| Objective:To identify the value of CT perfusion (CTP) in pathological differentiation of NSCLC, and the correlation between pathological differentiation and tumoral angiogenesis.Methods:Fourty-one patients (24 men, 17 women; age range, 38-76 years; mean, 58 years) with lung cancer underwent unenhanced thin-section CT, followed by perfusion CT after intravenous injection of contrast medium. All patients were proved by surgical diagnosis, including adenocarcinoma (n=29, contain 1 case of alveolar cell carcinoma) and squamous cell carcinoma (n=12). And all cases consisted of high differentiation (n=6), moderate differentiation (n=18) and low differentiation (n=17). Measure the focal diameter in 5mm thickness of the plain CT image. Chose thoracic aorta as the input aorta. The diameter of the region of interest (ROI) was about 60% to 80% of that of the nodule and excluded the cavity and calcify portion. The data were analyzed by CT perfusion tumor software to calculate and construct of regional maps of tissue blood volume (BV), blood flow (BF), mean transit time (MTT) and permeability surface (PS). Micro-vessel density (MVD) was evaluated using immunohistochemical staining of surgical specimens (n=20) with anti-CD34, and then MVD was correlated with CTP parameters. One-Way ANOVA, Independent- Samples T Test and nonparametric tests were used in different group.Results:We divided the NSCLCs and the adenocarcinomas into three groups according to differentiation, containing high differentiate group, moderate differentiate group and low differentiate group. The value of BV was 279.70±122.40 ml/100mg, 259.88±115.86 ml/100mg, 222.02±120.41ml/100mg separately, and the value of PS was 58.22±29.61ml/(min·100g), 62.09±31.45 ml/(min·100g), 70.62±33.07ml/(min·100g) separately. Both the values of BV and PS have no correlation to the grade of differentiation, and there was no statistical significance (P>0.05). There was the same rule among the three groups of adenocarcinoma. We didn't analyze squamous cell carcinoma because of its little cases.The values of BF, BV, PS of adenocarcinoma were higher than those of squamous cell carcinoma, and the value of MTT of adenocarcinoma was lower than that of squamous cell carcinoma. But there were no statistical significance between adenocarcinoma and squamous cell carcinoma (P>0.05).The value of BV was significantly higher in cancers with more than 3.0cm diameter compared to smaller ones (P<0.05).MVD of 20 surgical specimens were counted. We divided those into two groups, low differentiated group and moderate differentiated and high differentiated group separately. There was no statistical significance (P>0.05) of the number of MVD in every high power field between the two groups. The number of MVD in every high power field of adenocarcinoma is higher than that of squamous cell carcinoma, but there was no statistical significance (P>0.05). The number of MVD in every high power field was lower in cancers with more than 3.0cm diameter compared to smaller ones, but there was no statistical significance (P>0.05). There is also no significant correlation between MVD and CTP parameters (P>0.05).Conclusion : MVD and CTP parameters are not associated with differentiation and histological category in NSCLC (P>0.05). But the value of BV is significantly higher in cancers with more than 3.0cm diameter compared to smaller ones (P<0.05), and MVD in those is lower compared to smaller ones, but there was no statistical significance between them (P>0.05). There is also no significant correlation between MVD and CTP parameters (P>0.05).
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