Diagnosis and treatment of solitary pulmonary nodule (SPN, less than 30 mm in diameter) has been a formidable problem in clinical work. It is often detected in medical examination or other disease examinations by chance. There are no corresponding signs and symptoms of SPN except those on the imaging, so it is difficult to make a correct diagnosis as early as possible. Literature shows that there is a certain probability of malignant SPN, so early correct diagnosis is the key factor in deciding the prognosis and appropriate treatment. With the accumulation of clinical experiences, the development of new fiberoptic bronchoscopy, highresolution CT, and videoassisted thoracoscopic surgery, as well as the evolution of some invasive examination technologies, it is less difficult in distinguishing benign from malignant SPN than ever before. In this article, we will make a comprehensive review on the development in the aspect of differential diagnosis of SPN.
Abstract: Objective To observe the expression of integrinlinked kinase (ILK) and matrix metalloproteinases9 (MMP9) in human nonsmall cell lung cancer (NSCLC) and investigate the correlation of ILK and MMP9 expression with the prognosis of NSCLC. Methods The expression of ILK and MMP9 in 75 specimens of NSCLC resected from January 2002 to January 2004 were detected by immunohistochemistry. According to the median of integral optical density (IOD), all patients were divided into the high or low ILK expression group and the high or low MMP-9 expression group. The relativity of ILK and MMP9 was determined, and the relationship of survival time with clinical features including expression of ILK and MMP-9 was compared by Logrank test. Results Both ILK and MMP-9 were expressed in NSCLC specimens. The expression between ILK and MMP-9 was positively correlated in 75 patients of our group (r=0.79, Plt;0.05). Patients with lower expression of ILK and MMP9 had a significantly longer survival time than those with higher expression of ILK and MMP-9 in the postoperative followup (χ2=15.067,14301,Plt;0.05). The survival time was not correlated with sex,age,smoking history or pathological type(χ2=0450,0078, 1.460, 1.623，Pgt;0.05), while tumor diameter, lymph node metastasis, TNM stage, the expression of ILK and MMP-9 significantly influenced the survival time (χ2=3.963, 15.169,20.529, 15.067，14.301，Plt;0.05). Conclusion The expression of ILK and MMP9 affects the prognosis of NSCLC. MMP-9 may advance infiltration and metastasis of tumor cells through ILK pathway. In summary, the expression of ILK and MMP9 may play an important role in the evaluation of prognosis for patients with NSCLC.