非小细胞肺癌podoplanin阳性淋巴管密度与多层螺旋CT表现的关系

Correlation between Podoplanin-positive Lymphatic Microvessel Density and CT Characteristics of Non-small Cell Lung Cancer

背景与目的现有的研究表明:肺癌微淋巴管密度(lymphatic microvessel density,LMVD)与淋巴结转移密切相关,但与肺癌多层螺旋CT(multi-slice spiral computed tomography,MSCT)的影像学改变的相关性尚不十分清楚。本研究通过podoplanin标记非小细胞肺癌患者手术标本微淋巴管并计数LMVD,观察患者肺癌病灶MSCT表现。方法对34例非小细胞肺癌术前行MSCT检查,收集相关临床病理结果;评价MSCT表现(包括边缘形态、内部结构、邻近结构的CT征象);免疫组织化学SP法检测肿瘤组织中心区、周边区的LMVD。结果 MSCT表现有棘状突起、胸膜凹陷征和癌性淋巴管炎的患者,其肺癌切除标本周围区LMVD均高于无上述表现者(P均<0.05)。结论 MSCT出现棘状突起、胸膜凹陷征或癌性淋巴管炎表现提示更高的肿瘤淋巴管生成水平,具有更高的淋巴结转移风险。

Background and objective It has been proven that ymphatic microvessel density （LMVD） was closely correlated with the lymphatic metastasis of non-small cell lung cancer （NSCLC）. e aim of the present study is to explore the relationship between podoplanin-LMVD and multi-slice spiral computed tomography （MSCT） characteristics of NSCLC. Methods MSCT scanning was performed on 34 cases of NSCLC （squamous carcinoma, 15 cases; adenocarcinoma, 15 cases; and adenosquamous carcinoma, 4 cases） prior to operation. Clinical pathology results, including lymph node metastasis, were obtained. CT characteristics, such as shape of the edge, internal structure, and adjacent structures, were described. LMVD in the central and peripheral areas examined respectively using SP immunohistochemical technique were analyzed. Results Lymph node metastasis was found to be associated with LMVD in the peripheral areas. LMVD in the peripheral areas of the resected lesions, the MSCT ndings of which included spinous process, pleural indentation, and carcinomatous lymphangitis, was higher than that of the lesions without these MSCT characteristics （P0.05）. Conclusion MSCT ndings of spinous process, pleural indentation, or carcinomatous lymphangitis of NSCLC may suggest a higher level of tumor lymphangiogenesis with a higher risk of lymph node metastasis.