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Quantitative comparison between carotid plaque hardness and histopathological findings: an observational study
BACKGROUND: Plaque hardness in carotid artery stenosis correlates with cerebral infarction. This study aimed to quantitatively compare plaque hardness with histopathological findings and identify the pathological factors involved in plaque hardness. METHODS: This study included 84 patients (89 lesio...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9275256/ https://www.ncbi.nlm.nih.gov/pubmed/35818059 http://dx.doi.org/10.1186/s13000-022-01239-y |
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author | Fukushima, Daisuke Kondo, Kosuke Harada, Naoyuki Terazono, Sayaka Uchino, Kei Shibuya, Kazutoshi Sugo, Nobuo |
author_facet | Fukushima, Daisuke Kondo, Kosuke Harada, Naoyuki Terazono, Sayaka Uchino, Kei Shibuya, Kazutoshi Sugo, Nobuo |
author_sort | Fukushima, Daisuke |
collection | PubMed |
description | BACKGROUND: Plaque hardness in carotid artery stenosis correlates with cerebral infarction. This study aimed to quantitatively compare plaque hardness with histopathological findings and identify the pathological factors involved in plaque hardness. METHODS: This study included 84 patients (89 lesions) undergoing carotid endarterectomy (CEA) at our institution. Plaque hardness was quantitatively measured immediately after excision using a hardness meter. Collagen and calcification were evaluated as the pathological factors. Collagen was stained with Elastica van Gieson stain, converted to a gray-scale image, and displayed in a 256-step histogram. The median gray-scale median (GSM) was used as the collagen content. The degree of calcification was defined by the hematoxylin–eosin stain as follows: "0:" no calcification, "1:" scattered microcalcification, or "2:" calcification greater than 1 mm or more than 2% of the total calcification. Carotid echocardiographic findings, specifically echoluminance or the brightness of the narrowest lesion of the plaque, classified as hypo-, iso-, or hyper-echoic by comparison with the intima-media complex surrounding the plaque, and clinical data were reviewed. RESULTS: Plaque hardness was significantly negatively correlated with GSM [Spearman's correlation coefficient: -0.7137 (p < 0.0001)]: the harder the plaque, the higher the collagen content. There were significant differences between plaque hardness and degree of calcification between "0" and "2" (p = 0.0206). For plaque hardness and echoluminance (hypo-iso-hyper), significant differences were found between hypo-iso (p = 0.0220), hypo-hyper (p = 0.0006), and iso-hyper (p = 0.0015): the harder the plaque, the higher the luminance. In single regression analysis, GSM, sex, and diabetes mellitus were significant variables, and in multiple regression analysis, only GSM was extracted as a significant variable. CONCLUSIONS: Plaque hardness was associated with a higher amount of collagen, which is the main component of the fibrous cap. Greater plaque hardness was associated with increased plaque stability. The degree of calcification may also be associated with plaque hardness. |
format | Online Article Text |
id | pubmed-9275256 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-92752562022-07-13 Quantitative comparison between carotid plaque hardness and histopathological findings: an observational study Fukushima, Daisuke Kondo, Kosuke Harada, Naoyuki Terazono, Sayaka Uchino, Kei Shibuya, Kazutoshi Sugo, Nobuo Diagn Pathol Research BACKGROUND: Plaque hardness in carotid artery stenosis correlates with cerebral infarction. This study aimed to quantitatively compare plaque hardness with histopathological findings and identify the pathological factors involved in plaque hardness. METHODS: This study included 84 patients (89 lesions) undergoing carotid endarterectomy (CEA) at our institution. Plaque hardness was quantitatively measured immediately after excision using a hardness meter. Collagen and calcification were evaluated as the pathological factors. Collagen was stained with Elastica van Gieson stain, converted to a gray-scale image, and displayed in a 256-step histogram. The median gray-scale median (GSM) was used as the collagen content. The degree of calcification was defined by the hematoxylin–eosin stain as follows: "0:" no calcification, "1:" scattered microcalcification, or "2:" calcification greater than 1 mm or more than 2% of the total calcification. Carotid echocardiographic findings, specifically echoluminance or the brightness of the narrowest lesion of the plaque, classified as hypo-, iso-, or hyper-echoic by comparison with the intima-media complex surrounding the plaque, and clinical data were reviewed. RESULTS: Plaque hardness was significantly negatively correlated with GSM [Spearman's correlation coefficient: -0.7137 (p < 0.0001)]: the harder the plaque, the higher the collagen content. There were significant differences between plaque hardness and degree of calcification between "0" and "2" (p = 0.0206). For plaque hardness and echoluminance (hypo-iso-hyper), significant differences were found between hypo-iso (p = 0.0220), hypo-hyper (p = 0.0006), and iso-hyper (p = 0.0015): the harder the plaque, the higher the luminance. In single regression analysis, GSM, sex, and diabetes mellitus were significant variables, and in multiple regression analysis, only GSM was extracted as a significant variable. CONCLUSIONS: Plaque hardness was associated with a higher amount of collagen, which is the main component of the fibrous cap. Greater plaque hardness was associated with increased plaque stability. The degree of calcification may also be associated with plaque hardness. BioMed Central 2022-07-11 /pmc/articles/PMC9275256/ /pubmed/35818059 http://dx.doi.org/10.1186/s13000-022-01239-y Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Fukushima, Daisuke Kondo, Kosuke Harada, Naoyuki Terazono, Sayaka Uchino, Kei Shibuya, Kazutoshi Sugo, Nobuo Quantitative comparison between carotid plaque hardness and histopathological findings: an observational study |
title | Quantitative comparison between carotid plaque hardness and histopathological findings: an observational study |
title_full | Quantitative comparison between carotid plaque hardness and histopathological findings: an observational study |
title_fullStr | Quantitative comparison between carotid plaque hardness and histopathological findings: an observational study |
title_full_unstemmed | Quantitative comparison between carotid plaque hardness and histopathological findings: an observational study |
title_short | Quantitative comparison between carotid plaque hardness and histopathological findings: an observational study |
title_sort | quantitative comparison between carotid plaque hardness and histopathological findings: an observational study |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9275256/ https://www.ncbi.nlm.nih.gov/pubmed/35818059 http://dx.doi.org/10.1186/s13000-022-01239-y |
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