Prognostic Factors In Pathological Stage â… A Peripheral Non-small Cell Lung Cancer And Medical Image Study

ObjectiveTo analyze prognostic factors for pathological stage Ⅰ A peripheralnon-small cell lung cancer(NSCLC), To evaluate the application of CT inpredicting prognostic factors of patients with pathological stage ⅠA peripheralNSCLC.Methods96pathological stage ⅠA peripheral NSCLC patients who had undergonesurgical resection in the First Affiliated Hospital of Liaoning Medical Collegefrom January2004to December2007are enrolled, and patients didn’t undergoany Anti-tumor therapy. All the patient underwent CT plain scan and highresolution computer tomography（HRCT）scan on chest. before operation.Vascular endothelial growth factor-C(VEGF-C) and D2-40expression wasexamined in the tissues of lung cancer using immunohistochemical technology,and examine the presence of Lymphatic vessel invasion(LVI). The overallsurvival was estimated using the Kaplan-Meier method and the Cox proportional,and explore the correlation of CT sign and prognosis factor in patients withpathological stage ⅠA peripheral NSCLC.Results1、For96patients with pathological stage ⅠA peripheral NSCLC, the3years,5years overall survival rate is87.9%and81.3%, respectively. Asstatistically significant recurrence prognostic factors, the univariate analysesdetected histological type, differentiation, the level of preoperativeCarcino-embryonic antigen(CEA), VEGF-C expression and LVI（P＜0.05）. The multivariate analysis revealed that the level of preoperative CEA, VEGF-Cexpression and LVI were independent prognostic factors（P＜0.05）; the RR was1.239,1.689and2.188, respectively.2、VEGF-C expression is correlated with lobulation sign and spinousprotuberant sign（P＜0.05）, but not with spiculation sign, vessel convergencesign, vacuole sign and air-bronchogram sign of CT signs in pathological stageⅠA peripheral NSCLC（P＞0.05）. LVI is correlated with spiculation sign andspinous protuberant sign（P＜0.05）, but not with lobulation sign, vesselconvergence sign, vacuole sign and air-bronchogram sign of CT signs inpathological stage ⅠA peripheral NSCLC（P＞0.05）Conclusions1、 Our study indicated that the level of preoperative CEA, VEGF-Cexpression and LVI have a significant impact on the prognostic of patients withpathological stage ⅠA peripheral NSCLC.2、Lobulation sign and spinous protuberant sign could reflect VEGF-Cexpression in pathological stage Ⅰ A peripheral NSCLC to some extent.Spiculation sign and spinous protuberant sign could reflect the state of LVI in thepatient with pathological stage ⅠA peripheral NSCLC, these CT signs promptproliferation and invasion, Therefore, analysis of CT sign provide importantinformation for prognosis analysis for patients with pathological stage ⅠAperipheral NSCLC.