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目的:探讨肺癌间质毛细血管基底膜完整性与CT 临床表现的关系.材料和方法:利用免疫组化方法通过Ⅳ型胶原表达测定87 例周围型肺癌毛细血管基底膜的完整性,并与CT 表现以及转移、预后情况进行对照分析.结果:鳞癌基底膜不连续甚至缺如的占70 .3 % ,腺癌占82 .9 % (P< 0 .05) .有、无淋巴结转移者基底膜保持连续的分别为9 .8 % 及46 .2 % ,差别非常显著(P< 0 .01) .3 年随访资料显示,存活无转移组与死亡组的基底膜情况差别显著(P< 0 .01) .随着肿瘤的增大,肿瘤基底膜断裂或缺如的比例逐渐增加(36 .4 % ,66 .7 % ,83 .9 % 及100 % ) ,各组之间差别显著.有、无分叶征的基底膜不连续者分别占83 .9 % 及68 % ,差别显著(P< 0 .05) .光整及毛糙界面者分别有38 .5 % 及23 .4 % 基底膜保持连续, 有毛刺征者无一例基底膜完整; 前两者相比P< 0 .05 , 前两者与后者比较P< 0 .01 .增强30Hu 以上的肺癌发生基底膜断裂或缺如者为82 .4 % (56/68) ,增强30Hu 以下的病人占68 .4 % (13/ 19) , 两组相差显著(P< 0 .05) .有、无胸膜凹陷征“,”Purpose:To study the relationship between the basement membrane(BM)of microvessels(represented by expressions of type Ⅳ collagen)and the CT,clinical features of the lung cancer.Material and Methods:The specimens of resected tumors in 87 cases of the lung cancer were expressed immunohistochemically for type Ⅳ collagen.The results were analyzed statistically by comparison with the follow up and CT findings.Results:The discontinuous or absent pattern of basement membrane occurred in 70.3% squamous cell carcinomas and 82.9% adenocarcinomas respectively with significant difference(P<0.05).Intact and continuous BM were seen in only 9.8% patients with nodal metastasis but in 46.2% patients without nodal metastasis,showing the big difference(P<0.01).The patients with the continuous pattern of BM tended to have a higher 3-year survival rate than those with the discontinouous pattern(P<0.05).We found the larger the tumor size,the more serious the BM disruption;while the tumor necrosis and pleural tail sign had no relationships with the BM patterns.The patients in the lobulated group and non-lobulated group also had significant difference in discontinuous BM(83.9% VS 68%,P<0.05).The tumors which had ill-defined or spiculated margins showed a significantly(P<0.01)higher malignant tendency with discontinuous BM than those with well defined margins.Finally,the discontinuous BM was seen in 82.4% patients whose masses enhanced more than 30 Hu,and in 68.4% patients with enhancement less than 30 Hu.The difference was statistically significant(P<0.01).Conclusion: The lobulated character,spiculated sign,significant enhancement of the masses and nodal metastasis are correlated well with Type Ⅳcollagen and can predict the degree of malignancy and prognosis.