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Objective: The pineal region is deep, and anatomical relationship is complex. Imaging evaluation can effectively guide all kind of neurosurgery. The aim of this study was to explore the value of image evaluation in pineal region microsurgery via modified Poppen approach. Methods: From January 2008 to December 2017, the imaging and clinical data form 62 patients received microsurgery of pineal lesions via the modified Poppen approach at our Hospital were reviewed. The incidences of postoperative complications were compared between the patients with differences in lesion diameter, tentorial angle and preoperative hydrocephalus. Result: According to the data from image evaluation, all the pineal lesions was removed through modified Poppen approach, with total tumor resection in 48 cases, subtotal resection in 10 cases, and partial resection in 4 cases. After 3 to 12 months follow-up, the complication was found in 13 cases (21.0%), including hemianopia (2 cases), occipital lobe contusion (7 cases), monoparesis (2 cases), intracranial infection (2 cases). The incidences of postoperative hemianopia and monoparesis for patients with a lesion > 4.5 cm were significantly higher than those with a lesion ≤ 4.5 cm (P < 0.05). The incidence of postoperative hemianopia for the patients with a tentorial angle > 60° was significantly higher than for those with a tentorial angle ≤ 60° (P < 0.05). Conclusion: Imaging evaluation is useful for microsurgical removal and prediction of complication for modified Poppen approach of pineal lesions.

Recently, the role of long noncoding RNA (lncRNA) has been identified in human diseases, and we aim to explore the role of lncRNA antidifferentiation noncoding RNA (ANCR) in glioma. Expression of lncRNA ANCR, enhancer of zeste homolog 2 (EZH2), and phosphatase and tensin homolog (PTEN) in glioma tissues and cells was determined by RT-PCR or western blot assay. The correlation between expression of ANCR, EZH2, and PTEN in glioma tissues was analyzed using Pearson test. The apoptosis, transwell invasion, migration, colony formation, and proliferation assays were conducted to evaluate the influences of lncRNA ANCR depletion, EZH2 reduction, or PTEN elevation on the cell biology of glioma cells. The relationships between ANCR and EZH2, and between EZH2 and PTEN were confirmed through RIP, RNA pull-down, and chromatin immunoprecipitation assays. Our results indicated that ANCR and EZH2 were upregulated and PTEN was downregulated in glioma tissues and cell lines. ANCR expression was positively related to EZH2 expression, while PTEN expression was negatively related to ANCR/EZH2 expression. Inhibited ANCR, reduced EZH2, or elevated PTEN could reduce the ability of invasion, migration, and proliferation, and promote apoptosis of glioma cells. PTEN overexpression or EZH2 inhibition reversed the promotive role of ANCR upregulation in glioma cell growth and metastasis. Mechanistically, PTEN was upregulated in ANCR knockdown glioma cells. EZH2 interacted with ANCR in glioma cells. In conclusion, we have found that restrained ANCR could repress invasion, migration, and proliferation, as well as promote apoptosis of glioma cells through interacting with EZH2 and regulating the expression of PTEN, offering an effective therapeutic target for patients with glioma.