Relationship between CT signs and Ki-67, p53 in peripheral lung cancer
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摘要:
目的 探讨周围型肺癌(PLC)CT征象与Ki-67、p53表达的关系。 方法 选取2016年1月~2022年2月在本院就诊的108例PLC患者为研究对象,采用飞利浦256层螺旋CT检查患者的CT征象,并检测PLC组织中Ki-67、p53的表达水平,分析PLC患者的病理组织类型、分化程度以及CT征象与Ki-67和p53表达的关系。 结果 PLC组织中,Ki-67和p53阳性表达率分别为69.44%(75/108)、51.85%(56/108);CT主要表现为瘤体直径≥3.0 cm、分叶征、棘状突起征、毛刺征、磨玻璃征、增强值≥20 Hu和肺门、纵隔淋巴结肿大,而胸膜凹陷征、空气支气管征、空洞征、空泡征、钙化征相对较少;腺癌的Ki-67阳性表达率低于鳞癌(P < 0.05),腺癌和鳞癌的p53阳性表达率差异无统计学意义(P > 0.05);PLC的分化程度越低,Ki-67和p53阳性表达率越高(P < 0.05);瘤体直径≥3.0 cm、有分叶征、棘状突起征、毛刺征、增强值≥20 Hu和肺门、纵隔淋巴结肿大的PLC,Ki-67阳性表达率较高,且有磨玻璃征和空泡征的PLC,Ki-67阳性表达率较低(P < 0.05);瘤体直径≥3.0 cm、有毛刺征、棘状突起征、分叶征、增强值≥20 Hu和肺门、纵隔淋巴结肿大的PLC,p53阳性表达率较高(P < 0.05)。 结论 PLC患者Ki-67、p53的表达与CT征象密切相关。 Abstract:Objective To explore the relationship between CT signs and Ki-67, p53 in peripheral lung cancer (PLC). Methods A total of 108 patients with PLC treated in the hospital were enrolled between January 2016 and February 2022. CT signs were examined by Philips 256-slice spiral CT. The expression levels of Ki-67 and p53 in PLC tissues were detected. The relationship between pathological tissue types, differentiation degree, CT signs and Ki-67, p53 was analyzed. Results In PLC tissues, positive expression rates of Ki- 67 and p53 were 69.44% (75/108) and 51.85% (56/108), respectively. The main CT findings included pleural indentation, tumor diameter ≥3.0 cm, lobulation sign, spiculate protuberance sign, spicule sign, enhancement value ≥20 Hu, hilar and mediastinal lymph node enlargement, while CT findings (air bronchus sign, cavity sign, glass sign, vacuole sign, calcification sign) were relatively rare. The positive expression rate of Ki-67 in adenocarcinoma was lower than that in squamous cell carcinoma (P < 0.05), but there was no significant difference in the positive expression rate of p53 between adenocarcinoma and squamous cell carcinoma (P > 0.05). The lower the differentiation degree of PLC, the higher the positive expression rates of Ki-67 and p53 (P < 0.05). The positive expression rate of Ki-67 was higher in patients with tumor diameter ≥ 3.0 cm, lobulation sign, spiculate protuberance sign, spicule sign, enhancement value ≥20 Hu, hilar and mediastinal lymph node enlargement, while which was lower in patients with glass sign and vacuole sign (P < 0.05). The positive expression rate of p53 was higher in patients with tumor diameter ≥3.0 cm, lobulation sign, spiculate protuberance sign, spicule sign, enhancement value ≥20 Hu, hilar and mediastinal lymph node enlargement (P < 0.05). Conclusion The expressions of Ki-67 and p53 are closely related to CT signs in PLC patients. -
Key words:
- peripheral lung cancer /
- CT sign /
- Ki-67 /
- p53
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表 1 PLC的病理组织类型与Ki-67、p53表达的关系
Table 1. Relationship between pathological tissue types of PLC and Ki-67, p53 [n(%)]
组织类型 Ki-67阳性 p53阳性 腺癌(n=76) 7(9.21) 39(51.32) 鳞癌(n=32) 28(87.50) 17(53.13) χ2 63.009 0.030 P < 0.001 0.864 表 2 PLC组织的分化程度与Ki-67、p53表达的关系
Table 2. Relationship between differentiation degree of PLC tissues and Ki-67, p53 [n(%)]
分化程度 Ki-67阳性 p53阳性 高分化(n=16) 7(43.75) 5(31.25) 中分化(n=78) 56(71.79) 41(52.56) 低分化(n=14) 12(85.71) 10(71.43) Z 6.393 4.831 P 0.011 0.028 表 3 PLC的CT征象与Ki-67表达的关系
Table 3. Relationship between CT signs of PLC and Ki-67
胸膜凹陷征 1.234 0.267 有 16 13(81.25) 无 92 62(67.39) 瘤体直径(cm) 7.768 0.005 ≥3 64 51(79.69) < 3 44 24(54.55) 分叶征 14.764 < 0.001 有 53 46(86.79) 无 55 29(52.73) 棘状突起征 4.303 0.038 有 65 50(76.92) 无 43 25(58.14) 毛刺征 10.341 0.001 有 37 33(89.19) 无 71 42(59.15) 空气支气管征 0.202 0.653 有 14 无 94 66(70.21) 增强值(Hu) 8.839 0.003 ≥20 56 46(82.14) < 20 52 29(55.77) 空洞征 0.126 0.723 有 8 6(75.00) 无 100 69(69.00) 磨玻璃征 6.863 0.009 有 65 39(60.00) 无 43 36(83.72) 空泡征 10.418 0.001 有 13 4(30.77) 无 95 71(74.74) 钙化征 1.896 0.168 有 3 1(33.33) 无 105 74(70.48) 肺门、纵隔淋巴结肿大 9.504 0.002 有 60 49(81.67) 无 48 26(54.17) 表 4 PLC的CT征象与p53表达的关系
Table 4. Relationship between CT signs of PLC and p53
CT影像学特征 例数(n) p53阳性[n(%)] χ2 P 胸膜凹陷征 2.148 0.143 有 16 11(68.75) 无 92 45(48.91) 瘤体直径(cm) 7.134 0.008 ≥3 64 40(62.50) < 3 44 16(36.36) 分叶征 13.446 < 0.001 有 53 37(69.81) 无 55 19(34.55) 棘状突起征 4.342 0.037 有 65 39(60.00) 无 43 17(39.53) 毛刺征 10.057 0.002 有 37 27(72.97) 无 71 29(40.85) 空气支气管征 0.180 0.671 有 14 8(57.14) 无 94 48(51.06) 增强值(Hu) 5.282 0.022 ≥20 56 35(62.50) < 20 52 21(40.38) 空洞征 0.392 0.531 有 8 5(62.50) 无 100 51(51.00) 磨玻璃征 1.131 0.287 有 65 31(47.69) 无 43 25(58.14) 空泡征 7.872 0.005 有 13 2(15.38) 无 95 54(56.84) 钙化征 0.424 0.515 有 3 1(33.33) 无 105 55(52.38) 肺门、纵隔淋巴结肿大 42.844 < 0.001 有 60 48(80.00) 无 48 8(16.67) -
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