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Objective To compare the differences of energy spectrum CT between small cell lung cancer(SCLC)with mediastinal lymph node metastasis and mediastinal sarcoidosis.Methods Twenty-five SCLC patients with mediastinal lymph node metastasis(SCLC group)and 26 patients with mediastinal sarcoidosis(sarcoidosis group)confirmed by bronchoscopy and biopsy in Tangshan People's Hospital from January 2018 to June 2019 were selected as the research objects.The CT value,iodine concentration,water concentration and energy spectrum curve slope under different single energy levels were compared between SCLC group and sarcoidosis group.Results The single-energy CT values of 40-80 keV segments in the arterial phase of the SCLC group were significantly higher than those in the sarcoidosis group(all P 0.05).The single-energy CT values of 40-90 keV segments in venous phase of the SCLC group were significantly higher than those of the sarcoidosis group(all P 0.05).The concentrations of iodine in the arterial phase and venous phase of the SCLC group were(11.56±4.06)μg/cm
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Humans , Lung Neoplasms/diagnostic imaging , Lymph Nodes , Lymphatic Metastasis , Sarcoidosis/diagnostic imaging , Small Cell Lung Carcinoma/diagnostic imaging , Tomography, X-Ray ComputedABSTRACT
Objective To investigate the value of standardized iodine concentration and energy spectrum curve of dual-source CT in diagnosis of metastatic lymph nodes of gastric cancer.Methods The clinical data of 60 patients diagnosed as gastric cancer were collected in our hospital.All patients underwent dual-source CT routine abdominal scanning and dual-phase energy spectrum enhancement.According to the pathologic results,the lymph nodes were divided into metastatic and non-metastatic groups.Then the enhanced degree,dual-phase normalized iodine concentration (NIC)were measured and compared between metastatic lymph nodes and non-metastatic lymph nodes.The slope of the energy spectrum curve of metastatic lymph nodes and non-metastatic lymph nodes were calculated by dual-energy software.Results When the enhanced degree was higher than 80 HU,the sensitivity (82.4%)and specificity (78.6%)were higher. The artery-phase NIC values of metastatic lymph node and non-metastatic lymph node were(0.546±0.086)and(0.144±0.077),respectively. The difference was statistically significant (P<0.05).The venous-phase NIC values of metastatic lymph node and non-metastatic lymph nodes were (0.479±0.013)and (0.307±0.082),respectively.The difference was statistically significant (P<0.05).The dual-phase energy spectrum curves of metastatic and non-metastatic lymph nodes were all descending patterns.The difference was obvious at 40-80 keV and minimal at 80-140 keV.The sensitivity of diagnosing metastatic lymph nodes was 83.5%,and the specificity was 85.6%when the arterial curve slope was 6.87.The sensitivity of diagnosing metastatic lymph nodes was 63.6% and the specificity was 96.7%when the venous curve slope was 6.67.Conclusion The multiple parameters provided by dual-source CT dual-energy imaging are helpful to the qualitative and quantitative diagnosis of metastatic lymph nodes in gastric cancer.
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BACKGROUND: Gastric cancer is a forth common malignancy world‑wide and the second most common cause of cancer‑related deaths. According to the current International Union Against Cancer staging system, nodal status is categorized based on the number of metastatic lymph nodes (LNs). Some groups have recently proposed the metastatic lymph node ratio (MLR) (the ratio between metastatic LNs and total dissected LNs; MLR) as an alternative prognostic factor. The aim of the present study is to evaluate the relationship between MLR and different clinico pathologic factors including patients’ age, tumor grade, stage, sites of involvement and disease prognosis. METHODS: A total of 70 patients with gastric adenocarcinoma who underwent gastrectomy with negative margin and LN resection during 2004‑2009 and were referred to Radiotherapy‑Oncology Department of Name of Hospital, Name of City, were included in the study. MLR status was divided to five groups. Collected data were analyzed with SPSS 16 (SPSS Inc., Chicago, IL, USA). RESULTS: The difference between MLR groups in age was significant; older patients had lower MLR (P = 0.01). The ratio of male to female was 5.3, which indicated higher prevalence of gastric cancer in males. The difference between MLR groups for tumor location, tumor stage, disease free periods and tumor T stages were not significant. A significant relation existed between different stages of LN involvement and MLR; and also between cancer stages and MLR. CONCLUSION: We found a significant relation between MLR and cancer stage and metastatic LN. Due to small sample size and short period of follow‑up, we could not find significant relation between MLR and other factors such as depth of tumor invasion, disease free period and tumor grading. In conclusion with regards to our results and other similar studies’ results, we acknowledge the importance of MLR in determining patients’ prognosis in gastric cancer.
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Objective To explore the value of spectral imaging technique in dual-energy CT in differential diagnosis of the metastatic lymph nodes in thyroid carcinoma,squamous cell carcinoma metastatic lymph nodes and lymphoma in the neck.Methods In 30 patients with pathologically confirmed with a total of 79 cervical lymph nodes enlargement which were using dual energy scan .Then observed the change trend of the spectrum curve and comparison the three kinds of lymph node energy spectrum curve’s slope.Results In the 79 lymph nodes,the metastatic lymph nodes in thyroid carcinoma were twenty-three,squamous cell carcinoma metastatic lymph nodes were twenty-four and lymphoma were thirty-two.From 60 to 180 keV,with the increase of keV values,the three kinds of malignant lymph nodes of the corresponding CT value decreasing and the higher the keV value,the CT value decrease magnitude was small,and the spectrum curve was〞drop type〞.The slope spectrum curve of the metastatic lymph nodes of thyroid carcinoma in arterial phase and parenchymal phase were maximum,which were 1.23±0.41 and 0.85±0.33,respectively.The slope spectrum curve of lymphoma in arterial phase and parenchymal phase were least,whcih were 0.40±0.16 and 0.47 ±0.09.The slope spectrum curve of the squamous cell carcinoma metastatic lymph nodes in arterial phase and parenchymal phase were 0.88±0.10 and 0.62±0.28.The energy spectrum curve slope of the three kinds of malignant lymph nodes have statistical significance.Conclusion The energy spectrum curve slope of arterial phase and parenchymal phase has some significance lymph node metastasis of in thyroid carcinoma,the metastatic lymph nodes and lymphoma in the neck.
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Background: Fine needle aspiration of neck nodes is quick, safe and convenient method for the diagnosis of various lesions. The procedure is well tolerated by the patients, has minimal complications and repeatable. Because of its minimally invasive characteristic, this technique is now being used routinely for quick and accurate diagnosis. Enlarged lymph nodes are one of the most frequently sampled tissues. The diagnostic accuracy of FNAC in neck node malignancy is high. Aims & Objective: To study efficacy of aspiration cytology in suspected metastatic neck lymph nodes. Material and Methods: A prospective hospital based study was conducted among patients attending cytology lab in Department of Pathology, of a tertiary care centre in this region over a period of three years. All new patients having clinically suspected neck lymph nodes were included in the study. All previously treated patients and those with recurrence were excluded from the study. Cervical lymph nodes were aspirated, and smears were prepared & processed following standard techniques. Findings were correlated with previous studies. A total number of 225 cases were examined. Results: A total of 225 cases of lymph node aspirates were examined. Out of these, 190 cytologically diagnosed cases, as metastatic cervical lymph nodes were further evaluated. Most number of cases was seen in males, in the age group of 45-76 years. Higher number of patients had known primary sites, seen in oral cavity. Confirmatory cytological diagnosis could be made in maximum number of cases. Conclusion: Fine needle aspiration cytology is a safe, rapid and highly accurate method for diagnosis of superficially palpable lymph nodes. It is now considered as a routine OPD procedure, and most convenient method for confirmation of suspected metastatic nodes.
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Objective to investigate the differences n expressions of P-glycoprotein (P-gp), breast cancer drug resistance protein (BCRP) and pulmonary resistance protsnn (LRP) between psimary breast careinoma and metastatic lymph nodes. Methods The expressions of P-gp, BCRP and LRP in breast cancer tissues, including 126 primary carcinoma and 66 metastasis lymph nodes, were determined immunohistochemically on formalin-fixed, paraffin-embedded tumor sections. Results (1)The positive expression rates of P-gp, BCRP and LRP were 41. 27% (52/126), 38. 89% (49/126), and 65. 87% (83/126) in primary breast carcinoma, and were 59. 09% (39/66), 63. 64%(42/66),and 60. 61% (40/66) n metastatic lymph nodes, respctively. The posiiive rates of P-gp and BCRP in the metastatic lymph nodes were significantly higher than those in primary cancer iissue(P0. 05). (2) There was a poor consistency in P-gp and BCRP expressoon between the psimary and metastatic sites(P0. 05). (3) The co-expresion rate of two resistance proteins in primary breast carcinoma was 35. 71%(45/126), of three resistance proteins was 15. 08%(19/ 126), and of two or three resistance proteins was 50. 79% (64/126), being significantly higher than that of a single protein 33. 33% (42/126,P<0. 05). The co-expression rate of two resistance proteins in metastasis lymph nodes was 53. 03% (35/66), which was significantly higher than that of a single protein 27. 27% (18/66, P < 0. 05). The co-expression rate of three resistance proteins was 16. 67%(11/66), two or three resistance proteins was 69. 70%(46/66), which was significantly higher than that of a single protein (P<0. 01). Both the co-expresion levels of two resistance proteins and two or three resistance proteins in metastatic lymph nodes were significantly higher than those in primary cancer (P<0. 05). (4)Kaplan-Meier analyses revealed that patients with P-gp, BCRP and LRP expressed in the metastatic lymph nodes had a lower 5-year survival rate compared with patients whose primary breast cancer being positive for them. Conclusion The expression of P-gp and BCRP is different between the primary and metastatic breast cancer sites, and there is no signAcant difference in LRP expression. Coordination of multi-protein expression is a major feature of resistance. Metastasis lymph nodes may have a stronger resistance.
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The plasminogen and plasmin system, which is mainly regulated by urokinase-type plasminogen activator (uPA), its receptor (uPAR) and its inhibitor (PAI-1), is generally believed to play a role in cancer invasion and metastasis. This study was conducted to investigate the role of uPA, uPAR and PAI-1 in the invasion and metastasis of gastric adenocarcinoma. The expression of mRNAs for uPA and PAI-1 was determined by Northern blot analysis in nine primary gastric cancer tissues, nine paired metastatic lymph nodes and normal gastric mucosa. The mRNA of uPA was not or faintly detected in normal mucosa, while the expression was increased in both primary gastric cancer tissues and metastatic lymph nodes to a similar degree. The mRNA expression for PAI-1 in the gastric cancer tissues was not different from that in the paired metastatic lymph nodes and normal mucosae. uPAR was determined by immunohistochemical staining, demonstrating that five (56%) and six (67%) out of nine primary gastric cancer tissues and nine paired metastatic lymph nodes were positive, respectively and the intensity was stronger in metastatic lymph nodes. The results support the concept that most gastric cancer cells may have an innately moderate level of uPA and uPAR, and that increase of uPAR expression can be considered to be closely associated with cancer invasion and metastasis.