title: Variation in vascular distribution in small lung cancers.
abstract: OBJECTIVE
  To assess the vascular component of small lung cancers.
  
  
  METHODS
  We identified 105 resected non-small-cell lung carcinomas without pathologic evidence of vascular, lymphatic, bronchial, or pleural invasion. The percentage of BAC (% BAC) of all adenocarcinomas was determined by a pulmonary pathologist. A representative histology slide of each carcinoma was digitally scanned and the number of blood vessels (#V) with at least a diameter of 200microm was identified as well as the area of these blood vessels (VA) and of the tumor (TA) was obtained. The CT consistency of the cancers was also recorded as non-solid (NS), part-solid (PS) and solid.
  
  
  RESULTS
  The number of blood vessels per cm(2) of tumor area (#V/TA) was higher for adenocarcinoma (7.3+/-4.7) as compared with large- and squamous-cell carcinoma (3.6+/-2.1, 2.3+/-1.1, respectively, P<0.0001). For adenocarcinoma, #V/TA decreased with decreasing % BAC from 10.3 vessels per cm(2) of tumor area for 100% BAC to 5.1 vessels per cm(2) of tumor area for 0% BAC. The ratio of the total vascular area to tumor area (VA/TA), however, did not differ significantly by cell type nor for the adenocarcinoma by % BAC (P=0.87). While #V/TA decreased from 9.6 for non-solid nodules, to 7.5 for part-solid nodules and to 5.1 for solid nodules, there was no significant difference (P=0.27) in the VA/TA ratio by nodule consistency. Overall, VA comprised 2.7% of the total tumor area (TA) for 105 cancers.
  
  
  CONCLUSIONS
  These results suggest that tumor vessels experience a continuous temporal and spatial remodeling as tumors grow and that bigger tumors tend to have fewer but larger blood vessels. It also suggests that, on average, squamous- or large-cell carcinomas have a larger average vessel diameter as compared with adenocarcinomas and that the vasculature of an adenocarcinoma might remodel as the % BAC decreases. The overall proportion of tumor volume comprised of vessels 200microm or larger is small and unlikely to influence overall tumor volume and doubling time estimates.
authors.affiliation: Department of Radiology, Weill Medical College of Cornell University, New York, NY, United States.
authors.forename: Lijuan
authors.initials: L
authors.lastname: Zhang
authors.forename: David F
authors.initials: DF
authors.lastname: Yankelevitz
authors.forename: Claudia I
authors.initials: CI
authors.lastname: Henschke
authors.forename: Anthony P
authors.initials: AP
authors.lastname: Reeves
authors.forename: Madeline F
authors.initials: MF
authors.lastname: Vazquez
authors.forename: Darryl
authors.initials: D
authors.lastname: Carter
mesh_terms: D001808:Blood Vessels / Q000473:pathology; D002289:Carcinoma, Non-Small-Cell Lung / Q000098:blood supply* / Q000473:pathology; D006801:Humans; D008175:Lung Neoplasms / Q000098:blood supply* / Q000473:pathology; D009389:Neovascularization, Pathologic / Q000473:pathology*; D014057:Tomography, X-Ray Computed