Study Of Blood Supply And Angiogenesis Of Lung Metastasis

There were no malignant tumors if no metastasis -the biology character of malignant tumors. Metastasis is no random but has its own law and it is the major cause of tumor sufferer death. Pulmonary circulation is a low pressure system and the slow blood velocity contribute to the settle and proliferation of tumor cells. Lung metastasis is a common phenomenon for the lung is the biggest filter of human body. According to the statistics, 30% tumor patients would suffer lung metastasis during their course of desease and the rate would increase to 40-50% in cadaver examining. Chinese patients often receive examining when its too late and lung metastasis is inevitably. The malignancy patients survival rate are keeping elongating as the widespread of early detection early diagnosis early treatment and the integrated therapy, so the lung metastasis rate are keeping increasing.Surgeon and physician always feel headache when they face lung metastasis patients. Most of the lung metastasis were multi-lesions which were not indication for surgery. Lung metastasis patients couldn't bear large area and high dosage radiotherapy for the lung was low tolerance to radiation. So the chemical treatment was an absolutely necessarily method. The main contradiction of vein chemical treatment is medicine dosage and side effect. High local dosage and little side effect make the interventional radiology a very important therapeutic tool of lung metastasis patients. But it is should through pulmonary artery or bronchial artery or even both remains controversy.Metastasis is a complex and multi-procedure process which include: 1,Tumor cells break away from original lesion;2. Decompose the basement membrane, infiltration outward, migration and adhere to the vessel endothelial cell;3. Entry to the circulation, flow with the blood stream and stop at vessel wall of a distant place; 4. finally, perforate vessel wall, inroad extracellular matrix(ECM) and enter into the definite tissue to form the metastasis. Tumor vessel endothelial cell divide 50 times higher than normal endothelial cell. The immaturity and high permeability of vessel, the un-integrity of basement membrane, and the decreasing of cell bond result in the easier tumor cell metastasis. A original tumor of 1cm diameter can release 2 106 cells into the blood everyday. The formation of neovascularization could be dividedinto 4 steps: 1, tumor cell release cytokine and ECM to degrading activate the sleeping endothelial cell; 2, proliferation of endothelial cell; 3, endothelial cell migration and arrangement of a cell cord orientate from stimulation; 4, lumen of blood vessel formation from cell cord. Finally, the whole blood supply passage was established connected to the host vessel. Compare to the pulmonary artery, bronchial artery owns higher oxygen pressure and higher nutritive material which make it the priority to the connection with the neovascularization in theory. Only in the peripheral area of lung field , where bronchial is too slim or even absent, pulmonary has the opportunity to feed the tumor metastasis .Besides traditional methods, people nowadays pay more and more attention to anti- neovascularization which was the hotspot of modern medical science. But most of the research focus on the original tumor and little on the metastasis, and the difference between them was rarely reported.Based on the above reality, this research focus on: 1, To evaluate the blood supply of pulmonary metastases using bronchial arterial and pulmonary arterial multi-slice CT angiography(BA-MSCTA,PA-MSCTA), and DSA was the comparison at the same time; 2,To evaluate the blood supply of pulmonary metastases using small quantity of lipiodol through pulmonary arterial and discuss safety and the feasibility of pulmonary arterial chemoembolization ; 3,To compare the angiogenesis between pulmonary metastases and the lung cancer with the research on microvessel density(MVD) and vessel endothelium growth factor(VEGF). Providing a new way to improve the curative effect of lung metastasis.Material an...