Huashan Hospital’s latest research results open a new era of glioma surgery, enabling intraoperative molecular pathology diagnosis in 1.5 minutes
Glioma is one of the most common primary malignant brain tumors. It has the characteristics of unclear boundaries, adjacent to functional areas, and insensitivity to radiotherapy and chemotherapy. It is difficult to undergo surgical resection and has a poor prognosis. Studies have found that 80% of patients with grade 2-3 gliomas have mutations in the metabolic enzyme isocitrate dehydrogenase. This type of IDH-mutated gliomas tend to occur in peripheral brain lobes and are common in young people. After maximum tumor surgical resection, , can significantly improve survival rate. Rapid identification of IDH mutations during surgery and intraoperative molecular pathological diagnosis of glioma are of great significance to improving patient prognosis.
After preliminary accumulation and nearly five years of research, yesterday, the National Medical Center for Neurological Diseases, the team of Professors Mao Ying/Hua Wei from the Department of Neurosurgery of Huashan Hospital Affiliated to Fudan University, the team of Professor Ouyang Zheng from the Department of Precision Instruments of Tsinghua University, and Professor Cooks from Purdue University in the United States The team and the team of Professor Ginunis from the Mayo Clinic published the latest research results titled "Intraoperative Mass Spectrometry for Rapid Detection of IDH Mutation in Glioma" in the Proceedings of the National Academy of Sciences, successfully constructing a complete glioma The IDH mutation intraoperative diagnosis process shortens the entire detection time to 1.5 minutes, providing a basis for assisting surgeons during surgery to quickly identify tumor types, balance tumor resection rate and nerve function protection, and determine surgical boundaries. The study also confirmed the role of mass spectrometry in rapid intraoperative diagnosis, bringing possibilities for innovative changes in various surgical operations in the future and having important clinical value.
In 2018, the team of Professors Mao Ying/Hua Wei from Huashan Hospital Affiliated to Fudan University used mass spectrometry to detect IDH mutation detection and intraoperative application by detecting the special small molecule metabolite 2-hydroxyglutarate produced after IDH mutation. Article Published in "LabInv". Since then, the team has persisted in collaborative innovation to improve the portability and accuracy of rapid intraoperative testing.
This study was completed in the past five years through the cooperation of four top research and clinical institutions in China and the United States, including Huashan Hospital Affiliated to Fudan University, Tsinghua University, Purdue University and the Mayo Clinic. It was independently conducted at Huashan Hospital Affiliated to Fudan University and the Mayo Clinic. The largest known clinical study of intraoperative IDH mutation detection in glioma to date.
During the research process, the Chinese and American teams worked together and carried out research as two independent teams: the Chinese team used a direct capillary electrospray portable mass spectrometry system, and the American team used an electrospray desorption ionization mass spectrometry system, both of which can complete rapid and accurate detection of metabolites and implement technology. Rapid detection of molecular typing.
Among them, the mass spectrometer used by the Chinese team has been miniaturized, making it truly possible to perform instant testing. The study constructed a complete intraoperative diagnosis process for IDH mutations in glioma and compressed the detection time of the entire process to 1.5 minutes. The study also found that the ratio of 2-HG to glutamate has better diagnostic performance than the single indicator of 2-HG; The study achieved 100% IDH mutation detection accuracy in 697 samples from 260 glioma patients. Compared with other methods, it takes very little time, and the diagnostic accuracy is still close to 100% in the operating room environment. Precise diagnosis of intraoperative molecular pathology brings good news to patients with related diseases.
The first author of the paper is Professor Hua Wei from Huashan Hospital Affiliated to Fudan University. Professor Zhang Wenpeng of Tsinghua University, Dr. Hannah Brown of Purdue University, and Dr. Wu Junhan of Tsinghua University are the co-first authors of the paper. The corresponding author is Professor Mao Ying of Huashan Hospital and Professor of Precision Medicine of Tsinghua University. Professor Ouyang Zheng of the Department of Instruments, Professor Cooks of Purdue University, and Professor Ginunis of the Mayo Clinic. This research was supported by the National Key R&D Program of the Ministry of Science and Technology, National Natural Science Key Projects, General Projects, and Major Projects of the Shanghai Municipal Development and Reform Commission.
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