| The background and objective of our researchThe Craniopharyngioma is not an unusual intracranial tumor in the saddle area, it represents 4%-6% of intracranial tumor. At the present time, operation is still the major treatment for craniopharyngioma. While in the operation, the calcification in the tumor has puzzled the operators for a long time. The calcification of craniopharyngioma has multivariate exhibition on the texture, the size, the location, et al, and the calcification may adhere to those structures around, like hypothalamus, bottom of the third ventricle, the tuber cinereum, the stalk hypophysial, and so on. When the operator try to dissection the calcification, it is easy to injure those structures mentioned above, and then result in serious post-operate complication, for example, dysfunction of the hypothalamus. In the other hand, if the calcification had not been cleared in grain, the tumour tissue adhered the reliquus calcification is considered to be an important factor to the recurrence of the tumor.In fact, not all the calcifications will adhere to the structures around. On images of the CT scan of head, we divide calcification into three grades based on the size: grade 1, the calcification looks like sands, it is small in size and dispersed, grade 2, it looks like eggshell or sheet, grade 3, it is massive, and its diameter is longer than 3 millimeters. Observing in clinic, the calcification of grade 3 is most easy to adhere to the structures around and it is hard to be dissected, while the calcification of grade 1 merely not, or the degree of conglutination is not serious and it is easy to clear.As we see on the operation, the "similar" calcifications from the craniopharyngiomas have different representations. Is this a cue that there are differences among the calcifications? We all know that the element composing and microstructure of one substance determines its character on physical and chemistry. In the circumstances, the calcifications with different grades have dissimilar textures, dissimilar guises, dissimilar representing on the image and even dissimilar clinical manifestation, it is due to the differences of there element composing and microstructure in all probability.It is a hotspot of the research of the craniopharyngioma. Although there are many divarications on the organizational origin, pathological grouping, treatment program, such-and such facets, there are also many theories or hypothesis accepted. However, there are few reports of basic research on the calcification of craniopharyngioma. What is its composing? How dose it form? Is there any modulate mechanism in the process of its form? Why there are different grade of the calcification? Nobody know so far.Aim to explore the essence of calcification, we designed such a research, use the technology of X-ray diffraction (XRD) and energy dispersive X-ray spectroscopy (EDS), which can tell us the character in a micro-world of the calcification. According to the date, we could explain the differences and how do the differences engender among different grades of calcification.Material and Method1. The resource of samples and their clinical information We follow a series of special standards (see the text) to filtrate the 121 case of patients who were ill with craniopharyngioma and treated in neuro surgery office of the Nangfang hospital, from January 2006 to January 2010. Finally,50 patients were brought into our research. There are 29 male with a age range form 3 to 66 years (23.31±3.12), in contrast with 21 female with a age range form 3 to 55 years (24±3.43).Based on images of the CT scan of head pre-operational, we divide the calcification into three grades by size:grade 1 (looks like sands, it is small in size and dispersed, marked with+), grade 2(looks like eggshell or sheet, marked with++), grade 3 (it is massive and its diameter is longer 3 millimeters, marked with+++).2. The method of experimentWe separate the calcification from the tumor tissue under the operative microscope, wipe off all the tissue, blood and the fluid from the vesicle of craniopharyngioma, washed by distillation-distillation H2O adequately, wait it to be dry in the air. Then, grind it to exiguous powder by an agate mortar and put those powders into a desiccation utensil for one night. After those steps, we use the technique of X-ray diffraction and energy dispersive X-ray spectroscopy to analyze those powders. The software respectively called Topas and Non-standardized quantitative analysis are used to analyze the date and export the results.3. Statistical TreatmentAll the statistical analysis are completed by the SPSS 13.0. We choose the One-Way ANOVA for the means compare of the contents of the element calcium, phosphor and carbon. And we use Bivariate to analyze the relationship between each two elements and the relationship between the content of one element and the calcified degree and the relationship between the content of carbon and the actual ratio of the contents of element calcium and phosphor. Besides, we select the One-Sample T Test for the compare that actual ratio of the contents of element calcium and phosphor to the academic value. We set a equals to 0.05, two-tailed.Result1. Result of the XRD1.1 All the samples contain Hydroxyapatite (structural formula:Ca10(P04)6(OH)2 molecular weight:1004) as the crystalloid component.1.2 All these samples are not pure crystal, there are some non-crystalloid components in each sample.2. Result of the EDS2.1 The calcium, phosphor, carbon, and oxygen are the major element in every sample, besides, there are a few natrium and magnesium. What's more, some samples may contain pretty few (less than 0.5%) other element which include chromium, kalium, chlorine, aluminum, silicon, ferrum, sulfur, the sample could contain one or several kinds of them.2.2 The contents of element calcium, phosphor and carbon have significant difference among three grades of calcified. (P<0.05)2.3 The contents of element calcium and phosphor have a positive correlation with the calcified degree (rp=0.745 and rp=0.778, P<0.001), while the contents of carbon has a negative correlation with it (rp=-0.526, P<0.001). The contents of element calcium and phosphor have a negative correlation with the contents of carbon (rp=-0.844 and rp=-0.786, P<0.001), besides, there is a positive correlation between the contents of calcium and phosphor (rp=0.938, P<0.001). At last, the content of carbon has a positive correlation with the actual ratio of the contents of element calcium and phosphor (rp=0.339, P=0.016).2.4 The actual ratio of the contents of element calcium and phosphor (2.60±0.21) is higher than the academic value (2.15), and the difference has statistical significance (P<0.001).Conclusion1. There are several kinds of calcification in the case of craniopharyngioma which have diverse calcified degrees, dissimilar textures, and distinct clinical manifestations, the causation is that there are difference on their micro-composing which contains the composing of elements and the micro-structures. The contents of the element calcium, phosphor and carbon determine the crystalline of the Hydroxyapatite and also the calcified degree of the calcification. The sample in which the contents of calcium and phosphor are high while the content of carbon is low has the higher crystalline and the higher calcified degree. Thereinto, the difference between the calcified grade 1 and grade 2 is inconspicuous, while the difference between them and the grade 3 is the most conspicuous.2. The substance of crystal in calcification is Hydroxyapatite (HA), and the HA has aberrance of crystal lattice. What's more, the calcification is not pure crystal, there are some contents of non-crystalloid components.3. The calcified degree lies on the relationship between the concentrations of PO43-and CO32- in the environment in which the HA crystal grows. If the concentration of PO43- is higher than the CO32-, then the calcified degree of the calcification is higher, contrarily, the calcified degree is lower.
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