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Objective To investigate the value of spectral CT with iodine parameters in distinguishing moderately-differentiated adnocarcinoma from poorly-differentiated adenocarcinoma.Methods 61 patients with gastric adenocarcinoma underwent preoperative CT scanning that included arterial phase(AP) and venous phase(VP) with gemstone spectral imaging(GSI) mode.All measurements were performed on the GSI viewer.The iodine concentration (IC) and the water concentration (WC) of the primary lesion were measured.Then the normalized iodine concentration (NIC) and contrast enhancement ratio (CER) were calculated.The CT values were measured at 70 keV Mono image.All the values of CER, NIC, IC and WC in the primary lesion were recorded and assessed by independent-samples t test.Receiver operating characteristic (ROC) was used to determine the threshold of IC and NIC for differentiating poorly-differentiated adenocarcinoma and moderately-differentiated adnocarcinoma.Results The IC values between moderate differentiation group and poor differentiation group were 8.73±4.05 vs 11.07±4.80(100 μg/cm3) in AP and 16.89±4.89 vs 21.18±5.96(100 μg/cm3) in VP.The values of NIC between moderately differentiated group and poorly differentiated group were 0.10±0.06 vs 0.13±0.06 in AP and 0.38±0.10 vs 0.49±0.12 in VP respectively.Significant difference of NIC (tVP=3.38, PVP0.05) in double phases revealed no significant difference between the two groups.Conclusion Iodine quantitative parameters of spectral CT can be potentially used to preoperatively evaluate the differentiation degree of gastric adenocarcinoma.Thus, the iodine parameters can reflect the differentiation degree of gastric adenocarcinoma.
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Background and purpose:Recent researches have shown that Secreted Protien Acidic and Rich in Cysteine (SPARC) was closely related to tumor genesis, tumor progression and tumor metastasis. SPARC was highly expressed in malignant melanoma, glioma, meningioma, bladder cancer, lung cancer and prostate cancer, etc. In this study we investigated SPARC expression in hepatocellar carcinoma (HCC) and its signifi cance. Methods:RT-PCR was used to detect SPARC mRNA expression in cancer tissue samples and their adjacent liver tissue samples from 62 patients with hepatocellar carcinoma and 30 normal liver tissue samples, respectively. And the differential protein expression of SPARC between these groups was analyzed by immunohistochemistry (IHC). Results:SPARC mRNA was highly expressed in HCC(14.0?3.6) and in the adjacent liver tissue (6.8?1.8); compared with low expression of 2.7?0.9 in normal liver tissue, there were signifi cant differences among the three groups (p=0.000). SPARC positively stained was found in 54 of 62 patients with HCC and 4 of 30 normal liver tissue, there was significant difference between these two groups (P=0.000). SPARC immunohistochemical score was 21.5?4.8 in the carcinoma group; 11.3?3.6 in paracarcinoma group and 5.7?1.8 in the normal group, there were also significant differences among the three groups (P=0.000). The expression of SPARC protein was significantly upregulated with the progress of Enmondson pathological classification. There was obviously differences between Ⅰvs Ⅱ(P=0.029), and Ⅱ vs Ⅲ Ⅳ(P=0.008). There was more SPARC expression in the patients with metastasis of HCC (26/27, 96.3%) than that without metastasis(23/35, 65.7%)(P=0.004). Conclusion:SPARC mRNA expression and its protein were related to HCC histological differentiation and metastatic lymph node; SPARC is helpful to clinical evaluation of HCC.