Correlation Between MSCT Manifestations And Expression Of VEGF In Peripheral Lung Cancer Cavity

Objective: To study the value of diagnsis and differential diagnsis of peripheral lungcancer cavity appearances in multi-slice computed tomography (MSCT), investigate thecorrelation between multi-slice computed tomography (MSCT) features and expression ofvascular endothelial growth factor (VEGF) in peripheral lung cancer cavity.Methods:50cases of peripheral lung cancer cavity and68cases tuberculous cavitiesfrom Feb.2009to Feb.2014of our hospital were proved by surgery, needle biopsy orbronchoscopy was retrospective analysis,42cases of peripheral lung cancer performed CTenhanced scan.Analyze the detection rate of lobulation signs, spicule sign, vesselconvergence sign, eccentric cavity, and form concordance or discordance of cavity internaland external walls on MSCT in the50cases of peripheral lung cancer cavity. Expression ofVEGF in32cases which was proved by surgically and pathologically were examined withSP immunohistochemical techniques and compared with MSCT findings.Results: There are34cases of squamous carcinoma,12cases of adenocarcinoma,3casesof adenosquamous and1case of small cell carcinoma in the50cases.17cases(34%) withdiameter≦3cm,33cases(66%) with diameter﹥3cm.Only2cases(4.0%) cavitary wallsthickness≦3mm, and48cases (96%) cavitary walls thickness﹥3mm. In the50cases, thelobulation signs in41cases(82%), speculation sign in35cases(70%), mural rugosity in38cases（76%）, eccentric cavity in43cases（86%）, the degree of enhancement≧30HUin33cases, enhancement﹤30HU in9cases.Surrounding structure show the appearancedetection rate of the pleural indentation sign in28cases, vessel convergence sign in32cases, swollen lymph nodes in26cases. The detection rate of FDCW-Ⅰ、FDCW-Ⅲ inperipheral lung cancer cavity were clearly higher than in pulmonary tuberculouscavities(χ2﹦64.70, p﹤0.01), the sensitivity and specificity were78%(39/50) and94.1%(64/68), respectively. The detection rate of FCCW-Ⅰ、FCCW-Ⅱin tuberculouscavities were clearly higher than in peripheral lung cancer cavity(χ2﹦59.81,p﹤0.01), thesensitivity and specificity were77.9%(53/68)and94.0%(47/50),respectively.In32cases of peripheral lung cancer cavity, the expression rate of VEGF was71.9%(23/32). The VEGFwere significantly associated with pathologic grade (p﹤0.05),while has no associated withthe pathological types(p﹥0.05). The expression of VEGF was closely correlated withMSCT features: the tumor size, lobulation sign, speculate protuberances, vesselconvergence and lymph node metastasis(p﹤0.05),and has closely correlated with theenhanced degree of CT attenuation value.The expression rate of VEGF has closelycorrelated with the24cases of FDCW-Ⅰ,FDCW-Ⅲ in peripheral lung cancer cavity.Conclusion:Peripheral lung cancer cavity has the important of appearance includelobulation signs, speculation sign, vessel convergence sign, eccentric cavity and theenhanced degree of≧30HU.FDCW-I, FDCW-III, FCCW-I and FCCW-II were valuablein differentiating between peripheral lung cancer cavities and tuberculous cavities, FDCW-Ⅰand FDCW-Ⅲwere common in the former, FCCW-Ⅰand FCCW-Ⅱwere common inthe latter.MSCT appearances of peripheral lung cancer cavity closely related to expressionof VEGF, it contribute to chose appropriate clinic therapy and evaluate the prognosis.