The Correlation Study Of CT Signs And Pathological Features With Ki-67 Expression In Peripheral Pulmonary Invasive Adenocarcinoma

Objective To study the correlation of CT signs and pathological features with Ki-67 expression in peripheral pulmonary invasive adenocarcinoma.Methods To retrospectively analyse the imaging,pathological and immunohistochemical data of 206 patients with invasive lung adenocarcinoma proved by surgery and pathology.There were 105 females and 101 males,aged 35-78 years,with an average age of 59.85±8.39 years.All patients underwent CT plain scan and dynamic contrast-enhanced scan 1-2 weeks before operation.The CT findings included: lesion size(nodule < 30 mm,mass≥30mm),location,morphological features(lobulation sign,burr sign,air bronchus sign,vacuole sign,vascular cluster sign,pleural indentation sign),plain CT value,two-phase enhancement value,CT enhancement value(difference between peak enhancement value and plain CT value),enhancement mode and lymph node metastasis.Analysis of the correlation between Ki-67 antigen expression.To analyze the correlation between pathological subtype classification,CT enhancement value and Ki-67 antigen expression value.Kruskal-Wallis test was used to examine the relation between Ki-67 expression and age,location and size of lesions.The difference was statistically significant(P < 0.05).Mann-Whitney test was used to analyze the relation between gender,morphological features of plain scan lesions,lymph node metastasis and expression of Ki-67 antigen.Kruskal-Wallis TEST and multiple comparison(Tamhane Test)were used to analyze the relationship between CT enhancement value,enhancement mode and Ki-67 expression,pathological subtype classification,CT enhancement value and Ki-67 antigen expression value.The difference was statistically significant(P<0.05).Results In 206 cases of invasive lung adenocarcinoma,27 cases(13%)were negative(-),65 cases(32%)were low(+),79 cases(38%)were moderate(++),35 cases(17%)were strong positive(+++).According to pathological subtypes,19 cases(9%)were grade 1adnexal type,115 cases(56%)were grade 2 acinar type and papillary type,72 cases(35%)were grade 3 solid type and micropapillary type.Tumor size was positively correlated with the expression of Ki-67 antigen;with deep lobulation(77/206),the expression of Ki-67 antigen was higher than that with superficial lobulation and no lobulation;with air bronchial sign(32/206),the expression of Ki-67 antigen was lower.The expression of Ki-67 antigen in tumors with pleural indentation sign(149/206)was higher than that in non-pleural indentation sign group.Age,sex,lesion location,burr sign,vacuole sign,vascular cluster sign and the expression of Ki-67 antigen had no significant difference.There was a significant difference between CT enhancement value and Ki-67 antigen expression value.There was a significant difference between the enhancementmode and the expression of Ki-67 antigen in the lesions 90 s after injection of contrast medium.There was significant difference between histopathological grading and CT enhancement value.Postoperative histopathological grading and expression of Ki-67 antigen were significantly different.Tumor with mediastinal or hilar lymph node metastasis(83/206),Ki-67 antigen expressed at a higher level.Conclusion Ki-67 antigen expression was higher in large tumors.lung adenocarcinoma with deep lobulation sign and pleural indentation sign,lung adenocarcinoma with high enhancement value,uneven enhancement degree and peripheral enhancement,and high expression of Ki-67 antigen indicate that the proliferation activity of the tumor is high.Lung adenocarcinoma with air bronchial sign,the expression of Ki-67 antigen was low,suggesting that the tumor may have low malignant biological behavior.Pathologically,the higher the grade of the tumors,the higher the expression of Ki-67 antigen,the higher the expression of Ki-67 antigen in lung adenocarcinoma with lymph node metastasis,and the higher the expression of Ki-67 antigen,suggesting that the tumors have higher malignant biological behavior...