[Correlation between podoplanin-positive lymphatic microvessel density and CT characteristics of non-small cell lung cancer]

Abstract

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). The 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 findings of which included spinous process, pleural indentation, and carcinomatous lymphangitis, was higher than that of the lesions without these MSCT characteristics (P<0.05).

Conclusion: MSCT findings 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.

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57岁男性右上肺NSCLC患者。MSCT横轴位（A）显示毛刺征，MPR技术显示分叶征和结节后下方阻塞病变（B）、胸膜凹陷征和棘状突起（C），VRT技术显示血管聚集征（D）。组织病理HE染色：低分化腺鳞癌（×200）；免疫组化PCNA、VEGF染色均呈强阳性表达（×200，F，G）；podoplanin染色见中心区微淋巴管稀少（×400，H），癌间质内少量podoplanin表达（×400，H），周围区微淋巴管较多，管腔扩大且不规则（×400，I）。 NSCLC found in the right upper lobe of a 57-year-old male. Axial images of MSCT shows spicules (A), MPR shows lobulated sign and distal side obstructive change (B), pleural indentation, and spinous process (C), VRT shows vessel convergence (D). HE staining of histopathology: poorly differentiated adenosquamous carcinoma (×200); Strongly positive expressions of PCNA, VEGF (SP×400, F, G); Lymphatic microvessels in the central areas were rare (podoplanin, SP×400, H), podoplanin were also expressed in few tumor stromata (SP×400, H), lymphatic microvessels in the peripheral areas were more with irregular and enlarged lumina (podoplanin, SP×400, I).