A Correlative Study Of CT Presentation With Histo-differentiation And Ki67、 P53expression In Peripheral Lung Cancer

In order to study the effect of peripheral lung cancer by spiral CT signsand tissue differentiation and immunohistochemistry of the relationship,according to the imaging appearances of the main characteristics of putativeperipheral lung pathology and immunohistochemical characteristics, so as todevelop the research programme. The results of this study show that, afterscanning reconstruction and the original axial to obtain a satisfactory image，lobulation sign, spiculation sign,tumor diameter less than3.0cm and having anair-bronchogram sign in patients with lung cancer, and the correlation ofexpression of Ki67antigen; There are spines, ground glass opacity, voids orcalcification and lymph node metastasis of lung cancer cases and Ki67antigenexpression in the absence of a clear correlation between the expression of Ki67antigen, and no statistical significance; Peripheral lung tumor diameter less than3.0cm and lymph node metastasis of peripheral lung cancer patients, andP53protein expression is associated with more than CT signs, no clearcorrelation; Lymph node metastasis and tissue differentiation betweenperipheral lung cancer, and other CT features and histological differentiation ofthe correlation is not strong. The spiral CT in peripheral lung cancerpreoperative tissue can make pathology at the initial assessment, for clinicalprovides preoperative tissue differentiation and immunological aspects ofinformation, to guide the clinical treatment.Objective： To investigate the connections among the imagingpresentations of peripheral lung cancer in Multiple Slice ComputerTomography(MSCT) scanning and its postoperative pathology organizationdifferentiation and p53、 Ki67expression. Materials and Methods:62cases with peripheral lung cancer which werediagnoised by pathological mechanism after pulmonary lobectomy throughoperation or thoracoscope were retrospective studied.These patients werecollecting from January2011to January2012.And all cases had got access toplain scanning or contrast-enhancement scanning using Siemens dual-sourceCT or64row helical CT.Among the cases,men38and women24,aging from33to79year,the middle age is62.They had suffered from the disease somemonths or some years.The region of scanning is from the apex of lung to thebottom of lung.During contrast-enhancement scanning, We used nonioniccontrast medium(Omnipaque300or ultravist300) through antecubital veinwith a kind of double tube high pressure injectors of a company named Medradin United States. We used lung double period scanning method,the arterialphase is20-25s after Injecting medium; the venous phase is25-35s afterInjecting medium.Scanning parameters:helical alignment64x1.25, scanning interval5mm,slice thickness5mm,120~140kV tube voltage, tube current260~320mAs, intothe bed velocity12mm/s,0.7s gantry rotation time.After scanning the originaldata for thin layer reconstruction, a thickness of1.25~1.5mm, and the data istransmitted to a workstation for multiple planar reconstruction, observation ofaxial CT and post-processing images, the evaluation of patients with imagequality, through the shaft phase and multi planar reconstruction like acombination of integrated way to analysis of lesions on CT indications(CT3Dimage of lobulation sign, spiculation sign, spines, tumor diameter greater than orequal to3cm, voids or calcification, ground glass opacity, air-bronchogramsign, and mediastinal lymph node metastasis from8aspects such as CTperformance),Than, The CT diagnosis and pathologic findings andimmunohistochemistry for comparison, the application of SPSS18.0softwarefor statistical analysis, Study of peripheral type carcinoma CT findings and histological differentiation, immunohistochemical factors p53and Ki67correlates, in peripheral lung cancer imaging findings and has certainassociated.Results:1、 Low differentiation groups15cases, middle and highdifferentiation groups47cases. The statistics analysis suggests Peripheral lungcancer lymph node metastasis and lung cancer organization differentiationdegree closely related（χ2=19.463，P=0.000），and failed to see clear correlationswith other signs of CT findings.2、There are26cases with P53expresspositive(41.9%),36cases P53express negative(58.1%), The statistics analysisshows relations between Lymph node metastasis (χ2=6.681，P=0.010) andtumor’s biggest diameter≥3.0cm (χ2=10.771，P=0.001) with p53express.3、There are21cases with Ki67express positive(33.8%),41cases Ki67expressnegative(66.2%). The statistics analysis illustrates there is a connectionbetween cancer’s signoflobulation(χ2=6.948， P=0.008)、 Spicular Sign（χ2=6.147，P=0.018）、tumor’s biggest diameter≥3.0cm(χ2=11.061，P=0.001)、Containing gas bronchial levy（χ2=5.885，P=0.015）with Ki67express.Conclusion: As a very important,a simple, and non-invasive method ofinspection, MSCT could estimate the relationship between peripheral lungcancer’s imaging findings and organization differentiation、 p53、 Ki67expression preliminary.And then understanding the biology behavior andimmunohistochemical characteristics of peripheral lung cancer on the level ofpathology and molecular. Then we can make an accurate assess to the tumors’recurrent, distant metastasis and prognosis degree. It also has a gooddiagnostic value in preoperative diagnosising for peripheral lung cancerorganization differentiation degree, analysing and evaluating of surgical clinicalprognostic.