Liang Pan, Ren Xiu-Chun, Gao Jian-Bo, Chen Kui-Sheng, Xu Xiao
1 Department of Radiology, The First Affiliated Hospital, Zhengzhou University, Zhengzhou, 1 Eastern Jianshe Rd, Zhengzhou, 450052, China.
2 Department of Pathology, The First Affiliated Hospital, Zhengzhou University, Zhengzhou, China.
AJR Am J Roentgenol. 2017 Nov;209(5):1033-1038. doi: 10.2214/AJR.16.16895. Epub 2017 Sep 5.
The purpose of this study was to use virtual monochromatic spectral CT to investigate the usefulness of iodine concentration (IC) and its correlation with clinicopathologically determined prognostic factors in gastric adenocarcinoma.
From June 2012 to March 2015, 34 patients with gastric adenocarcinoma underwent arterial and portal venous phase spectral CT. The ICs in the arterial and portal venous phases were calculated and then normalized with the aorta as normalized IC (NIC). The surgical specimen was evaluated with CD34 staining to determine microvessel density (MVD). The correlation between imaging results and clinicopathologic findings was investigated for histologic grading, lymph node metastasis, serosal involvement, distant metastasis, pathologic TNM stage, and MVD.
The mean arterial phase NIC value of tumors was 0.12 ± 0.03, portal venous phase NIC value was 0.39 ± 0.06, and MVD was 26.94 ± 7.87 vessels per high-power field (×400). Both arterial phase and portal venous phase NIC values were significantly higher in poorly differentiated gastric adenocarcinomas (p = 0.005) than in moderately differentiated tumors (p = 0.013). There was no significant correlation between NIC and serosal involvement or distant metastasis. There was significant correlation between the NIC and MVD in gastric adenocarcinoma (arterial phase NIC, p = 0.013; portal venous phase NIC, p = 0.001). However, neither the arterial nor the portal venous phase NIC of gastric adenocarcinoma had a significant relation to lymphatic metastasis or pathologic TNM stage. There was a significant difference between the high and low MVD groups with respect to portal venous phase NIC (p = 0.045).
NIC can serve as a useful predictor of angiogenesis and degree of differentiation of moderately and poorly differentiated gastric adenocarcinomas.
本研究旨在使用虚拟单色光谱CT探讨碘浓度（IC）在胃腺癌中的应用价值及其与临床病理确定的预后因素的相关性。
2012年6月至2015年3月，34例胃腺癌患者接受了动脉期和门静脉期光谱CT检查。计算动脉期和门静脉期的IC，并以主动脉为参照进行标准化，得到标准化碘浓度（NIC）。对手术标本进行CD34染色以确定微血管密度（MVD）。研究成像结果与组织学分级、淋巴结转移、浆膜侵犯、远处转移、病理TNM分期和MVD等临床病理结果之间的相关性。
肿瘤的平均动脉期NIC值为0.12±0.03，门静脉期NIC值为0.39±0.06，MVD为每高倍视野（×400）26.94±7.87个血管。低分化胃腺癌的动脉期和门静脉期NIC值均显著高于中分化肿瘤（动脉期，p = 0.005；门静脉期，p = 0.013）。NIC与浆膜侵犯或远处转移之间无显著相关性。胃腺癌中NIC与MVD之间存在显著相关性（动脉期NIC，p = 0.013；门静脉期NIC，p = 0.001）。然而，胃腺癌的动脉期和门静脉期NIC与淋巴转移或病理TNM分期均无显著关系。高MVD组和低MVD组在门静脉期NIC方面存在显著差异（p = 0.045）。
NIC可作为中低分化胃腺癌血管生成和分化程度的有用预测指标。
