The Study Of Diagnosis Of Early Lung Cancer With Imaging And Detecting Of Serum Tumor Makers

Obj iectiveTo evaluate the precise positioning intubation reperfusion methylcholanthrene (MCA),two diethylnitrosamine(DEN),and lipiodol suspension induced canine model of lung cancer,lung-depth studies provide new platform. Through the inspection X-ray, spiral computed tomograph digital substraction angiography, tumor maker and pathology. To disussion the relation between lung cancer and the method which is combining image science,tumor makers in serum with pathology for lung cancer, it is to find a new way for us to diagnose early lung cancer so that we can improve the clincic outcome of lung cancer.Material and methods30 dogs which are half-bred,1-3 years old and 15-20 kg weigh are studied, both male and female. Before we devide them into A(eight dogs),B(eight dogs),C(seven dogs),D(seven dogs) goups in random,we give them vaccination and look after some days so that the dogs are all health.1 month later,we get 3 ml boold from the forelegs of dogs. Then we take blood serum for detecting tumor makers(TM) after boold have been kept in outer at room temperature about 0.5-1 hour. After anaesthetization,tracheal intubation by Coaxial Microcatheter precise positioning leaves to the righr lung perfusion phrenic carcinogenic substances:for go up A,B,methylcholanthrene(MCA) 0.25g + diethylnitrosamine(DEN) 0.38g+ lipiodol suspension 3 ml; for goup C,D, MCA 0.35g+DEN 0.48g+ lipiodol suspension 3 ml. Then we detect the same TMs at 6,12,18 months again. At the same time, we give each goup the X-ray,CT, DSA dynamic observation. We kill the dogs of C,D groups after raised 12 month,get the injection sites tissue, plus 10% neutral formalin-fixed, Paraffin embedded (slice thickness of 5μm) HE staining. We Choose the complete tissue structure for the subsequent observation and statistical processing. CA125,cyfra21-1,CEA,SCC-Ag,Ca153,DR70,NSE 7 have been tested so as to we can find out if they are higher. For CT, we want to observe whether inflammation or tumor change can be found at the lung of dogs. Then we give dogs selective bronchial arteriography (BAG) testing with using modified Seldinger technique, punctured across the right femoral artery under general anesthesia. After the success of puncture, we put the guide wire,catheter sheath and C3 catheter into, then we find the open placement of the bronchial artery near by thoracic aorta. When we find out the bronachila artery, inject 4 ml contrast medium with the speed of 2 ml a second in order to know that if bronchial artery and arteriae intercostals are hemitruncus,or left and right bronchial artery are hemitruncus. At the same time,we also observe the shape of bronchial artery and its size, the tumor and its artery or other artery which take blood to tumor if they can be detected. Then we analyse the outcome which we have receive from digital substraction angiography(DSA). After angiography, we give each dog some antibiotic to guard against infection. At pathology, we stain each tissue with HE staining, so we can observe the pathological changes of the lung tissue which have been injected carcinogen and account the HE section with Pathologicalimage analysis systems.Results1. X-ray:6 month later, the carcingens suspension which is perfused at right lung of dogs is thiner and smaller. They become thiner and smaller than at 6month. There is no orther changes at the lung of dogs in study.2. CT scan:At 6 month, the carcingens suspension deposit very good and bronchus become dilatation,thickening there. Many glass-shadow can be seen surrounding them and adjacent pleura become thicker and adhesions. There are many centrilobular nodules can been seen at 2 dogs in group B. At 12 month,carcingens suspension is smaller than before and adjacen pleura are still thick and adhesioning. We can see markings at double lung of dogs are more than before and many centrilobular nodules, the degree of lung is not good. bronchus become un-regular and biger. A irregular soft tissue can been seen surround thicker bronchus at a dog in D group, two dogs (one at group B,the other at group D)have atelectasis sheet.3. DSA:bronchial artery and intercostal arteries of all dogs are from the same trunk. At 6 month,there doesn't any abnormal at lung of dogs. At 12 month, we can find bronchial artery is thicking and running tortuos at 1 dog at each goup of B and D. there are also tumor-like blood vessels transported blood to the irregular tumor which are seen at the position of carcingens suspension at these two dogs. These tumor staining are clear and they are staining from early arterial phase lasted until late arterial. The orther bronchial artery are all normal.4. TM detection:When we compare the concentration of CEA,Cyfra21-1,SCC,CA153,CA125,DR70,NSE of these four group at the beginning,6month, 12month,they are significant difference and statistically signidicant (P<0.05). the concentration of carcingens suspension perfused to the dogs at group A and C are different with group B and D, but they don't have different effect at the concentration of that seven TM, except Cal 53 (P>0.05)5. Pathological detection:There are almost no pathological changes in the left of lung of 15 dogs, but in the right lung there can be seen a variety of changes around the injection site. A large number of cell nests of atypical hyperplasia or cell groups can be seen in the right lung of one dog which has tumor in the right lung at group D. These cell nest or group are like "cancer nest", the cells are inflammatory cells and dysplasia cells,with blooding around. A part of pseudostratified bronchial epithelial cells become comlumnar epithelial with a change of squamous metaplasia. We can see some changes like emphysema, fibrosis, acute and chronic pneumonia in orther dogs. A large number of inflammatory cells also can be seen in these dogs, they are main of lymphocytes, plasma cells and neutrophils.Conclusion1. Imaging, serum tumor markers and pathological examinations were used to analyze the different manifestations of lung cancer, to find new standard for improving early diagnosis of lung cancer and improving outcome of comprehensive treatment in lung cancer..2. We first proposed a new reference standarad of early diagnosis of lung cancer:. When CT shows ground-glass-like changes and/or soft tissue mass in lung, DSA bronchial arteriography showed tumor-like blood vessels and staining, serum TM in Ca125, CEA, SCC-Ag, Ca153, Cyfra21-1, NSE, DR70 significantly higher than before, pathological changes had atypical hyperplasia, we can consider the early lung cancer is coming even when the chest film showed normal.3.7 serotypes TM(Cal25, Cyfra21-1, CEA, SCC-Ag, Ca153, DR70, NSE) had been detected one time and we find out there normal range:Ca125 (19.253-19.465μ/ml), CEA(7.707-27.543ng/1), SCC-Ag (71.519-109.351pg/ml), Ca153(1.397-1.711μ/ml), Cyfra21-1(0.738-1.722μg/l), NSE(175.095-195.425ng/l) DR70 (0.327-0.405u.g/l). It can provide some value in order to study the effect of serum TM in diagnosis of lung cancer further.4. The best dose of carcinogens for induceding lung cancer at dog is 0.35g MCA, 0.48g DEN and 3 milliliter of lipiodol.