HRCT征象联合TTF-1用于区分不同浸润程度的磨玻璃结节样肺腺癌

HRCT Signs Combined with TTF-1 were Used to Distinguish Nodular Ground-Glass Lung Adenocarcinoma with Different Degrees of Infiltration

目的分析高分辨率CT(HRCT)征象联合肺癌相关临床指标与不同浸润程度的磨玻璃结节样肺腺癌(GGNs)的相关性。方法回顾144例经手术和病理确诊为GGNs的患者临床资料,分为浸润前病变(PI)组(n=35)、微浸润性腺癌(MIA)组(n=46)和浸润性腺癌(IA)组(n=63),并通过单因素分析和无序多分类logistic回归分析比较三组患者的HRCT征象。收集144例患者的免疫组化切片,通过Image J 1.8.0分析肺癌相关临床指标:癌胚抗原(CEA)、表皮生长因子受体(EGFR)、血管内皮生长因子(VEGF)、天冬氨酸蛋白酶A(NapsinA)、角蛋白7(CK7)、甲状腺转录因子-1(TTF-1)、CK5/6、肿瘤蛋白p53(P53)、细胞增殖相关抗原Ki67和肿瘤蛋白p40(P40)的光密度(OD)值以计算这些基因的相对表达量,并分析这些指标与HRCT征象的相关性。结果单因素分析显示,三组患者的GGNs大小和密度、分叶征、毛刺征、胸膜牵拉征、瘤-肺边界、微血管穿行征和空气支气管征均有显著差异(P<0.05)。此外,高表达的TTF-1与不同的HRCT征象密切相关,提示TTF-1可能是GGNs患者中HRCT征象异常的潜在因素。结论HRCT征象联合TTF-1可用于进一步区分GGNs中的PI、MIA和IA病变。

Objective The correlation between high resolution computed tomography(HRCT) images combined with clinical indicato rs related to lung cancer and small ground glass nodule-like lung adenoca rcinoma(GGNs) with different degrees of infiltration was analyzed.Methods A retrospective study of 144 patients diagnosed as GGNs by su rgery and pathology,were divided into pre-invasive lesion(PI) group(n=35),micro-invasive adenocarcinoma(MIA) group(n=46),and invasive adenocarcinoma(IA) group(n=63).The HRCT signs of the three groups of patients were compared by univariate analysis and disordered multivariate logistic regression analysis.Immunohistochemical sections were collected from 144 patients,image J 1.8.0 was used to analyze the optical density(Optical Density,OD) value of some clinical indicators of lung cancer,including Carcinoembryonic Antigen(CEA),Epidermal G rowth Factor Receptor(EGFR),Vascular endothelial Growth Factor(VEGF),Aspartic protease A(N a psinA),Keratin 7(CK7),Thyroid tra nscription factor-1(TTF-1),CK5/6,Tumor protein p53(p53),cell prolife rationrelated antigen Ki67(Ki67) and Tumor protein p40(p40) to calculate the relative expression of these genes,and the correlation between these indicators and HRCT signs were analyzed.Results Univa riate analysis showed that there were significant differences in the size and density of GGNs,lobular sign,spicule sign,pleural traction sign,tumor-lung interface,microvascular penetrating sign,and bronchial air sign in the three groups(all P<0.05).In addition,the high expression of TTF-1 is closely related to diffe rent HRCT signs,suggesting that TTF-1 may be a potential factor for abnormal HRCT signs in GGNs patients.Conclusion HRCT signs combined with TTF-1 can be used to further distinguish PI,MIA and IA lesions.