title: Computed tomographic images reflect the biologic behavior of small lung adenocarcinoma: they correlate with cell proliferation, microvascularization, cell adhesion, degradation of extracellular matrix, and K-ras mutation.
abstract: BACKGROUND
  We previously reported that the computed tomographic M/L ratio (area of the tumor in the mediastinal computed tomographic image/area of the tumor in the lung computed tomographic image) of small peripheral lung adenocarcinoma is correlated with patient prognosis.
  
  
  METHODS
  Immunostaining for p53, bcl-2, Ki-67, vascular endothelial growth factor, CD34, matrix metalloproteinase 2, matrix metalloproteinase 9, tissue inhibitor of matrix metalloproteinase 2, and mutation of K-ras was assessed in 131 surgically resected, primary peripheral lung adenocarcinomas of 30 mm or less in maximum diameter to clarify the relationship between computed tomographic findings and biologic activities.
  
  
  RESULTS
  The numbers of patients with high labeling indexes of Ki-67 and high expression of vascular endothelial growth factor, CD34, matrix metalloproteinase 2, and matrix metalloproteinase 9 in the solid-type group (computed tomographic M/L ratio > or = 50%) were significantly higher than those in the faint density-type group (computed tomographic M/L ratio < 50%; P = .04 for Ki-67, P = .03 for vascular endothelial growth factor, P = .0009 for CD34, P = .001 for matrix metalloproteinase 2, and P = .00001 for matrix metalloproteinase 9). The number of patients with high levels of CD44v6 or tissue inhibitor of matrix metalloproteinase 2 staining in the faint density-type group was significantly higher than that in the solid-type group (P = .02 for CD44v6 and P = .01 for tissue inhibitor of matrix metalloproteinase 2). Independent variables capable of predicting computed tomographic M/L ratio included CD34, matrix metalloproteinase 2, matrix metalloproteinase 9, and tissue inhibitor of matrix metalloproteinase 2 (P = .0093, P = .0003, P = .0027, and P = .01, respectively; binary logistic regression analysis).
  
  
  CONCLUSIONS
  Our results suggest that the computed tomographic image of small lung adenocarcinoma is correlated with biologic activities and thus provides possible prognostic information.
authors.affiliation: Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University School of Medicine, Sendai, Japan.
authors.forename: Boming
authors.initials: B
authors.lastname: Dong
authors.forename: Masami
authors.initials: M
authors.lastname: Sato
authors.forename: Akira
authors.initials: A
authors.lastname: Sakurada
authors.forename: Motoyasu
authors.initials: M
authors.lastname: Sagawa
authors.forename: Chiaki
authors.initials: C
authors.lastname: Endo
authors.forename: Shulin
authors.initials: S
authors.lastname: Wu
authors.forename: Sumitaka
authors.initials: S
authors.lastname: Yamanaka
authors.forename: Akira
authors.initials: A
authors.lastname: Horii
authors.forename: Takashi
authors.initials: T
authors.lastname: Kondo
mesh_terms: D000230:Adenocarcinoma / Q000098:blood supply / Q000000981:diagnostic imaging / Q000235:genetics / Q000503:physiopathology*; D002448:Cell Adhesion; D049109:Cell Proliferation; D005109:Extracellular Matrix; D005260:Female; D011905:Genes, ras / Q000235:genetics*; D006801:Humans; D019394:Ki-67 Antigen / Q000032:analysis; D008175:Lung Neoplasms / Q000098:blood supply / Q000000981:diagnostic imaging / Q000235:genetics / Q000503:physiopathology*; D008297:Male; D045726:Metalloproteases / Q000032:analysis; D008875:Middle Aged; D009154:Mutation; D011379:Prognosis; D015996:Survival Rate; D019716:Tissue Inhibitor of Metalloproteinase-2 / Q000032:analysis; D014057:Tomography, X-Ray Computed; D042461:Vascular Endothelial Growth Factor A / Q000032:analysis
chemical_list: D019394:Ki-67 Antigen; D042461:Vascular Endothelial Growth Factor A; D019716:Tissue Inhibitor of Metalloproteinase-2; D045726:Metalloproteases