RESUMEN
Objective:To explore the role of active screening in the diagnosis and treatment of early lung cancer, and give health management recommendations.Methods:A retrospective study was conducted to collect lung cancer patients who had complete population sociology, clinical information, pathology and imaging characteristics in the Thoracic Surgery in Xiangya Hospital of Central South University from 2016 to 2019. According to different diagnostic modes, they were divided into an active screening group (1082 cases) and a passive case finding group (974 cases), to analyze their differences in demographic sociological, clinical information, pathology and imaging characteristics, and to discuss the key points of population management in the active screening group.Results:From 2016 to 2019, the proportion of lung cancer patients in the active screening group increased from 36.1% to 54.2%, and the proportion of patients found to have lung cancer by CT examination in the active screening group increased from 82.2% to 96.8%. Compared with the passive case finding group, the active screening group had a higher proportion of women, non-smokers, patients with precursor glandular lesions and adenocarcinoma, patients in stage 0 and stage I, patients with lesion diameter (d)≤1 cm and 1<d≤2 cm, patients with sublobectomy and lymph node sampling (46.9% vs 32.9%, 59.2% vs 43.8%, 4.0% vs 2.1%, 80.5% vs 56.8%, 4.0% vs 2.1%, 72.0% vs 56.8%, 14.5% vs 7.6%, 42.5% vs 33.3%, 6.3% vs 2.9%, 2.4% vs 1.0%, respectively, all P<0.05). Conclusion:Active screening is helpful to find early lung cancer, and the health management and physical examination center should pay attention to the management of such physical examination population.
RESUMEN
In the outbreak of COVID-19,triage procedures based on epidemiology were implemented in a local hospital in Changsha to control the transmission of SARS-CoV-2 and avoid healthcare-associated infection.This re-trospective study analyzed the data collected during the triage period and found that COVID-19 patients were en-riched 7 folds into the Section A designated for patients with obvious epidemiological history.On the other side,nearly triple amounts of visits were received at the Section B for patients without obvious epidemiological history.8 COVID-19 cases were spotted out of 247 suspected patients.More than 50%of the suspected patients were submi-tted to multiple rounds of nucleic acid analysis for SARS-CoV-2 infection.Of the 239 patients who were diagnosed as negative of the virus infection,188 were successfully revisited and none was reported as COVID-19 case.Of the 8 COVID-19 patients,3 were confirmed only after multiple rounds of nucleic acid analysis.Besides comorbidities,delayed sharing of epidemiological history added complexity to the diagnosis in practice.The triaging experience and strategy will be helpful for the control of infectious diseases in the future.
RESUMEN
OBJECTIVES@#Low dose computed tomography (LDCT) is the best method for early diagnosis of lung cancer. Even though it has been widely used in clinic, the selection of screening objects and the management scheme of pulmonary nodules are still not unified among research institutions. This study aims to evaluate the effect of LDCT in detection effect and follow-up process for pulmonary nodules in asymptomatic participants.@*METHODS@#A total of 1 600 asymptomatic participants (37 to 82 years old), who came from Yantian District People's Hospital, Southern University of Science and Technology, received LDCT. The lung nodules were categorized into positive nodules and semi-positive nodules, and according to the density of positive nodules they were categorized into 4 types: solid nodules (SN), partial solid nodules (pSN), pure ground glass nodules (pGGN), and pleural nodules (PN). The number, detection rate, imaging findings, follow-up change of lung nodules, and the postoperative pathological results of positive nodules were recorded and analyzed.@*RESULTS@#Lung nodules were found in 221 cases by LDCT. The total detection rate of lung nodule was 13.8% (221/1 600), and the detection rate in positive nodules was 4.9% (79/1 600). The detected nodules were mainly single (173 cases), solid (133 cases) and semi-positive nodules (142 cases). Most of nodules (177 cases) had no change in the follow-up process. The enlargement and/or increased density of nodules (5 cases) were lung cancer. Pathological results were obtained in 10 cases, 8 cases were malignant (1 small cell lung cancer and 7 adenocarcinomas), 2 cases were benign (cryptococcal infection and alveolar epithelial dysplasia). The detection rate of lung cancer was 0.5% (8/1 600), and the proportion of early lung cancer was 75% (6/8).@*CONCLUSIONS@#LDCT screening can identify and increase the detection rate in the early lung cancer, which is an effective screening method. It is safe and feasible to take regular follow-up and re-examination for nodules with diameter less than 5 mm. When the size and or density of nodule increases, it indicates the malignant prognosis of the nodule and timely clinical intervention is needed.
Asunto(s)
Adulto , Anciano , Anciano de 80 o más Años , Humanos , Persona de Mediana Edad , Adenocarcinoma , Detección Precoz del Cáncer/métodos , Neoplasias Pulmonares/patología , Tamizaje Masivo/métodos , Tomografía Computarizada por Rayos X/métodosRESUMEN
With the development of treatment, the survival rate of premature infants has significantly increased, especially extremely premature infants and very low birth weight infants. This has led to an increase in incidence of bronchopulmonary dysplasia (BPD) year by year. BPD has been one of the most common respiratory system diseases in premature infants, especially the small premature infants. Arrested alveolar development is an important cause of BPD. Therefore, the mechanism of arrested alveolar development and the intervention measures for promoting alveolar development are the focuses of research on BPD. Selecting the appropriate animal model of BPD is the key to obtaining meaningful results in the basic research on BPD. Based on above, several common methods for establishing an animal model of BPD and the corresponding changes in pathophysiology are summarized and evaluated in order to provide a reference for selecting the appropriate animal model in studies on the pathogenesis, pathophysiology, and prevention and control strategies of BPD.
Asunto(s)
Animales , Humanos , Displasia Broncopulmonar , Modelos Animales de Enfermedad , Hiperoxia , Respiración ArtificialRESUMEN
Objective:To analyze the features of the connective tissue associated interstitial lung disease (CTD-ILD) by high resolution computed tomography (HRCT).Methods:A total of 127 patients with CTD-ILD,who were diagnosed by clinic laboratory examination and pathology in Xiangya Hospital of Central South University form September 2013 to September 2015,were enrolled for this study.Their lung features of HRCT imaging were retrospectively analyzed.Results:The classifications for 127 patients were as follows:36 cases of rheumatoid arthritis (28.3%),34 cases of dermatomyositis and polymyositis (26.8%),31 cases of systemic sclerosis (24.4%),18 cases of Sj(o)gren syndrome (14.2%),7 cases of mixed connective tissue disease (5.5%),and 1 cases of systemic lupus erythematosus (0.8%).According to the features of HRCT imaging,the patients were divided as follows:77 cases (60.6%) ofnonspecific interstitial pneumonia (NSIP),46 cases (36.2%) of usual interstitial pneumonia (UIP),2 cases (1.6%) of lymphocytic interstitial pneumonia (LIP),1 case (0.8%) of cryptogenic interstitial pneumonia (COP),and 1 case (0.8%) of acute interstitial pneumonia (AIP).The HRCT findings for 36 cases of rheumatoid arthritis associated interstitial lung disease were UIP (24 cases,66.7%) and NSIP (12 cases,33.3%);the HRCT findings for 34 cases of dermatomyositis and polymyositis associated interstitial lung disease were NSIP (32 cases,94.1%),UIP (1 case,2.9%) and COP (1 case,2.9%);the HRCT findings for 31 cases of systemic sclerosis associated interstitial lung disease were NSIP (21 cases,67.8%),UIP.(9 cases,29%),LIP(1 case,3.2%);the HRCT findings for 18 cases of Sj(o)gren syndrome associated interstitial lung disease were NSIP (9 cases,50.0%),UIP (8 cases,44.4%),LIP (1 case,5.6%);the HRCT findings for 7 cases of mixed connective tissue disease associated interstitial lung disease were UIP (4 cases,57.1%),NSIP (3 cases,42.9%).SLE-ILD was rare,with only 1 case of AIP.Conclusion:Different types of CTD-ILD patients display relatively unique manifestation of HRCT.
RESUMEN
AIM@#Microvasculature and microenvironment play important roles in proliferation, invasion, metastasis and prognosis in non-small cell lung cancer (NSCLC), which might be altered by many anti-angiogenic drugs. Epigallocatechin-3-gallate (EGCG), a natural anti-angiogenesis agent refined from green tea, was defined to have multiple effects on angiogenesis factors, such as endothelial growth factor (VEGF), platelet-derived growth factor (PDGF) and angiopoietins (ANGs). Hypothesizing that EGCG might regulate microvasculature and microenvironment in NSCLC, the effects of EGCG on microvessel density (MVD), expression of Ang-1 and Ang-2, interstitial fluid pressure (IFP), tumor hypoxia, and chemotherapy sensitivity were examined.@*METHODS AND RESULTS@#EGCG treatment of A549 cells in mice bearing xenografts in vivo led to a significant decrease of MVD detected by CD31, and of Ang-2 expression detected by quantum dots double-label immunofluorescence assessment, while Ang-1 decreased with no significance. Decreased IFP was measured by the Wink-in-needle method, while hypoxia was assessed by polarographic electrode and pimonidazole (PIMO) immunohistochemistry. Assuming that these changes would increase response to chemotherapy, tumor growth studies were p[erformed in nude mice with xenografts, which were then treated with EGCG and the chemotherapeutic agent cisplatin. EGCG therapy combined with cisplatin led to synergistic inhibition of tumor growth, compared with administration of each treatment separately (P < 0.001). According to linear regression analysis, IFP was positively correlated with PIMO staining (R(2) = 0.618, P = 0.002), Ang-2 was correlated with MVD (R(2) = 0.423, P = 0.022), IFP (R(2) = 0.663, P = 0.01) and PIMO staining (R(2) = 0.694, P = 0.01).@*CONCLUSION@#IFP and delivery of oxygen might be improved by rebalance of Ang-1/Ang-2 under the treatment of EGCG in NSCLC, which also acts as a sensitizer of chemotherapy. These studies established a new mechanism for using EGCG as an adjuvant chemotherapy agent through modifying microvasculature and microenvironment.
Asunto(s)
Animales , Femenino , Humanos , Ratones , Inhibidores de la Angiogénesis , Angiopoyetina 1 , Genética , Metabolismo , Angiopoyetina 2 , Genética , Metabolismo , Antineoplásicos , Usos Terapéuticos , Carcinoma de Pulmón de Células no Pequeñas , Quimioterapia , Genética , Metabolismo , Catequina , Quimioterapia Adyuvante , Cisplatino , Usos Terapéuticos , Quimioterapia Combinada , Líquido Extracelular , Metabolismo , Neoplasias Pulmonares , Quimioterapia , Genética , Metabolismo , Ratones Endogámicos BALB C , Ratones Desnudos , Oxígeno , MetabolismoRESUMEN
<p><b>OBJECTIVE</b>To investigate the correlation between blood flow assessed by CT perfusion imaging and characteristics of microvascular ultrastructure in non-small cell lung cancer (NSCLC).</p><p><b>METHODS</b>twenty-eight patients with non-small cell lung cancer proven surgically and pathologically underwent perfusion CT examination. The patients were divided into a hyper-perfusion group and a hypo-perfusion group by the median value of blood flow, and then the differences of microvascular ultrastructure in the two groups were analyzed.</p><p><b>RESULTS</b>The median BF value of the 28 patients was 36.40 ml×100 g(-1)×min(-1). Take this median value as the boundary, the group with hypo-perfusion showed a significantly lower BF value than the group with hyper-perfusion [(30.84 ± 4.79) ml×100 g(-1)×min(-1) vs. (49.67 ± 10.89) ml×100 g(-1)×min(-1), t = -5.925, P < 0.001]. The group with lymph node metastasis showed a significantly lower BF value than the group without lymph node metastasis [(30.78 ± 5.24) ml×100 g(-1)×min(-1) vs. (50.73 ± 11.16) ml×100 g(-1)×min(-1), t = 3.490, P = 0.015]. The maturity of microvessels of the hyper-perfusion group was higher than that of the hypo-perfusion group. Under the electron microscope, the microvessels in the hypo-perfusion group showed a more narrow lumen, poorer integrity of basement membrane, a more close relationship between cancer cells and microvascular wall, and cancer cells were more easily seen in the microvascular lumen.</p><p><b>CONCLUSION</b>The blood flow value of CT perfusion imaging may be related with the abnormal microvascular ultrastructure, and may be helpful to the prediction of metastasis risk in NSCLC.</p>
Asunto(s)
Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Carcinoma de Pulmón de Células no Pequeñas , Diagnóstico por Imagen , Metabolismo , Patología , Estudios de Seguimiento , Neoplasias Pulmonares , Diagnóstico por Imagen , Metabolismo , Patología , Metástasis Linfática , Microvasos , Diagnóstico por Imagen , Metástasis de la Neoplasia , Imagen de Perfusión , Tomografía Computarizada Espiral , Factor A de Crecimiento Endotelial Vascular , MetabolismoRESUMEN
Objective To investigate the teaching effect of‘index’teaching method used in practical teaching of the medical imaging.Methods A total of 178 medical undergraduates were selected this study,113 clinical medical students using‘index’teaching method were taken as experimental group while others 65 anesthesia medical students using traditional teaching method as control group.The teaching effect of‘index’teaching method was evaluated quantitatively and qualitatively by practical test and questionnaire survey.Results The test scors of experimental group were(80.3±16.5),obviously higher than those of(71.3±25.8)in control group(P<0.05),especially instudents with low scores.Conclusion The new teaching method had obvious advantages in culturing the thinking of imaging diagnosis and in improving the ability to solve clinical practical problems,the‘index’teaching method was more effective than traditional teaching method.
RESUMEN
OBJECTIVE@#To explore the degree, mechanism and clinical significance of three-dimensional tumor microvascular architecture phenotype heterogeneity (3D-TMAPH) in non-small cell carcinoma (NSCLC).@*METHODS@#Twenty-one samples of solitary pulmonary nodules were collected integrally. To establish two-dimensional tumor microvascular architecture phenotype (2D-TMAP) and three-dimensional tumor microvascular architecture phenotype (3D-TMAP), five layers of each nodule were selected and embedded in paraffin. Test indices included the expressions of vascular endothelial growth factor (VEGF), proliferating cell nuclear antigen (PCNA), EphB4, ephfinB2 and microvascular density marked by anti-CD34 (CD34-MVD). The degrees of 3D-TMAPH were evaluated by the coefficient of variation and extend of heterogeneity. Spearman rank correlation analysis was used to investigate the relationships between 2D-TMAP, 3D-TMAP and clinicopathological features.@*RESULTS@#3D-TMAPH showed that 2D-TMAP heterogeneity was expressed in the tissues of NSCLC. The heterogeneities in the malignant nodules were significantly higher than those in the active inflammatory nodules and tubercular nodules. In addition, different degrees of heterogeneity of CD34-MVD and PCNA were found in NSCLC tissues. The coefficients of variation of CD34- MVD and PCNA were positively related to the degree of differentiation (all P0.05). The level of heterogeneity of various expression indexes (ephrinB2, EphB4, VEGF) in NSCLC tissues were inconsistent, but there were no significant differences in heterogeneity in NSCLC tissues with different histological types (P>0.05).@*CONCLUSION@#3D-TMAPH exists widely in the microenvironment during the genesis and development of NSCLC and has a significant impact on its biological complexity.
Asunto(s)
Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Capilares , Carcinoma de Pulmón de Células no Pequeñas , Efrina-B2 , Metabolismo , Neoplasias Pulmonares , Neovascularización Patológica , Patología , Fenotipo , Antígeno Nuclear de Célula en Proliferación , Metabolismo , Factor A de Crecimiento Endotelial Vascular , MetabolismoRESUMEN
<p><b>OBJECTIVE</b>To investigate the role of the expression of ephrinB2 and EphB4 in non-small cell lung cancer (NSCLC), and their relationship with multi-slice spiral CT pulmonary perfusion imaging.</p><p><b>METHODS</b>Thirty-one nodules with pathologically proven NSCLC underwent CT perfusion scan. The perfusion parameters including blood flow (BF), blood volume (BV), peak enhancement image (PEI) were collected. The expression of ephrinB2 and EphB4 in tumor cells and interstitial vasculature were detected by immunohistochemistry. Correlation analysis and trend test were used to assess the relationship between ephrinB2/EphB4 expression and clinicopathological features, and between ephrinB2/EphB4 expression and perfusion parameters.</p><p><b>RESULTS</b>Positive expression of ephrinB2 and EphB4 in the NSCLC group was 83.9% and 71.0%, respectively, significantly higher than that in the internal control group (P < 0.01). The expression of ephrinB2 and EphB4 was consistently in tumor parenchyma but differently in tumor vessels. The expressions of ephrinB2 and EphB4 were positively correlated with lymphatic metastasis (P < 0.05). The expression of EphB4 was negatively correlated with blood flow (BF) and blood volume (BV), respectively (P < 0.05). There was a significant positive correlation between ephrinB2 expression and BF (r = 0.516, P = 0.003), and a positive correlation between ephrinB2 expression and BV (r = 0.448, P = 0.013). The expressions of ephrinB2 and EphB4 were not correlated with PEI (P > 0.05). The values of BF and BV in the high and moderate EphB4 expression groups were significantly decreased compared with that in the negative group (P < 0.01). The value of BF in the high ephrinB2 expression group was significantly increased compared with that in the moderately positive group and negative group (P < 0.01). The value of BV in the high ephrinB2 expression group was significantly increased compared with that in the negative group (P < 0.01).</p><p><b>CONCLUSION</b>The CT pulmonary perfusion imaging reflects the density difference of blood vessels with functional lumen, and such difference also depends on the quantity and quality of vasculature with functional lumen.</p>
Asunto(s)
Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Volumen Sanguíneo , Carcinoma de Pulmón de Células no Pequeñas , Diagnóstico por Imagen , Metabolismo , Patología , Efrina-B2 , Metabolismo , Neoplasias Pulmonares , Diagnóstico por Imagen , Metabolismo , Patología , Metástasis Linfática , Imagen de Perfusión , Circulación Pulmonar , Receptor EphB4 , Metabolismo , Tomografía Computarizada Espiral , MétodosRESUMEN
Experience-oriented teaching approach was introduced into the bilingual course of medical imaging in order to improve the teaching effect.This approach was performed through English literature translation activities and scene-teaching.Meanwhile it points out that this approach has particular advantages in stimulating students' interest and initiative in study.
RESUMEN
OBJECTIVE@#To investigate the relation between multi-slice spiral CT pulmonary perfusion imaging and the cavity of microvessel in lung cancer.@*METHODS@#Altogether 36 patients with malignant nodules who underwent multi-slice spiral CT perfusion scan were examined.The perfusion parameters were collected and compared with the microvessel density (MVD), the incomplete lumen MVD, and the differentiation of non-small cell lung cancer (NSCLC). The patients were divided into a hyper-perfusion group and a hypo-perfusion group by the value of perfusion parameters. The maturity of microvessel and the degree of differentiation in NSCLC between the 2 groups was analyzed.@*RESULTS@#Blood flow (BF), blood volume (BV), and peak enhancement image(PEI) of the malignant nodules were (39.7±11.5) mL/(100 mg.min), (8.6±3.8)mL/100 g, and (20.1±8.6)HU, respectively. There was a positive correlation between PEI and MVD(r=0.645,P<0.01), and a negative correlation between BF and MVD(r=-0.280,P=0.048). There were negative correlations of BF, BV, PEI with the incomplete lumen MVD (P<0.05). BF had the highest correlation coefficient(r=-0.882,P<0.01).The incomplete lumen MVD of the hyper-perfusion group was significantly lower than that of hypo-perfusion group (P<0.05),but there was no significant difference in MVD between the 2 groups. There were negative correlations of BF, BV,PEI with the degree of differentiation (P<0.05). BF had the highest correlation coefficient(r=-0.751,P<0.01).@*CONCLUSION@#Multi-slice spiral CT pulmonary perfusion imaging is helpful to evaluate the degree of differentiation and status of angiogenesis in lung cancer, and its basis is the cavity of microvessel.
Asunto(s)
Femenino , Humanos , Masculino , Capilares , Patología , Carcinoma de Pulmón de Células no Pequeñas , Diagnóstico por Imagen , Patología , Diagnóstico Diferencial , Neoplasias Pulmonares , Diagnóstico por Imagen , Patología , Neovascularización Patológica , Diagnóstico por Imagen , Nódulo Pulmonar Solitario , Diagnóstico por Imagen , Patología , Tomografía Computarizada Espiral , MétodosRESUMEN
OBJECTIVE@#To investigate the relation between expression of vascular endothelial growth factor (VEGF)/ proliferating cell nuclear antigen (PCNA) and multi-slice spiral computer tomography (MSCT) perfusion imaging.@*METHODS@#Sixty-one patients who underwent CT perfusion scan by 16-slice spiral CT were examined. Among them,22 were brought into our research after surgery. The corresponding layers of tumor tissue specimens to the layer of CT perfusion scan were selected to determine the expression of CD34,VEGF, and PCNA. Spearman correlation analysis was used to determine the relation between differentiation of non-small cell lung cancer (NSCLC), the expression of CD34,VEGF/PCNA, and CT perfusion parameters.@*RESULTS@#There was a lot of heterogeneity in VEGF and PCNA expression of NSCLC.The degree of differentiation had positive correlation with the uncomplete lumen of the surrounding area CD34-MVD and the expression of PCNA and VEGF (P<0.05).There were positive correlations between the uncomplete lumen of the surrounding area CD34-MVD and expression of VEGF and PCNA, respectively (both P<0.05). Blood flow (BF), blood volume (BV),and peak enhancement image (PEI) decreased with the decreasing differentiation of NSCLC (P<0.05). The total CD34-MVD showed a positive correlation with PEI (P<0.05),and the uncomplete lumen of the surrounding area CD34-MVD showed a negative correlation with BF,BV, and PEI (all P<0.05). The PCNA expression showed a negative correlation with BF,BV, and PEI (P<0.05).@*CONCLUSION@#PCNA and VEGF expression in NSCLC regulates angiogenesis and proliferation at the same time. Perfusion parameters reflect the expression of microvascular architecture phenotype, and exactly evaluate the malignant degree of tumor.
Asunto(s)
Femenino , Humanos , Masculino , Adenocarcinoma , Diagnóstico por Imagen , Patología , Carcinoma de Pulmón de Células no Pequeñas , Diagnóstico por Imagen , Patología , Carcinoma de Células Escamosas , Diagnóstico por Imagen , Patología , Proliferación Celular , Neoplasias Pulmonares , Diagnóstico por Imagen , Patología , Neovascularización Patológica , Antígeno Nuclear de Célula en Proliferación , Metabolismo , Tomografía Computarizada Espiral , Factor A de Crecimiento Endotelial Vascular , MetabolismoRESUMEN
OBJECTIVE@#To explore the feasibility and the value of Bayes analysis in clinical decision-making for solitary pulmonary nodules (SPNs).@*METHODS@#We collected 352 consecutive SPN patients (malignancy, n=135; benignity, n=217) retrospectively to form the training set. Utilizing Bayes analysis, the prior odds of malignant SPNs and the likelihood ratios of clinical and CT findings were derived from the training set, which were then used to calculate the probability of malignancy in each SPN. Bayes analysis was also tested prospectively for its diagnostic validation and precision of predictive probability on the test set of 132 SPN patients (malignancy, n=61; benignity, n=71), and compared with the performance of physicians using routine judgment. The actual results of patients diagnosis were analyzed according to the scale of calculated malignant probability in SPNs.@*RESULTS@#The sensitivity, specificity, and accuracy of Bayes analysis for the training samples were 88.9%, 93.1%, and 91.5%, respectively. In the test set, the sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of Bayes analysis were 88.5%, 85.9%, 87.1%, 84.4%, and 89.7%, respectively. The accuracy of Bayes analysis had no statistically significant difference with that of senior physician A (80.3%, chi2=2.37, P=0.122) and B (79.5%, chi2=3.12, P=0.076), and was higher than that of junior physician C (74.2%, chi2=7.05, P=0.012) and D (74.2%, chi2=6.56, P=0.009); The Brier score was 0.099, 0.140, 0.137,0.154, and 0.179 for Bayes analysis,senior physician A, senior physician B, junior physician C, and junior physician D, respectively. Excluding the solitary metastasis (n=11) misclassified, the false negative rate of Bayes analysis was 1.0% (5/484) for SPNs with <20% estimated probability of malignancy.@*CONCLUSION@#Bayes analysis is accurate in qualitative diagnosis, precise in forecasting the malignant probability, and has low false negative rate for SPNs. It is feasible to use Bayes analysis for the management of SPNs.
Asunto(s)
Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adenocarcinoma , Diagnóstico , Teorema de Bayes , Toma de Decisiones , Diagnóstico Diferencial , Estudios de Factibilidad , Neoplasias Pulmonares , Diagnóstico , Nódulo Pulmonar Solitario , Diagnóstico , Tomografía Computarizada por Rayos X , Tuberculoma , Diagnóstico , Tuberculosis Pulmonar , DiagnósticoRESUMEN
<p><b>OBJECTIVE</b>To investigate the structural characteristics and clinical significance of two-dimensional tumor microvascular architecture phenotype (2D-TMAP) in non-small cell lung cancer (NSCLC).</p><p><b>METHODS</b>Thirty surgical specimens of NSCLC were collected. The sections of the tumor tissues corresponding to the slice of CT perfusion imaging were selected to construct the 2D-TMAP expression. Spearman correlation analysis was used to examine the relation between the 2D-TMAP expression and the clinicopathological features of NSCLC.</p><p><b>RESULTS</b>A heterogeneity was noted in the 2D-TMAP expression of NSCLC. The microvascular density (MVD) in the area surrounding the tumor was higher than that in the central area, but the difference was not statistically significant. The density of the microvessels without intact lumen was significantly greater in the surrounding area than in the central area (P=0.030). The total MVD was not correlated to tumor differentiation (r=0.042, P=0.831). The density of the microvessels without intact lumen in the surrounding area was positively correlated to degree of tumor differentiation and lymph node metastasis (r=0.528 and 0.533, P=0.041 and 0.028, respectively), and also to the expressions of vascular endothelial growth factor (VEGF), ephrinB2, EphB4, and proliferating cell nuclear antigen (PCNA) (r=0.504, 0.549, 0.549, and 0.370; P=0.005, 0.002, 0.002, and 0.048, respectively). The degree of tumor differentiation was positively correlated to PCNA and VEGF expression (r=0.604 and 0.370, P=0.001 and 0.048, respectively), but inversely to the integrity of microvascular basement membrane (r=-0.531, P=0.033).</p><p><b>CONCLUSION</b>The 2D-TMAP suggests the overall state of the micro-environment for tumor growth. The 2D-TMAP of NSCLC regulates angiogenesis and tumor cell proliferation through a mesh-like structure, and better understanding of the characteristics and possible mechanism of 2D-TMAP expression can be of great clinical importance.</p>
Asunto(s)
Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Capilares , Carcinoma de Pulmón de Células no Pequeñas , Diagnóstico por Imagen , Neoplasias Pulmonares , Diagnóstico por Imagen , Tomografía Computarizada EspiralRESUMEN
<p><b>OBJECTIVE</b>To determine the significance of MSCT perfusion scan on differentiation of NSCLC and to investigate its possible mechanisms.</p><p><b>METHODS</b>Forty four NSCLC patients underwent CT perfusion scan by MSCT. Among them, 22 cases were selected to detected the two-dimensional tumor microvascular architecture phenotype (2D-TMAP), the relationships between CT perfusion parameters (BF, BV, PEI, TIP), and the differentiation of NSCLC were analysed by using the correlation analysis and trend test. Spearman correlation analysis was used to study the relationships between CT perfusion parameters, differentiation, and 2D-TMAP.</p><p><b>RESULTS</b>The total BF, BV and PEI decreased with decreasing differentiation of NSCLC (P<0.05). The total PEI showed a positive correlation with the total MVD (P<0.05). There were negative correlations between the surrounding area BF, the total BF, BV, and PEI, the uncomplete lumen of the surrounding area MVD, and expression of PCNA, respectively (P<0.05). There were positive correlations between degree of differentiation and the uncomplete lumen of the surrounding area MVD (P<0.05). It was the same as degree of differentiation and expression of PCNA, VEGF, respectively. There were positive correlations between the uncomplete lumen of the surrounding area MVD and expression of VEGF, ephrinB2, EphB4, and PCNA, respectively (P<0.05).</p><p><b>CONCLUSION</b>Perfusion parameters reflect the difference of density of vassels with mature functional lumen. Careful evaluation of the differences of blood flow pattern in pulmonary space-occupying lesions by MSCT perfusion scan can be used to identify the degree of NSCLC differentiation.</p>
Asunto(s)
Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven , Carcinoma de Pulmón de Células no Pequeñas , Diagnóstico por Imagen , Patología , Diferenciación Celular , Pulmón , Diagnóstico por Imagen , Patología , Neoplasias Pulmonares , Diagnóstico por Imagen , Patología , Microvasos , Diagnóstico por Imagen , Patología , Neovascularización Patológica , Diagnóstico por Imagen , Patología , Perfusión , Tomografía Computarizada Espiral , Métodos , Factor A de Crecimiento Endotelial VascularRESUMEN
OBJECTIVE@#To construct a technological platform of 2-dimensional tumor microvascular architecture phenotype (2D-TAMP) expression.@*METHODS@#Thirty samples of non-small cell lung cancer (NSCLC) were collected after surgery. The corresponding sections of tumor tissue specimens to the slice of CT perfusion imaging were selected. Immunohistochemical staining,Gomori methenamine silver stain, and electron microscope observation were performed to build a technological platform of 2D-TMAP expression by detecting the morphology and the integrity of basement membrane of microvasculature, microvascular density, various microvascular subtype, the degree of the maturity and lumenization of microvasculature, and the characteristics of immunogenetics of microvasculature.@*RESULTS@#The technological platform of 2D-TMAP expression was constructed successfully. There was heterogeneity in 2D-TMAP expression of non-small cell lung cancer. The microvascular of NSCLC had certain characteristics.@*CONCLUSION@#2D-TMAP is a key technology that can be used to observe the overall state of micro-environment in tumor growth.
Asunto(s)
Humanos , Capilares , Carcinoma de Pulmón de Células no Pequeñas , Patología , Neoplasias Pulmonares , Patología , Neovascularización Patológica , Patología , Fenotipo , Flujo Sanguíneo Regional , FisiologíaRESUMEN
benign,of which,there were significan differences in PV and PE value between any two of the three lesions. There were significant differences in BV value only between benign and inflammatory pulmonary lesions(P0. 05). Conclusion CT perfusion imaging is of important value in differentiating inflammatory,malignant and benign masses of the lung and estimating the degree of malignancy of lung cancer.
RESUMEN
0.05),but existed between B0 and B10,B5 and B10(P