| objective: To analyze the differences of clinical symptoms,serum tumor markers,blood coagulation status-related indicators,imaging features and PET/CT(positron emission tomography/X-ray tomography)in Primary Pulmonary Squamous Carcinoma(PPSC)and Primary Pulmonary Adenocarcinoma(PPAC),and to explore the difference of clinical features between Primary Pulmonary Squamous Carcinoma and Primary Pulmonary Adenocarcinoma,in addition,the SUVmax value of primary lesions,tumor size and TNM staging of PPSC and PPAC were analyzed by correlation analysis.Methods :A retrospective analysis of patients who were considered with lung cancer after 18F-FDG PET/CT examination in Southwest Medical University First Affiliated Hospital during January 2013-May 2016,we selected patients diagnosed as primary non-small cell lung cancer(primary NSCLC)by pathological and immunohistochemical examination and consummated the 18F-FDG PET/CT examinations,whose histological or cytological basis were obtained by surgery,bending fiber bronchoscopy,medical thoracoscopy,percutaneous lung puncture,lymph node puncture and other methods.All the cases were divided into PPSC group and PPAC group,we analyzed and compared the difference of gender,age,smoking status,clinical symptoms(whether cough,hemoptysis and dyspnea,chest pain,fever,weight loss,etc.),serum tumor markers CEA(carcino-embryonic antigen),NSE(neuron-specific enolase),CA125(carbohydrate antigen 125),SCCA(squamous cell carcinoma associated antigen)and CYFRA-21-1(cytokeratin 19 Fragments),blood coagulation status-related indicator D-dimer,FIB(plasma fibrinogen),platelet count,chest CT imaging features of primary lesions(lobulation,spiculation,pleural traction,obstructive pulmonary atelectasis,obstructive pneumonia,vacuole sign,tracheal stenosis,etc.),the size of primary lesion,SUVmax value in 18F-FDG PET/CT(maximum standard uptake value)and other aspects of two different pathological types of lung cancer patients and the SUVmax value of primary lesions and tumor size were analyzed by correlation analysis,in addition,the PPSC group and PPAC group were devided into three subgroups respectively according to the size of the primary tumor,(diameter<3cm subgroup,3cm<diameter?7cm subgroup,diameter>7cm subgroup),analyzed the differences between the three subgroups of primary lesion SUVmax value,respectively,the SUVmax value of primary lesion and TNM staging were analyzed by correlation analysis.Results: 1.General situations: The total number of cases was 259,the total number of PPSC group was 116,and the total number of PPAC group was 143.In addition,the percentage of sex in PPAC group was 51.7%(74 cases)and 48.3%(69 cases),male and female respectively.The sex ratio of PPSC group was 94.0%(109 cases)and 6.0%(7 cases),respectively.There was significant difference between the two groups(P <0.05).The minimum age in PPAC group was 29 years,the maximum age was 80 years,the average age was(57.2±11.0)years,the youngest age in the PPSC group was 37 years,the oldest age was 83 years,the average age was(58.4±9.4)years.There was no significant difference between the two groups.The smoking rates in PPSC group and PPAC group were 87.1%(101cases)and 40.5%(58cases)respectively,and there was significant difference between the two groups(P <0.05).2.Clinical symptoms: in PPSC group,99 cases(85.3%)of cough,50 cases(43.1%)of hemoptysis,53 cases(45.7%)of dyspnea,49 cases(42.2%)of weight loss.Besides,in PPAC group,there were 37 cases(72.0%)of cough,35 cases(24.5%)of hemoptysis,37 cases(25.9%)of dyspnea,41 cases(28.7%)of weight loss,the incidence of clinical symptoms(cough,hemoptysis,dyspnea,weight decreased)in PPSC group was higher than that in PPAC group,the difference between the two groups was statistically significant.3.The serum tumor markers: the levels of CEA,NSE,CA125,SCCA and CYFRA-21-1 in serum of patients with primary pulmonary squamous carcinoma were(9.16±18.35)ng/ml,(11.91±10.39)ng/ml,(48.78±108.24)IU/ml,(11.18±30.57)IU/ml,(9.23±15.25)ng/ml,the levels of CEA,NSE,CA125,SCCA and CYFRA-21-1 in serum of patients with primary pulmonary adenocarcinoma were(24.27±36.37)ng/ml,(10.61±9.08)ng/ml,(140.09±250.65)IU/ml,(1.29±2.86)IU/ml,(9.16±21.71)ng/ml.The content of CEA and CA125 in serum of PPAC group was higher than that in PPSC group,and the content of SCFR and CYFRA-21-1 were lower than that of PPSC group,the difference between the two groups was statistically significant.4.Blood coagulation status-related indicators: The levels of D-dimer in PPAC group were(1.66±2.51)ug/ml and higher than that(0.59±0.49)ug/ml in PPSC group,the difference was statistically significant.The content of platelet in PPSC group and PPAC group was not significantly different,(297.36±93.21)×109/L,(288.46±89.56)×109/L respectively.There was no significant difference in FIB(plasma fibrinogen)between these two groups,(4.32±1.28)g/L and(4.47±1.42)g/L respectively.5.Imaging examination: the size of the primary lesions in PPSC group were(5.15±2.40)cm,which was greater than that(3.73±2.10)cm of PPAC group,the differences between the two groups were statistically significant,the mean value of primary lesions SUVmax in PPSC group were(13.22±4.92)and higher than that of PPAC group(8.94±4.06),the differences between the two groups were statistically significant.In the PPSC group,there were 67 cases(57.3%)of lobulation,20 cases(17.2%)of spiculation,40 cases(34.5%)of pleural traction,41 cases(35.3%)of obstructive pulmonary atelectasis,39 cases(33.6%)of obstructive pneumonia,12 cases(10.3%)of vacuole sign,57 cases(49.1%)of tracheal stenosis primary lesions,In the PPAC group,there were 88 cases(61.5%)of lobulation,32 cases(22.4%)of spiculation,82 cases(57.3%)of pleural traction,18 cases(12.6%)of obstructive pulmonary atelectasis,17 cases(11.9%)of obstructive pneumonia,15 cases(10.5%)of vacuole sign,36 cases(25.2%)of tracheal stenosis primary lesions respectively.In addition,the incidence of obstructive pulmonary atelectasis,obstructive pneumonia,tracheal stenosis of the thoracic CT examinations in PPSC group was higher than that in PPAC group but the incidence of pleural traction were lower than that in PPAC group,the difference between the two groups was statistically significant.6.Correlation analysis: The SUVmax value of primary tumor in PPSC group had significant positive correlation with primary tumor size,the correlation coefficient was 0.31(P=0.008),and there were differences in different SUVmax primary tumor size between subgroups,the greater the primary lesion,the higher the SUVmax value.The SUVmax value of primary tumor were significantly correlated with T stage,correlation coefficient was 0.324(P=0.005),but had no significant correlation and N stage,M stage,the correlation coefficient was 0.066(P=0.581),0.046(P=0.699);Besides,the SUVmax value of primary tumor in PPAC group also had significant positive correlation with primary tumor size,the correlation coefficient was 0.41(P=0),and there were differences in different SUVmax primary tumor size between subgroups,the greater the primary lesion,the higher the SUVmax value.the correlation coefficient between SUVmax value and T stage was 0.479(P=0),the correlation coefficient between N stage and M stage were 0.268(P=0.011),0.262(P=0.013)respectively,the SUVmax value of primary lesion were significantly correlated with T staging,N staging and M staging.Conclusion: 1.The proportion of male and the rate of smoking in PPSC group were higher than that in PPAC group and there was no significant difference in the age structure of PPSC group and PPAC group.2.The incidence of clinical symptoms(cough,hemoptysis,dyspnea,weight loss)in PPSC group was higher than that in PPAC group.3.The serum levels of CEA and CA125 in patients of PPAC group were higher than those of patients in PPSC group,the content of SCCA and CYFRA-21-1were lower than that of patients in PPSC group.4.The D-dimers in serum of patients in PPAC group may be higher than that in PPSC group,and there was no significant difference in blood platelet and FIB in patients of two groups.5.According to the thoracic CT examination,the proportions of obstructive atelectasis,obstructive pneumonia,and tracheal stenosis of patients in PPSC group were higher than that of patients in PPAC group,whereas the incidence of spiculation of patients in PPAC group was higher than that of patients in PPSC group.The size of the primary tumor and the SUVmax value of the primary tumor in the PPSC group were higher than those in the PPAC group.6.The SUVmax value was significantly correlated with the size of primary tumor positively both in in PPSC group and PPAC group,the greater the primary lesion,the higher the SUVmax value;The SUVmax value of primary tumor were significantly correlated with T stage,the SUVmax value was higher,the stage was later.In addition,the SUVmax value in PPAC group was significantly correlated with T stage,N stage and M stage,and the SUVmax value was higher,the stage was later. |
PDF Full Text Request