Comparative Evaluation Of Microvessels And Lymphatic Vessels In Non-small Cell Lung Cancer With Or Without Neoadjuvant Chemotherapy By Electron Microscope And Immunohistochemistry

AIMS: to evaluate the ultrastructure, morphous, density changes in microvessels and lymphatic vessels, and the proliferation of tumor cells and microvascular endothelial cells between the patients who had undergone operations after neoadjuvant chemotherapy (NACT group) and those who had undergone operations only(Control group),at the same time make the same evaluation in the same patients of pre-NACT and post-NACT for stage I-III non-small cell lung cancer(NSCLC) to explore the new proof of NACT. METHODS: Double immunohistochemistry was used to identify the expression of podoplanin, CD34 and Ki-67 in the formalin-fixed paraffin embedded sections of tumor tissues of pre-NACT and post-NACT sections from the 20 same patients and of NACT group and Control group sections from 35 different patients. Electron microscope was applied to identify the microvascular ultrastructural changes in the 5 same NSCLC's patients. RESULTS:1. The microvessel density (MVD) of pre-NACT and post-NACT have significant differences (t=3.98, p<0.01).The microlymphatic density(MLD) of those have statistic significance (t=2.20, p<0.05).Ki-67 Labling Index(Ki-67 LI) of tumor cells of those have significant differences (t=4.39, P<0.001).Ki-67 Index of microvascular endothelial cells of those have significant differences(t=2.87, p<0.01). 2. MVD of NACT group and Control group are separately 52.22±9.36 and 62.96±16.35, which shows significant differences(t=3.37, P<0.01). MLD of those are separately 10.80±3.00 and 12.95±3.86, which shows statistic significance(t=2.60,P<0.05). Ki-67 LI of tumor cells of those are separately (32.53 ± 10.20)% and (43.71 ± 14.03)%, which shows significant differences(t=3.81,P<0.001). Ki-67 LI of microvascular endothelial cells of those are separately (20±7.1)% and (23±8.3)%, which shows statistic significance (t=2.04,P<0.05).3.Ultrastrucrural observation:The ultrastructural changes in microvessels in NSCLC with NACT showed vacuolar degeneration of endothelial cells and thickening of the basal membrane. CONCLUSIONS: 1. NACT obviously inhibited NSCLC's angiogenesis. 2. NACT had an inhibition to a certain extent on the formation of lymphatic vessels in NSCLC. 3. NACT inhibited significantly the proliferation activity of tumor cells in NSCLC. 4. After NACT the ultrastructure of microvessels had been damaged.