Glioma ; pathology ; Humans ; Neoplastic Stem Cells ; pathology

Brain Neoplasms ; pathology ; Glioma ; pathology ; Humans ; Infant, Newborn ; Male

OBJECTIVE: The aim of this study is to compare the frequency of postoperative epilepsies of patients with chronic as opposed to recent onset epilepsy due to glial tumors in the frontal or temporal lobe with the hypothesis that patients with chronic epilepsy do worse. METHODS: We compared the clinical and diagnostic characteristics of the patients(n=73) who had seizures preoperatively to those of the patients(n=153) who did not. Among those who have had seizures preoperatively, we compared those(n=32, chronic seizure group) who had seizures a year or more prior to surgery to those(n=41, acute seizure group) who had seizures within a year prior to surgery. RESULTS: Among the various factors, the frequency of benign pathology and favorable neurological state were higher in seizure group than in non-seizure group(p<0.05). Complex partial seizure and low-grade tumors were frequent in chronic seizure group, whereas simple partial seizure and high-grade tumors were frequent in acute seizure group. Seizure-free rate was significantly higher in acute seizure group than in chronic one(p<0.05). Also, the difference of seizure control rate between surgical strategies were statistically significant(p<0.05). CONCLUSION: This study indicates that preoperative seizure durations and frequencies have a close relationship with the frequency of postoperative epilepsy of glial tumors. A longer lapse may allow the formation of epileptogenic foci, leading to chronic epilepsy, and eventually having a negative effect on the prognosis of the patients. Factors including histopathological characteristics of the tumor, its location, seizure duration/frequency, and semiology should be taken account of deciding on surgical strategies.
Brain Neoplasms ; Epilepsy* ; Glioma ; Humans ; Pathology ; Prognosis ; Seizures ; Temporal Lobe

The treatment of gliomas is highly individualized. Surgery for gliomas is essentially for histological diagnosis, to alleviate mass effect, and most importantly, to favor longer survival expectancy. During the past two decades, many surgical techniques and adjuvants have been applied to glioma surgery in China, which lead to a rapid development in the field of cerebral glioma surgery. This article broadly and critically reviewed the existing studies on cerebral glioma surgery and to portrait the current status of glioma surgery in China. A literature search was conducted covering major innovative surgical techniques and adjuvants for glioma surgery in China. The following databases were searched: the Pubmed (January 1995 to date); China Knowledge Resource Integrated Database (January 1995 to date) and VIP Database for Chinese Technical Periodicals (January 1995 to date). A selection criterion was established to exclude duplicates and irrelevant studies. The outcome measures were extracted from included studies. A total of 3307 articles were initially searched. After excluded by abstracts and full texts, 69 studies conducted in the mainland of China were included and went through further analysis. The philosophy of surgical strategies for cerebral gliomas in China is undergoing tremendous change. Nowadays Chinese neurosurgeons pay more attention to the postoperative neurofunctional status of the patients. The aim of the glioma surgery is not only the more extensive tumor resection but also the maximal safety of intervention. The well balance of longer overall survival and higher quality of life should be judged with respect to each individual patient.
China ; Glioma ; pathology ; surgery ; Humans ; Magnetic Resonance Imaging ; Neurosurgery

Patients afflicted with low-grade glioma frequently suffer from seizures. The mechanisms for seizure initiation in these patients remain poorly understood. Tumor location is correlated with seizure initiation. However, these correlative studies rely on dichotomized data analysis which is based on arbitrary lobe assignments. As a result, the lesion-symptom correlation may be incorrectly interpreted. Categorizing patients according to tumor involvement in a single brain lobe might cause the neglect of important information, such as lesion location and lesion volume. Tumors that invaded more than one brain lobe may could be counted repeatedly. The anatomic correlation of the tumor-induced seizures is therefore difficult to be identified. Investigations based on voxel-wise quantitative lesion analysis could avoid the above statistical bias. According to the voxel-wise analysis, the increased seizure risks were identified for patients with low-grade gliomas that involved the left premotor area.
Brain ; pathology ; Brain Neoplasms ; complications ; pathology ; Glioma ; complications ; pathology ; Humans ; Seizures ; etiology

Humans ; Child ; Glioma/pathology* ; Brain Neoplasms/pathology* ; World Health Organization ; Mutation ; Central Nervous System Neoplasms/pathology*

Female ; Glioma ; pathology ; Humans ; Neoplasms, Germ Cell and Embryonal ; pathology ; Ovarian Neoplasms ; pathology ; Peritoneal Neoplasms ; pathology ; Teratoma ; pathology

OBJECTIVETo investigate the clinical value of high-field-strength intraoperative magnetic resonance imaging (iMRI) combined with optic radiation neuro-navigation for the resection of temporal lobe low-grade gliomas.

METHODSFrom April 2009 to September 2013, 65 patients with temporal lobe low-grade gliomas (WHO grade II) involving optic radiation were operated with iMRI and functional neuro-navigation. Diffusion tensor imaging (DTI) based fiber tracking was used to delineate optic radiation. The reconstructed optic radiations were integrated into a navigation system, in order to achieve intraoperative microscopic-based functional neuro-navigation. iMRI was used to update the images for both optic radiations and residual tumors. Volumetric analyses were performed using 3D Slicer for pre- and intra-operative tumor volumes in all cases. All patients were evaluated for visual field deficits preoperatively and postoperatively. The Student t test was used to evaluate the average rate of extent of resection between groups. Spearman rank correlation analysis was used to assess correlations between predictors and epilepsy prognosis.

RESULTSPreoperative tumor volumes were (78±40) cm3. In 29 cases, iMRI scan detected residual tumor that could be further resected, and extent of resection were increased from 76.2% to 92.7% (t=7.314, P<0.01). In 19 cases (29.2%), gross total resection was accomplished, and iMRI contributed directly to 8 of these cases. Postsurgical follow-up period varied from 13 months to 59 months, mean (33±13) months. Tumor progression were observed in 3 patients, newly developed or deteriorated visual field defects occurred in 4 patients (6.2%). For patients with pre-operative seizures, Engel Class I were achieved for 89.7% of them. Spearman rank correlation analysis revealed that seizure outcome (Engel Class) was related to increased excision of ratio (r=-0.452, P=0.004, 95% CI: -0.636--0.261) and larger tumors (r=0.391, P=0.014, 95% CI: 0.178-0.484).

CONCLUSIONSWith iMRI and functional neuro-navigation, the optic radiation can be accurately located, while extent of resection can be evaluated intra-operatively. This technique is safe and helpful for preservation of visual field for the resection of temporal lobe low-grade gliomas involving optic radiation.

Brain Neoplasms ; pathology ; surgery ; Glioma ; pathology ; surgery ; Humans ; Magnetic Resonance Imaging ; Neuronavigation ; Temporal Lobe ; surgery

OBJECTIVEThis overview seeked to bring together the microRNA (miRNA) researches on biogenesis and bio-function in these areas of clinical diagnosis and therapy for malignant glioma.

DATA SOURCESUsing the keyword terms "glioma" and "miRNA," we performed the literature search in PubMed, Ovid, and web.metstr.com databases from their inception to October 2014.

STUDY SELECTIONIn screening out the quality of the articles, factors such as clinical setting of the study, the size of clinical samples were taken into consideration. Animal studied for verification and reviews article were also included in our data collection.

RESULTSDespite many advance in miRNA for malignant glioma, further studies were still required to focus on the following aspects: (i) Improving the understanding about biogenesis of miRNA and up-down regulation; (ii) utilizing high-throughput miRNA expression analysis to screen out the core miRNA for glioma; (iii) Focusing related miRNAs on the signal transduction pathways that regulate the proliferation and growth of glioma.

CONCLUSIONSWe discussed the most promising miRNA, correlative signaling pathway and their relation with gliomas in the way of prompting miRNA target into being a clinical therapeutic strategy.

Brain Neoplasms ; genetics ; pathology ; Gene Expression Regulation, Neoplastic ; Glioma ; genetics ; pathology ; Humans ; MicroRNAs ; genetics

OBJECTIVETo establish malignant progression associated gene expression profiles in human brain glioma.

METHODSThe primary (WHO grade II), recurrent (WHO grade III) and re-recurrent (WHO grade IV) glioma specimens were sequentially collected from one single patient. Gene expression of different tumor specimens and normal brain tissue of the same patient was compared by microarrary techniques.

RESULTS197 differentially expressed genes with differential ratio > or = 3 were observed when compared with normal brain tissue. When the specimens (3 tumor, 1 normal brain) were paired with each other, 7 groups containing 489 genes (upregulated 193, downregulated 296) were observed. According to the descending frequency of the 109 genes with known function, they were the genes associated with development, metabolism, differentiation, signal transduction, DNA binding transcription, cellular receptor, immunity, ion-channel transportation, protein translation, cell backbone motion, stress, protooncogene and anti-oncogene and cell apoptosis, respectively.

CONCLUSIONFrom the 197 differentially expressed genes found in one glioma patient experiencing tumor malignant progression, 17 genes screened out by bioinformatics assay, may offer valuable information on molecular mechanisms on genesis and malignant progression of glioma.

Brain Neoplasms ; genetics ; pathology ; Gene Expression Profiling ; Glioma ; genetics ; pathology ; Humans ; Oligonucleotide Array Sequence Analysis