| Background and purpose: Peripheral pulmonary carcinoma is one of the most common malignant tumors in respiratory system. Invasion and metastasis are initially characteristics of pulmonary carcinoma, which are the ultimately cause of death in pulmonary carcinoma, and tumor angiogenesis is its premise. Vascular endothelial growth factors (VEGF) and its receptors are the most important factors which are controlled by many kinds of related factors, and play an important role in stimulating vascular growth and vascular permeability. There are two kinds of vascular endothelial growth receptors highly expressed in endothelial cell and tumor cell, Kinase insert domain-containing receptor(KDR) is one of the important receptors. E-cadherin(E-cad) is one of the most important adhesive molecules responsible for the calcium-dependent intra-cellular adhesion mechanism, The aberrant expression of E-cad possesses a close relationship with invasion and metastasis of tumor. The purpose of this study is to investigate the correlation between SCT features and expressions of VEGF, E-cad to evaluate the growth and the invasion of pulmonary carcinoma.Materials and methods: Pulmonary carcinoma of 58 cases confirmed by pathology, and was performed SCT within one week before surgery, 16 of the 58 patients were diagnosed by CT-guided biopsy yet. Spiral CT examination was performed with a GE Hispeed advantage RP22 scanner. Scanning parameter of SCT were 120kv, 200mAs, 10 collimation, pitch= 1. The whole lung was examined and the tumor was scanned with high-resolution CT in 38 casses. About 100ml contrast medium was injected via the cubital vein with the speed of 3.0 ml/s, 21 patients were performed enhanced scan. All the specimens were fixed in 10% neutral formalin and embedded in paraffin after operation. Expressions of VEGF, KDR and E-cad in 58 cases of pulmonary carcinoma wereexamined with SP immunohistochemical technique. Statistical analysis was performed with SPSS 10.0 software using Chi-square test, Fisher's exact test and Spearman correlation test, and the P values less than 0.05 were considered significantly different.Results: 1. On SCT scans, the accuracy in diagnosing invasion of pleural and scanning for lymph metastasis was 86.67% and 88.24% respectively, whereas the accuracy of staging in TNM was 81.25%. The malignant features could be seen better on HRCT than that on convention CT.2. In 58 cases of peripheral pulmonary carcinoma, VEGF positive expression was detected in 35 patients, which was no relationship to the type of tumor cell (P>0.05). The expression of VEGF in III-IV was significantly higher than that in grade I-II (F<0.05).3. KDR expression was detected in 28 patients, the KDR positive rates is 48.28%, which is closely associated with the grades of cancer cell (P<0.05), but it was not related to the type of carcinoma (P>.05).4. The E-cad abnormal expression was detected in 32 patients. The abnormal expression of E-cad in grade III-IV was obviously higher than that in grade I-II.5. The VEGF positive expression closely correlated with the CT features, such as spicular sign, cavity sign et al, and was apparently associated with pleural invasion and lymph node metastasis, but it was not related to pleural retraction sign, lobulation sign, and the diameter of tumor.6. The abnormal expression of E-cad was associated with the CT features, such as lymph node metastasis, pleural invasion and the size of tumor, but was not related to cavity sign, spicular sign, vessel convergence sign et al,7. On non-enhanced SCT scans, the CT attenuation values of tumors ranges from 28.0Hu to 46.4Hu with a mean of 36.08(36.08 +4.69)HU, the CT attenuation ranges from 23.3HU to 43.0HU with a mean of 36.66HU(36.66+7.41HU); the expression of VEGF was closely associated with the enhanced degree of CT attenuation value (P<0.05).8. Expression of VEGF positively correlated with expression of KDR (rs=0.572), but their expression was not related to the expression of E-cad (-0.049 and -0.177). Conclusion: 1. SCT...
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