The application of intraoperative molecular diagnosis in glioma surgery

Background Glioma is the most common malignant tumor of the central nervous system, and intraoperative accurate diagnosis is critical for formulating rational surgical strategies. Traditional intraoperative frozen section pathology has certain limitations, while molecular diagnosis provides a new di...

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Main Authors: HAN Zhe, LI Gang, XUE Hao
Format: Article
Language:English
Published: Tianjin Huanhu Hospital 2025-03-01
Series:Chinese Journal of Contemporary Neurology and Neurosurgery
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Online Access:http://www.cjcnn.org/index.php/cjcnn/article/view/2998
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author HAN Zhe
LI Gang
XUE Hao
author_facet HAN Zhe
LI Gang
XUE Hao
author_sort HAN Zhe
collection DOAJ
description Background Glioma is the most common malignant tumor of the central nervous system, and intraoperative accurate diagnosis is critical for formulating rational surgical strategies. Traditional intraoperative frozen section pathology has certain limitations, while molecular diagnosis provides a new direction for precise glioma diagnosis and treatment. This study aimed to explore the clinical value of intraoperative frozen section pathology alone and combined with molecular diagnosis to improve diagnostic accuracy and optimize surgical strategies for gliomas. Methods A total of 230 patients preoperatively diagnosed with glioma via MRI at Qilu Hospital of Shandong University from January 2021 to December 2023 were enrolled. All patients underwent intraoperative frozen section pathology (traditional diagnosis group, n = 113), while a subset also underwent molecular diagnosis (molecular diagnosis group, n = 117). Using postoperative histopathological diagnosis as the "gold standard", we evaluated the accuracy of intraoperative frozen section pathology alone and combined with molecular diagnosis, as well as the impact of molecular diagnostic techniques on surgical strategies. Results The accuracy of intraoperative frozen section pathology was 77.88% (88/113). When combined with molecular diagnosis, the accuracy of intraoperative integrated diagnosis improved to 94.87% (111/117). Among the molecular diagnosis group, 20 cases showed discrepancies between intraoperative frozen section pathology and postoperative histopathological diagnosis. Molecular diagnosis corrected 14 of these errors, resulting in only 6 cases with unresolved discrepancies, achieving a correction rate of 70% (14/20). Additionally, 86.32% (101/117) of patients had their surgical strategies optimized based on positive molecular markers, including extended tumor resection (58 cases, 57.43%) and molecular total resection (43 cases, 42.57%). Conclusions The combination of intraoperative frozen section pathology with molecular diagnosis significantly improve the accuracy of intraoperative diagnosis, optimize surgical strategies, and provide critical support for personalized treatment and precision medicine. This study also validates the clinical value of molecular diagnostic techniques in intraoperative diagnosis of glioma, laying a foundation for future advancements in diagnostic and therapeutic paradigms.
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spelling doaj-art-1928a0c8d9c549f3ba9406d58df320072025-08-20T03:18:52ZengTianjin Huanhu HospitalChinese Journal of Contemporary Neurology and Neurosurgery1672-67312025-03-0125318719210.3969/j.issn.1672⁃6731.2025.03.004The application of intraoperative molecular diagnosis in glioma surgeryHAN Zhe0LI Gang1XUE Hao2Department of Neurosurgery, Qilu Hospital of Shandong University, Ji'nan 250012, Shandong, ChinaDepartment of Neurosurgery, Qilu Hospital of Shandong University, Ji'nan 250012, Shandong, ChinaDepartment of Neurosurgery, Qilu Hospital of Shandong University, Ji'nan 250012, Shandong, ChinaBackground Glioma is the most common malignant tumor of the central nervous system, and intraoperative accurate diagnosis is critical for formulating rational surgical strategies. Traditional intraoperative frozen section pathology has certain limitations, while molecular diagnosis provides a new direction for precise glioma diagnosis and treatment. This study aimed to explore the clinical value of intraoperative frozen section pathology alone and combined with molecular diagnosis to improve diagnostic accuracy and optimize surgical strategies for gliomas. Methods A total of 230 patients preoperatively diagnosed with glioma via MRI at Qilu Hospital of Shandong University from January 2021 to December 2023 were enrolled. All patients underwent intraoperative frozen section pathology (traditional diagnosis group, n = 113), while a subset also underwent molecular diagnosis (molecular diagnosis group, n = 117). Using postoperative histopathological diagnosis as the "gold standard", we evaluated the accuracy of intraoperative frozen section pathology alone and combined with molecular diagnosis, as well as the impact of molecular diagnostic techniques on surgical strategies. Results The accuracy of intraoperative frozen section pathology was 77.88% (88/113). When combined with molecular diagnosis, the accuracy of intraoperative integrated diagnosis improved to 94.87% (111/117). Among the molecular diagnosis group, 20 cases showed discrepancies between intraoperative frozen section pathology and postoperative histopathological diagnosis. Molecular diagnosis corrected 14 of these errors, resulting in only 6 cases with unresolved discrepancies, achieving a correction rate of 70% (14/20). Additionally, 86.32% (101/117) of patients had their surgical strategies optimized based on positive molecular markers, including extended tumor resection (58 cases, 57.43%) and molecular total resection (43 cases, 42.57%). Conclusions The combination of intraoperative frozen section pathology with molecular diagnosis significantly improve the accuracy of intraoperative diagnosis, optimize surgical strategies, and provide critical support for personalized treatment and precision medicine. This study also validates the clinical value of molecular diagnostic techniques in intraoperative diagnosis of glioma, laying a foundation for future advancements in diagnostic and therapeutic paradigms.http://www.cjcnn.org/index.php/cjcnn/article/view/2998gliomaneurosurgical procedurescryoultramicrotomymolecular diagnostic techniquespathology
spellingShingle HAN Zhe
LI Gang
XUE Hao
The application of intraoperative molecular diagnosis in glioma surgery
Chinese Journal of Contemporary Neurology and Neurosurgery
glioma
neurosurgical procedures
cryoultramicrotomy
molecular diagnostic techniques
pathology
title The application of intraoperative molecular diagnosis in glioma surgery
title_full The application of intraoperative molecular diagnosis in glioma surgery
title_fullStr The application of intraoperative molecular diagnosis in glioma surgery
title_full_unstemmed The application of intraoperative molecular diagnosis in glioma surgery
title_short The application of intraoperative molecular diagnosis in glioma surgery
title_sort application of intraoperative molecular diagnosis in glioma surgery
topic glioma
neurosurgical procedures
cryoultramicrotomy
molecular diagnostic techniques
pathology
url http://www.cjcnn.org/index.php/cjcnn/article/view/2998
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AT hanzhe applicationofintraoperativemoleculardiagnosisingliomasurgery
AT ligang applicationofintraoperativemoleculardiagnosisingliomasurgery
AT xuehao applicationofintraoperativemoleculardiagnosisingliomasurgery