| Part-1 The Application of 18F-FDG Imaging in Lung CancerObjective:To evaluate the characteristics of 18F-FDG imaging in patients with lung cancer; To analysis the diagnosis value of F-FDG SPECT/CT in primary tumors and staging of lung cancer pre-treatment.Methods:18F-FDG SPECT/CT was performed pre-treatment on 45 patients with lung cancer, and images were analyzed by image fusion software. Meanwhile, primary tumor size and T/B value, lymph node size and T/B value were measured by software. Comparison of the relationship between primary tumor T/B of lung and clinic pathological factors using SPSS 19.0 analyzes. The focal property was established according to the pathologic results of surgery or/and cytological detection, multi-modalities of imaging and clinical following-up.Results:1.95.6%(43/45) patients with lung cancer were diagnosed by 18F-FDG SPECT/CT, primary tumor T/B and size of lung were 6.5(7.2) and 3.3cm(2.4cm) respectively; With the size increasing, T/B value was significantly increased (p<0.05); with the age increasing, T/B value was decreased (p<0.05); There were no significant correlation between T/B value with sex, histological type, clinical staging and metastasis states.2. In 45 patients with lung cancer,30 patients were detected with lymph nodes metastases by 18F-FDG imaging. T/B value and size of all lymph nodes was 3.35(2.8) and 1.8cm(0.8cm) respectively. Regional lymph nodes T/B value was 3.35(3.1), and distant metastases T/B value was 4.0(3.8).There was no statistical difference between the two groups(p>0.05).With the T/B value of primary tumor increasing, the T/B value and size of lymph node were increased (p<0.01); T/B value of lymph node was associated with size of lymph node (r=0.653, p<0.01)3. In 45 patients with lung cancer,7 cases’clinical staging has changed, 6 of 7 cases’staging have up-regulated and 1 of 7 cases’staging has down-regulated.6 of 45 patients have changed their treatment protocols.Summary:1.18F-FDG imaging has a high detection rate for the diagnosis of lung cancer. Lung cancer primary focal T/B value associated with the tumor size and age group. But, it might have nothing to do with sex, pathological type, staging, metastasis states.2.18F-FDG imaging has important value to the diagnosis of regional lymph nodes metastases and distant metastases of lung cancer before treatment.3. F-FDG imaging has changed some clinical staging and treatment protocols of lung cancer. F-FDG imaging has significant value for making clinical staging and treatment protocols of newly diagnosis lung cancer.Part-2 The Serum Level and Clinical Value of DKK-1 and VEGF in Lung CancerObjective:To investigate the serum levels of DKK-1 and VEGF in lung cancer; To analyze the relationship between the serum level of DKK-1, VEGF and T/B value, tumor size, metastasis states and pathological type before receiving the treatment.Methods:29 patients with lung cancer who were performed 18F-FDG imaging same time before treatment,8 patients with pulmonary inflammation and 31 healthy individuals were selected into this study. The serum levels of DKK-1, VEGF were measured by ELISA. The relationship between the levels of two groups of growth factors and the clinical pathological characteristics was analyzed by SPSS 19.0 statistical software.Results:1. The serum level of DKK-1 and VEGF were 3055 (2303.7) pg/ml、 142.5 (141.9) pg/ml respectively in lung cancer; they were 2428.4 (1913.65) pg/ml、210.4 (197.6) pg/ml respectively in pulmonary inflammation, and they were 606.2 (484.4) pg/ml、95.654 (89.8) pg/ml respectively in healthy cases. The serum levels of DKK-1 and VEGF in lung cancer and pulmonary inflammation were significantly higher than those in healthy cases (p<0.05). There was no significantly difference in the serum levels of DKK-1 and VEGF between lung cancer and pulmonary inflammation (p>0.05).2. According to tumor’s largest diameter, it was divided into three groups, 3 cm or less,3-5cm, larger than 5cm.There was no significant statistical differences in the serum levels of DKK-1 and VEGF between these three groups.3. The serum levels of VEGF in patients with distant metastasis was significantly higher than that of regional lymph node metastasis (p<0.05). There was no difference in the serum level of VEGF between metastases-free group and metastases group (p>0.05).4. There was no significant correlation between the serum level of VEGF with sex, age, pathological type and clinical staging (p>0.05). There was no significant correlation between the serum level of DKK-1 with sex, age, pathological type, clinical staging, and metastasis states (p>0.05). No correlations were found between DKK-1, VEGF and age, clinical staging, metastasis states (p>0.05).5. There was a positive correlation between serum DKK-1, VEGF and tumor size, T/B value of lung tumor (p<0.05). It means that with the increasing of tumor size and T/B value, the serum DKK-1 and VEGF concentration increased.6. There was a positive correlation between serum DKK-1 and VEGF of lung cancer (p<0.05).Summary:1. The serum levels of DKK-1 and VEGF in patient of lung cancer were higher than healthy cases’. It may correlate with oncogenesis of lung cancer.2. The serum levels of DKK-1, VEGF in patient of lung cancer correlated with primary tumor T/B value. It indicated that the expression of DKK-1, VEGF was related to the serum level of tumor focal glucose metabolism.3. The serum level of VEGF in patient of lung cancer was associated with tumor size and metastasis distance. It indicated that the expression of VEGF correlated with the tumor invasion and metastasis.4. There was a positive correlation between the serum levels of DKK-1 and VEGF in patient of lung cancer.Conclusion1. F-FDG imaging has obvious value in detecting primary tumors of lung cancer, regional lymph node metastasis and distant metastasis. Also, It has a help value for increasing the accuracy of staging, and making the reasonable treatment plans.2. VEGF is closely related to the appearance, invasion and metastasis of lung cancer, DKK-1 may relate to the appearance of lung cancer.3. There was a positive correlation between serum level of DKK-1 and VEGF in patient of lung cancer.The serum level of DKK-1 and VEGF may related to the glucose metabolic level in patient of lung cancer. |
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