Characteristics of Bronchial Arterial Reconstruction of Lung Cancer and the Clinical Significance

摘要

Objective: To study vascular characteristics of bronchial arterial reconstruction for lung cancer in relation to patient's prognosis. Methods: According to the International Staging System for Lung Cancer, bronchial arteriography was performed in 16 patients with stage III_a, 42 patients with stage III_b lung cancer before bronchial arterial infusion (BAI) of chemotherapy. Angiograms was read by radiologists and analyzed by real-multicolour picture system. All patients were followed up and the data were collected. Results: The common findings of angiographic vessels were variable distending, hypervascularity with shunting as net, and extravasation of contrast, light or dense staining in the regions of the tumors for ail patients. Radial growth vessels in pericancer were found in 30 patients, including 20 cases (66.7%) of small cell lung cancer (SCLC), 7 cases (23.3%) of adenocarcinoma, 3 cases (10%) of squamous carcinoma; a thick circular vessels in pericancer in 16 patients; both characteristics above were seen in 5 cases. Hcmatogcnous dissemination was found in 19 of 30 patients (63.3%) with radial growth vessels in pericancer; lymphatic spread (supraclavicular nodes) in 3 of 30 (10%); local recurrences in 2 of 30 (6.7%) 6 and 30 months respectively after curable resection. Hematogenous dissemination was found in 2 of 28 patients (7.1%) without radial growth vessels in pericancer during the period of follow-up. There was significant difference in the rate of hematogenous dissemination in two groups (P<0.01). Conclusion: Radial growth vessels at, pericancer for bronchial arteriography of lung cancer was an important sign of high rate of hematogenous dissemination and lymphatic spread.