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The correlation between stroma analysis and MDCT early phase contrast enhancement in small solid lung adenocarcinoma

The Chinese-German Journal of Clinical Oncology volume 6, pages 419–424 (2007)Cite this article

Abstract

Objective

To evaluate correlations between proportion and distribution of tumor stroma and MDCT early phase enhancement character in solid lung adenocarcinoma, and compare with microvessel density and histological subtypes.

Methods

Thirty-one patients with lung adenocarcinoma shown as solid solitary pulmonary nodules underwent routine contrast-enhanced MDCT followed by surgical resections. CT character included net enhancement and distribution of enhancement. The largest cut surface of tumor specimens were stained by hematoxylin and eosin. About 25 fields of view of each specimen were scanned as digitized pictures at low magnification. Semi-auto segmentation software was used to calculate mean stroma proportion. Pearson correlation coefficient was used to represent the relationships between extent of tumor enhancement, proportion of tumor stroma and MVD respectively. Fisher’s exact test was used to analyze statistical differences in degree of CT enhancement among groups of different histological subtypes.

Results

Proportion of invasive tumor stroma (13.2%–54.5%, mean 26.2 ± 8.8%) was correlated positively with net enhancement (8–60.8 HU, mean 31.2 ± 13.6 HU; r = 0.483, P = 0.006) which was more than MVD. 58.1% cases showed homogenous enhancement, 32.3% cases showed peripheral inhomogenous enhancement, 3.2% cases showed central inhomogeneous enhancement, 3.2% cases showed asymmetrical inhomogenous enhancement, and 3.2% cases showed no enhancement. 58.1% cases’ stroma showed mixed distribution, 35.5% cases showed peripheral distribution, 3.2% cases showed central distribution, and 3.2% cases showed asymmetrical distribution. Significantly more adenocarcinomas classified with ‘net enhancement > 20 HU” were found in the acinar group than in the solid with mucin subtype (P = 0.005).

Conclusion

Extent of CT enhancement reflects underlying not only the tumor angiogenesis but also stroma proliferation in solid small lung adenocarcinoma. Tumor stroma proportion could reflect the histopathologic basis of small lung adenocarcinoma’s CT enhancement substantially than MVD. Distribution between enhancement and tumor stroma have good correspondence. Most of acinar adenocarcinomas have higher degree of CT net enhancement than solid with mucin adenocarcinomas.

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Abbreviations

MDCT:

multi-detector row computed tomography

MVD:

microvessel density

WHO:

World Health Organization

BAC:

bronchioloalveolar carcinoma

ITSP:

invasive tumor stroma proportion

TTSP:

total tumor stroma proportion

NTSP:

noninvasive tumor stroma proportion

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Authors and Affiliations

  1. Department of Radiology, The 5th Affiliated Hospital of Sun Yat-Sen University, Zhuhai, 519000, China

    Yong Wang, Xueguo Liu, Yujing Lin, Xianping Yi, Xiaohong Wang, Mingzhu Liang, Peixin Qin, Guomei Zhong, Yanli He & Xiaobin Liu

  2. Department of Radiology, Zhongshan Hospital of Xiamen University, Xiamen, 361004, China

    Yong Wang

  3. Department of Thoracic Surgery, The 5th Affiliated Hospital of Sun Yat-Sen University, Zhuhai, 519000, China

    Lianju Ding

  4. Department of Radiology, The 1st Affiliated Hospital of Guangzhou Medical College, Guangzhou, 510000, China

    Qingsi Zeng

  5. Department of Thoracic Surgery, The 1st Affiliated Hospital of Guangzhou Medical College, Guangzhou, 510000, China

    Jianxing He

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  1. Yong Wang
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  2. Xueguo Liu
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  10. Peixin Qin
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  13. Xiaobin Liu
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Correspondence to Xueguo Liu.

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Wang, Y., Liu, X., Lin, Y. et al. The correlation between stroma analysis and MDCT early phase contrast enhancement in small solid lung adenocarcinoma. Chinese German J Clin Oncol 6, 419–424 (2007). https://doi.org/10.1007/s10330-007-0061-0

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  • DOI: https://doi.org/10.1007/s10330-007-0061-0

Key words

  • adenocarcinoma
  • lung
  • extracellular matrix