ABSTRACT
BACKGROUND The aim of this study was to examine the role of magnetic resonance imaging-diffusion weighted imaging (MRI-DWI) in the early detection of chemotherapy resistance in non-small cell lung cancer (NSCLC) patients. MATERIAL AND METHODS MRI-DWI and computed tomography (CT) were carried out in 75 patients with newly diagnostic NSCLC before and after first, second, fourth, and sixth cycles of chemotherapy. Resistance to chemotherapy was assessed based on the change in the largest tumor diameter after chemotherapy. Diffusion of water molecule in each lesion was quantitatively measured by apparent diffusion coefficient (ADC). The diagnostic results of DWI after first and second cycle of chemotherapy were analyzed by the area under receiver operating characteristics curve (ROC). RESULTS Among the patients, 43 patients were chemo-resistance while 32 patients were chemo-sensitive. The ADC changing rate between second and first cycle of chemotherapy was significantly higher in chemo-sensitive patients compared with chemo-resistance patients (t=3.236, P=0.002). The ROC showed cutoff values of the ADC changing rate after first and second cycles of chemotherapy for resistance/sensitive discrimination were 23.6% and 5.56%, respectively. DWI after first and second cycles of therapy showed sensitivities of 55.8% and 55.8%, specificities of 65.6% and 87.5%, and area under ROC of 0.568 and 0.733, respectively. CONCLUSIONS ADC changing rate between first and second cycles of chemotherapy could sensitively distinguish chemo-sensitive and chemo-resistant tumors at earlier stages, which may direct treatment adjustment and improve the prognosis of patients.
Subject(s)
Carcinoma, Non-Small-Cell Lung/diagnostic imaging , Carcinoma, Non-Small-Cell Lung/diagnosis , Diffusion Magnetic Resonance Imaging , Drug Resistance, Neoplasm , Early Detection of Cancer , Lung Neoplasms/diagnostic imaging , Lung Neoplasms/diagnosis , Female , Humans , Male , Middle Aged , ROC Curve , Tomography, X-Ray ComputedABSTRACT
BACKGROUND: E-cadherin is a subclass of the cadherin family that plays an important role in the maintenance of intercellular junctions in normal epithelium.Decreased expression of E-cadherin might be closely related to invasiveness and dedifferentiation in human cancers.There is increasing evidence that modulation of the E-cadherin-catenin cell-cell adhesion complex is an important step in the initiation and progression of human cancers.The aim of this study is to investigate the relationship between the level of E-cadherin mRNA expression and pathological grades and clinical stages of non-small cell lung cancer(NSCLC). METHODS: RT-PCR was used to measure the level of E-cadherin mRNA expression in 53 specimens of NSCLC,46 of para-cancer lung tissues,5 of benign nodal lung diseases,and the stages of disease was determined according to the results of surgery,pathology and imaging diagnoses.Then analyses were carried out between the level of E-cadherin mRNA expression and the clinical variables. RESULTS: 45.3%(24/53) and 45.7%(21/46) specimens of NSCLC and para-cancer lung tissue were positive for E-cadherin mRNA expression respectively(P > 0.05);NSCLC with low differentiation,advanced stages and nodal metastases showed a magnificantly lower expression of E-cadherin mRNA(P < 0.05).The median survival time for E-cadherin mRNA positive and negative patients were 15.5 months and 46 months,respectively,but the expression of E-cadherin mRNA did not correlate with patient's survival(P > 0.05). CONCLUSIONS: E-cadherin expression is related to the differentiation,lymph node metastasis and pathological staging of NSCLC,but probably does not effectively affect its prognosis.
