The primary objective of this study was to investigate the association of certain genetic alterations and intraoperative fluorescent activity of 5-aminolevulinic acid (ALA) in brain metastasis (BM) of lung adenocarcinoma. A retrospective cohort study was conducted among 72 patients who underwent surgical resection of BM of lung adenocarcinoma at our institute for five years. Cancer cell infiltration was estimated by the intraoperative fluorescent activity of 5-ALA, and genetic alterations were analyzed by next-generation sequencing (NGS). The sensitivity and specificity for detecting cancer cell infiltration using 5-ALA were 87.5% and 96.4%, respectively. Genes associated with cell cycle regulation (p= 0.003) and cell proliferation (p= 0.044) were significantly associated with positive fluorescence activity of 5-ALA in the adjacent brain tissue. Genetic alterations in cell cycle regulation and cell proliferation were also associated with shorter recurrence-free survival (p= 0.013 andp= 0.042, respectively) and overall survival (p= 0.026 andp= 0.042, respectively) in the multivariate analysis. The results suggest that genetic alterations in cell cycle regulation and cell proliferation are associated with positive fluorescence activity of 5-ALA in the adjacent infiltrative brain tissue and influence the clinical outcome of BM of lung adenocarcinoma.
本研究旨在探讨肺腺癌脑转移（BM）中特定基因改变与5-氨基乙酰丙酸（ALA）术中荧光活性之间的关联。我们对本院五年来接受肺腺癌脑转移手术切除的72例患者进行了回顾性队列研究。通过5-ALA术中荧光活性评估癌细胞浸润程度，并采用新一代测序技术（NGS）分析基因变异。5-ALA检测癌细胞浸润的敏感性和特异性分别为87.5%和96.4%。与细胞周期调控（p=0.003）和细胞增殖（p=0.044）相关的基因与邻近脑组织中5-ALA荧光阳性活性显著相关。多变量分析显示，细胞周期调控和细胞增殖相关的基因改变与较短的无复发生存期（分别为p=0.013和p=0.042）及总生存期（分别为p=0.026和p=0.042）显著相关。研究结果表明，细胞周期调控和细胞增殖相关的基因改变与邻近浸润脑组织中5-ALA荧光阳性活性相关，并影响肺腺癌脑转移的临床预后。
肿瘤(癌症)患者之家