Clinical Study Of Tumor Angiogenesis With Dynamic Contrast-enhanced MR Imaging In Non-small-Cell-Lung-Cancer

Most research confirms that biologic characteristic of non-small cell lung cancer (NSCLC) , such as the growth, TNM stage, malignant degree, metastasis and prognosis, is closely correlation with angiogenesis. At present, the most widely used method to assess neovascularization is the quantitation of intratumoral microvessel density (MVD) or vascular endothelial growth factor (VEGF) by immunohistochemical methods in clinic. Although the histological microvessel density technique is the current gold standard to characterize tumor angiogenesis, it may not be the ideal tool for clinical purposes because it is a wounded, unrepeated method. Recently, dynamic contrast-enhanced magnetic resonance imaging is used to assess angiogenesis of tumor, such as glioma, carcinoma of cervix and of liver. However, there is no pertinent study in lung cancer. Therefore we designed this investigation. Purpose: To investigate the correlation of dynamic contrast-enhanced MRI features with MVD and VEGF in non-small cell lung carcinoma. Materials and Methods: Forty-four consecutive patients firstly found solitary pulmonary nodules (SPNs) by plain film or CT were performed with non-contrast conventional MR imaging, dynamic and static contrast-enhanced scan. MVD and VEGF were stained with immuno- histochemical technique in thirty-six cases with surgically- and pathologically- proved NSCLC among the SPNs. Some parameters of dynamic contrast-enhanced (DCE) MRI, including maximum amplitude of signal intensity (Asi) , slope and time ofpeak (TP) at rim or center, were put more analysis. Correlation analysis was used to determine the relation between results of DCE MRJ and of immuno-histochemistryResults: The MVD and VEGF of tumor were significantly positive-correlated between the slope (r:Srim=0.629,0.733; Scen=0.615,0.723,P<0.001); markedly negative-correlated between the TP and (r: TPrim=-0.554, -0.601; TPcen= -0.478,-0.538, P<0.001) .But the Asi showed no obvious correlation with MVD and VEGF express levels of tumor(r=0.087, 0.196;P>0.05).Rim and center in slope or in TP showed apparent difference (Seen 1.40?.56, Srim 1.73?.69, t=2.198,P=0.031O.05; TPcen 217.00?7.57s, TPrim 192?4.76s, t=2.546,P=0.013<0.05),and rim super to center. Srim, Seen, TPrim and TPcen were significant difference between adenocarcinoma and squamous cell carcinoma. Adenocarcinoma and squamous cell carcinoma were founded apparent difference in their MVD or VEGF express levels(MVD: Adenocarcinoma 50.19?.59, squamous cell carcinoma 33.16?.65; t=6.34,P<0.001; VEGF: Fisher's exact test P=0.015 <0.05).The MVD of VEGF-positive tumor were significantly higher than those of negative(MVT) of VEGF- positive: 50.04?.15, MVD of VEGF-negative: 34.41?.24; t= 5.803, PO.001). Conclusion: Srim, Seen, TPrim and TPcen in DCEMRI, especially Srim and TPrim, can reflect MVD and VEGF express levels in NSCLC. The Srim and TPrim might be indexes for VEGF-related tumor angiogenesis .