| Background and purpose: Pulmonary carcinoma is one of the most common malignant tumors in respiratory system. With emerging of the new technique and pathway in imaging such as spiral CT, and studying of tumor matrix metalloproteinases and angiogenesis, provided an effective way of accurate diagnosis and estimate the invasion, metasistasis and prognosis of peripheral pulmonary carcinoma. Invasion and metastasis were essential characteristics of peripheral pulmonary carcinoma, Vascular endothelial growth factors (VEGF) was the most important factors and play an important role in stimulating vascular growth and vascular permeability. Biological behavior determines the SCT features of tumor; the later primly reflected the differentiation, invasion and prognosis of tumor. Pathology connected the SCT features with biological behavior, it would be impossible to study the relation between imaging and molecular. The purpose of this study was to evaluate the correlation among SCT features , pathology , MMP-2 and VEGF in pulmonary carcinoma.Materials and methods: SCT were performed in 57 patients with pulmonary carcinoma, among them 31 patients were confirmed by postoperative pathology, 26patients were diagnosed by CT-guided biopsy. Spiral CT examination was performed with GE Hispeed advantage RP22 scanner. Scanning parameter of SCT were 120kv, 200mAs, 10 collimation, pitch= 1. The whole lung was examined and the tumor was scanned with high-resolution SCT in 38 cases, with enhanced SCT in 31 patients. About 100ml contrast medium was injected via the elbow vein with the speed of 3.0 ml/s. All the specimens were fixed in 10% neutral formalin and embedded in paraffin after operation. Expressions of MMP-2 and VEGF in 57 cases of pulmonary carcinoma were examined with SP immunohistochemical technique. Statistical analysis was performed with SPSS 11.0 software using Chi-square test, Fisher's exact test and the P values less than 0.05 were considered significantly different.Results: (1) On SCT scans, the accuracy of invasion to pleural and lymph metastasis of SCT were 90.00 %( 9/10) and 96.50 %( 55/57) respectively. The malignant features could be seen well on HRCT than that on convention CT. (2) In 57 cases of peripheral pulmonary carcinoma, MMP-2 positive expression was detected in 35 patients, which was no relationship to the pathologic types (P>0.05). The expression of MMP-2 in III was significantly higher than that in grade I—II (P<0.05). (3) In 57 cases of peripheral pulmonary carcinoma, VEGF positive expression was detected in 36 patients, which was no relationship to the pathologic types (P>0.05). The expression of VEGF in III was significantly higher than that in grade I—II (,P<0.05). (4) The MMP-2 positive expression was closely correlated with the CT features, such as the tumor size ,deep lobulation, spinous protuberance and mediastional lymph node metastasis, but no correlation with speculation sign, pleural invasion, vacuole sign, et al. ?The VEGF positive expression was closely correlated with the CT features, such as the tumor size ,pleural invasion, deep lobulation, spinous protuberance and mediastional lymph node metastasis, but no correlation with speculation sign, vacuole sign, et al. ?On non-enhanced SCT scans, the CT attenuation values of tumors ranged from 28.0Hu to 46.4Hu with a mean of 36.08(36.08±4.69)Hu, the CT attenuation ranges from 23.3Hu to 43.0Hu with a mean of 36.66 (36.66±7.41u) Hu; the expression of VEGF was closely associated with the enhanced degree of CT attenuation value (P<0.05).Conclusion: (D SCT scan was a reliable technique in the diagnosis of peripheral pulmonary cancer. ? The abnormal expression of MMP-2 positively was correlated with pathologic grade, which indicated that it promoted growth, invasion and metastasis of tumor. The abnormal expression of MMP-2 was closely correlated with SCT features: tumor size, deep lobulation, spinous protuberance and mediastional lymph node metastasis, which indicated that it might be their biological basis of formation. ?The expression of VEGF was closely associated with pathologic grade, which indicated that VEGF may play an important role in the invasion and metastasis of peripheral pulmonary cancer. The expression of VEGF was closely correlated with SCT features: the tumor size, pleural invasion, deep lobulation, spinous protuberance and mediastional lymph node metastasis, which indicated that that angiogenesis could promote the progression of pulmonary carcinoma. ? The SCT features were closely related to expression of MMP-2 and VEGF, it was of great clinical significance for evaluation of the invasion, metastasis and prognosis of peripheral pulmonary cancer. |
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