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MSCT perfusion imaging for assessment of non-small cell lung cancer metastasis and recurrence of experimental study

Author: ZhouZuo
Tutor: LiuJinKang
School: Central South University
Course: Medical Imaging and Nuclear Medicine
Keywords: MSCT lung perfusion imaging Mechanism Microvasculature phenotype Metastasis and recurrence Non-small cell lung cancer
CLC: R734.2
Type: Master's thesis
Year: 2008
Downloads: 55
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Abstract

Objective: To study MSCT perfusion imaging evaluation of non-small cell lung cancer metastasis and recurrence of the feasibility and predictive value, and to seek further theoretical basis. Materials and Methods: March 2005 to January 2008 in our hospital during thoracic surgery pathologically confirmed 44 cases of NSCLC patients MSCT perfusion scan, with the multiple correlation to investigate into cases of perfusion parameters and clinical pathological features , and according to the results of multiple correlation has focused subgroup analysis, logistic regression and then draw BF values ??predicted postoperative metastasis or recurrence prediction formula and evaluate their predictive value. Of which 22 cases of postoperative pulmonary nodules for complete specimens, according to anatomical orientation selected in vivo lung perfusion imaging with MSCT maximum level rather pathological level, the use of immunohistochemistry, special stains, electron microscopy and other techniques to build microvasculature phenotype, focus on detection of microvascular basement membrane integrity and lymphatic microvessel density to investigate cases of MSCT perfusion parameters evaluated included in non-small cell lung cancer metastasis and recurrence mechanism. Results: 1, CT perfusion imaging with clinicopathological features: (1) multivariate correlation analysis showed: BF and degree of differentiation, P-TNM stage, lymph node metastasis, postoperative metastasis (recurrence) was significantly correlated (p <0.01), PEI and differentiation, lymph node metastasis (p <0.05). (2) to reduce the degree of differentiation with NSCLC, BF, and PEI decreased between the two groups show highly differentiated group BF value higher than that in poorly differentiated group, high, higher than the poorly differentiated group of PEI group (p < 0.05). Lymph node metastasis group BF and PEI values ??greater than without lymph node metastasis (p <0.01); P-TNM staging group Ⅰ Ⅱ Ⅲ Ⅳ BF group was significantly lower than the value (p <0.01). Postoperative metastasis or recurrence group was significantly lower than BF does not appear or metastasis group (p <0.01). (3) logistic regression analysis showed that the BF value of non-small cell lung cancer metastasis or recurrence of significant factors (p <0.01), with the resulting logistic regression equation to predict the metastatic or recurrent postoperative group of patients overall accuracy rate 86.4%. 2, NSCLC microvascular architecture phenotype and clinical pathological features: (1) the surrounding area, the central area and the total MVD MVD MVD was significantly higher than those in border areas (p <0.05), the central area, and the total MVD MVD surrounding area among There was no difference (p> 0.05), the surrounding area is not a complete lumen MVD was significantly more than the central area (p <0.05). NSCLC tumor surrounding area LMVD> peritumoral normal lung tissue and total LMVD> Central District LMVD (p <0.05). Tumor microvasculature multiple correlation with clinicopathological features Display: MVD did not form a complete lumen and the surrounding area LMVD and differentiation, lymph node metastasis was significantly positively correlated (p <0.01), and P-TNM staging and histological type of tumor, preoperative hilar and mediastinal lymph nodes was no significant relationship (p> 0.05). Do not form a complete lumen and the surrounding area LMVD MVD and VEGF expression intensity and positive rate of PCNA positive correlation (p <0.05). PCNA-positive rate and degree of differentiation, lymph node metastasis, VEGF expression positively correlated (p <0.05), with PCNA-positive rate among the strongest correlation. Lymph node metastasis and PTNM stage, degree of differentiation, PCNA positive rate was significantly positively correlated (p <0.01), and VEGF expression correlated (p <0.05). (2) Total MVD and total LMVD in adenocarcinoma and squamous cell carcinoma was no significant difference between (p> 0.05). (3) capillary basement membrane integrity and pathological type (p> 0.05), positively correlated with the degree of differentiation (p <0.01), the lower the degree of differentiation, basement membrane integrity is worse. Basement membrane integrity correlated with lymph node metastasis (p <0.05). 3, CT perfusion imaging with NSCLC microvascular architecture phenotype: (1) do not form a complete lumen CD34-MVD and BF, PEI significant negative correlation (p <0.01), and BV negative correlation (p <0.05). Total CD34-MVD was positively correlated with total PEI (p <0.05), with other perfusion parameters and degree of differentiation are not related (p> 0.05). PCNA was significantly negatively correlated with BF (p <0.01), and BV, PEI were negatively correlated (p <0.05). (2) BF negatively correlated with microvascular basement membrane integrity (p <0.05). (3) BF, BV, PEI, TTP and overall LMVD, center, surrounded by area LMVD were unrelated (p> 0.05). Conclusions: (1) MSCT perfusion imaging NSCLC can effectively evaluate the degree of differentiation, and the mechanism is through the detection of mature functional blood vessel lumen and microvascular density difference to evaluate the integrity of the basement membrane of NSCLC flow patterns. (2) NSCLC lower the level of differentiation, CT perfusion parameters BF, BV, PEI lower values; among the best correlation BF value and is not weight, cardiac output, blood volume effects, is used noninvasive better evaluation of the degree of differentiation and relatively objective indicators. (3) BF lower the value, the occurrence of lymph node metastasis and recurrence, and the greater the risk, the mechanism that can be integrated evaluation BF capillaries and lymphatic metastasis pathway and to reflect microvasculature phenotype mesh regulatory level. (4) the use of CT perfusion imaging of tumor angiogenesis can get more comprehensive information can be judged indirectly lymphangiogenesis, and thereby the evaluation of NSCLC lymph node and distant metastasis and recurrence of great significance to help develop the best treatment plan and improve prognosis.

MSCT perfusion imaging for assessment of non-small cell lung cancer metastasis and recurrence of experimental study

Abstract

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