 cases (30.77%). The postoperative pathological examination found that the incidence of glioma or gliosis in the experimental group was significantly higher than that in control group (P0.05). ②Characteristics of ECoG wave in the experimental group: In the 22 cases that were confirmed as glioma or gliosis by postoperative pathological examination
17 cases (77.27%) had recurring single high amplitude spikes and multispike-slow wave in ECoG
and 5 cases (22.72%) had high amplitude sharp wave rhythm. In the other 6 cases that were confirmed as congestion and edema by postoperative pathological examination
1 case (16.67%) had high amplitude sharp wave rhythm
4 cases (66.67%) had clustered medium-high amplitude spikes/multispike-sharp wave
and 1 case (16.67%) had single spike sharp wave/spike-and-sharp slow wave scattered in the background. Conclusion The pathological features of brain tissues with ECoG abnormalities on the secondary epilepsy in patients with supratentorial glioma are mainly glioma cells and glial cell proliferation. Cerebral cortex around glioma with recurring high amplitude spikes
spike sharp waves and sharp wave rhythm of discharge in ECoG should be actively treated.
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