A Correlative Study Of CT Features Of Tumor Margin And Expressions Of Ki67,VEGF In Peripheral Lung Carcinoma In Rat And Humen

A research about the relationship among CT, pathological type. and the expresses of protein ki67 and VEGF in induced lung carcinoma of rat (partⅠ)Objective:To establish a cancerogenic model of SD rat which was induced by low density diethylnitrosamine (DEN) medication in order to dynamically observe the pathological changes of liver and lung, then approach its biochemical and pathological bases, the expression levels of ki67 and VEGF.Methods:128 male SD rats were choosed in the study (age:3 weeks; weight:60 g). The experimental group (96 rats) was continuously fed by 100 ppm DEN water solution for 12 weeks, then changed to normal water. At the mean time, the control group (32 rats) was fed by tap water. The changes of each rat both of the two groups would be observed in the first twenty-fourth week, then Two groups of rats would be checked in every two weeks after that. After anesthetizing which was operated by intraperitoneal injection, the liver and lungs of the two gropes rats would be examed by abdominal MRI inspection and chest CT imaging respectively. The rats that inspection results are positive by dispatched imaging would be checked by pathological examination, and the protein ki67 and VEGF existed in tumors would be detected. Results:1 The experiments last for 28-42 weeks. In experimental group, the incidence of cancer was identified as 37.8% (33/87), squamous cancer and adencarcimoma accounted 10.2% and 24.1% respectively, the incidence of squamous cancer combined with adencarcimoma was 3.4%; In control group, the incidence of carcinoma was zero. There is a significant difference between experimental group and control group about intra-pulmonary tumorigenic incidence (x2=9.659, P=0.002)2 41 rats of experimental group were found abnormal lung in CT scan. Namely:11 rats were found to be the pulmonary atelectasis (including 9 rats of cutinization type lung squamous cancer and 2 of mould pneumonia). There were 27 single nodules in the lungs (including 21 cases of adencarcimoma and 6 of mould pneumonia). Besides, there were 3 cases with multiple nodules combined with pulmonary atelectasis, the squamous cancer and adencarcimoma components could be seen in them. There were 2 cases of pulmonary atelectasis and 1 single nodule in control group. Both of two diseases were mould pneumonia in pathology. The incidence of carcinoma was zero. The detection rate of abnormal lung between the two groups was significantly different (x2=11.889, P=0.001)3 The rats were implemented laparotomy. In the mean time, their blood were collected via hepatic vein in order to detect alanine aminotransferase(ALT),aspartate aminotransferase (AST),total cholesterol (TCHOL), AST/ALT. In 38th week, mean value and standard deviation of AST/ALT in the two groups are 3.89±0.45 and 3.12±0.14. T test with independent samples data shows:F=0.001, P=0.934, t=2.680, P=0.008, There was no abnormal change in the liver with the experimental time extended.4 The positive expressed incidences of protein ki67 and VEGF in 33 rats (experimental group) with 36 carcinomatous tissues were 75% (27/36) and 61.1% (22/36) respectively. The chi-spuare value of positive incidence between protein ki67 and VEGF was 1.597, the difference was not statistically significant (P=0.206>0.05).5 The positive expresses of protein ki67 and VEGF in 24 peripheral lung cancer tissues of rats and the regulational verge of tumors were significantly different (x2=5.874, P=0.015;x2=4.867, P=0.027)Conclusion:Tumorigenic rats which drank low density DEN for a long time can induce lung cancer after the period of the eighth to tenth month. The incidence of adencarcinoma was higher than squamous cancer. Imaging is an important method to monitor the process of lung cancer.The expresses of protein ki67 and VEGF existed in carcinomatous tissues were highly positive, in another way, it reflected the vegetative state of the tissues and a high malignant degree. A Correlative Study of Spiral CT Features and Expressions of ki67 in Peripheral Lung Carcinoma (partⅡ)Objective:To study the relationship between the expression of proliferating cell nuclear antigen (ki67), vascular endothelial growth factor (VEGF) and spiral computed tomography (SCT) findings of tumor-lung interface including spiculation, lobulation and enhancement in resectable peripheral lung carcinoma.Methods:The patients with peripheral lung carcinoma proved pathologically and examined with plain and contrast-enhancement SCT scan were collected from september 2006 to march 2010 in first affiliated hospital of Jinan University. The expressions of ki67 and VEGF were detected with immunohistochemistry. The SCT findings of tumor-lung interface of peripheral lung carcinoma included length of spiculation, depth of lobulation, degree of enhancement in arterial phase and venous phase. The relationship between CT findings of tumor-lung interface and the expression of ki67,VEGF was analysed comparatively. The relationship between CT findings of tumor-lung interface and the expression of ki67, VEGF was analyzed with Chi-square test. The valuable CT findings and clinical factors of positive expression of ki67, VEGF were analyzed with unconditional logistic regression analysis.Results:1 There were 48 cases meeting the inclusion criteria among 51 resected specimens which included 13 squamous carcinomas,29 adenocarcinomas,5 small-cell carcinomas,1 large cell carcinoma and 3 tuberculosis.2 The CT findings of tumor-lung interface were irregular in the 51 cases. There were statistical differences for spiculation classification among different pathological types (P=0.001), but there were no statistical differences in depth of lobulation (P=0.057). Spiculation length and lobulation depth of 29 resectable adenocarcinomas were statistically different from 19 resectable non-adenocarcinomas (P=0.000 P =0.006).3 The positive rate of ki67 in the 48 peripheral lung carcinomas was 77.1%(37/48). There were significant difference of ki67 between the groups according to the tumor size, lobulation length, lobulation depth and enhanced valude in double phase(P< 0.05). The positive rate of VEGF in the 48 peripheral lung carcinomas was 60.4%(29/48). There were significant difference of VEGF between the groups according to the tumor size, lobulation length, lobulation depth and enhanced valude in double phase(P<0.05).The positive rate of both VEGF and ki67 was 43.7%.4 The positive expression of ki67 (dependent variable) was affected by age (independent variable) (P=0.015,95%.C.I 0.806-0.977), combination of spiculation (P=0.076) and clinical feature can be included in the independent factor. The valuable independent variables of the positive expression of VEGF (dependent variable) were age(P= 0.003), location (P= 0.013), spiculation(P= 0.039), lobulation (P= 0.045) and all the variables can be included in the independent factor by unconditional logistic regression analysis.Conclution:The CT findings of tumor-lung interface are irregular in peripheral lung carcinoma, age is the independent variable of expression of ki67. Age, location, spiculation and lobulation are the independent variables of expression of VEGF. Both VEGF and ki67 are involved in tumor proliferation and angiogenesis regulation, and their expression level can be reflected by conbining the CT findings of tumor-lung interface with age.