彩色多普勒超声检测宫颈管内肿瘤血流参数与MVD的相关性研究
摘要
研究目的：
将经阴道彩色多谱勒超声测定早期宫颈管内癌变血流动力学参数(PI.RI)与检测早期宫颈管内癌变病理标本中的微血管密度(MVD),二者联合用于对早期宫颈管内癌变的分析,有助于判断宫颈癌的临床分期及术前周围转移情况,对宫颈癌,尤其是宫颈管内癌变的早期发现、早期诊断、提供了新的诊断信息,对临床有较大意义,并为临床诊断,治疗提供有价值的超声影像学信息。
研究方法：
采用临床试验,连续收集2008年6月～2010年2月在本院入住妇科0-Ⅱa的早期宫颈管内癌变病人20例作为研究对象,选择同期因子宫良性病变行子宫全切术病人20例为对照组。全部研究对象在手术前1-3天内接受经阴道二维彩色多普勒超声检查,观查宫颈的血流情况并记录所测血流学参数搏动指数(PI)和阻力指数(RI)。手术后,宫颈病理组织切片,采用常规S-P免疫组化法染色,鼠抗人CD34相关抗原为血管标记物,用已知阳性片作为阳性对照,以PBS代替一抗做阴性对照,显微镜下微血管密度计数。对实验所得数据进行分析,计量资料以均数±标准差表示,两变量间的关系采用直线相关分析,计量资料间的比较拟采用t检验,以P<0.05为有统计学意义。
结果：
1、经阴道超声探查早期宫颈管内恶性肿瘤病例组的宫颈宽度与正常对照组宫颈宽度相比明显增宽
2、彩色多普勒超声(CDFI)探及早期宫颈管内恶性肿瘤病例组血流明显比正常对照组血流丰富
3、经阴道彩色多普勒超声检查测定的病例组的血流指数与正常对照组所得数值比较,RI、PI值均有显著性差异,病例组RI值与正常对照组比较有降低趋势；病例组PI值于正常对照组比较有下降趋势。
4、术后病理组织免疫组化法测定MVD统计学分析,病例组与对照组相比有显著差异。阻力指数(RI)与MVD无相关性,PI与MVD呈显著负相关。
结论：
1、经阴道彩色多普勒超声检测早期宫颈管内恶性肿瘤的血流参数RI,PI与对照组均有显著差异；以及早期宫颈管内肿瘤血流信号的变化,为宫颈管内恶性肿瘤的早期发现提供了新的影像学信息。
2、经阴道彩色多谱勒超声检测早期宫颈管内恶性肿瘤的血流学参数PI与术后宫颈病理组织MVD呈显著负相关,提示经阴道彩色多普勒超声定量分析可用于术前活体评估早期宫颈管内恶性肿瘤的血管生成。
Objective:Will be measured by transvaginal color Doppler ultrasound hemodynamic parameters of early cervical cancer (PI.RI) and detecting early stage cervical canal tumor of pathology specimens microvessel density (MVD) in combination, used for the analysis of early cervical cancer. Help to determine the clinical stage of cervical cancer and pre-operative around the transfer situation, cervical cancer, especially cervical canal lesions of early detection, early diagnosis, provide a new diagnostic information, to have greater clinical significance, and clinical diagnosis and treatment of ultrasound imaging provide valuable information.
Metheds:Using clinical trials, continuous collecting 20 cases of early cervical cancer patients been in shanxi medical first hospital in June 2008～February 2010 as an object of study, selected the same period were because of benign uterine lesions hysterectomy patients 20 cases were the control group. All cases before surgery, within 1 to 3 days received transvaginal two-dimensional color Doppler ultrasound to watch blood condition and record the measured parameters of blood flow pulsatility index (PI) and resistance index (RI). After the operation, cervical pathology biopsy,immunohistochemistry staining method, mouse anti-human CD34-related antigen-positive blood vessel marker sheet used as a positive control known to PBS instead of a negative control anti-doing, microvessel density count under the microscope. The experimental analysis of the data, measurement data to mean±standard deviation indicated that the relationship between two variables using linear correlation analysis, a comparison between the measurement data to be used "t" tests to P<0.05 as statistically significant.
Results:
1、Transvaginal ultrasound detecting early stage cervical canal tumor group cervical width and the width of the normal control group, compared with obviously enlarged cervix uteri.
2、Transvaginal color Doppler ultrasound (CDFI) detection and early cervical canal tumor group than the normal control group, blood flow markedly enriched.
3、Transvaginal color Doppler ultrasound examined early cervical canal tumor blood flow index group compared with the normal control group, RI, PI values were significantly different. Early cervical cancer group of RI values compared with the normal control group had lower trend; early cervical cancer group PI values in normal control group had a downward trend.
4、After the surgery, the pathology tissue immunohistochemistry detected MVD, statistics analysis, the case group and the control group compare have the remarkable difference. The drag index (RI) with the MVD were not relevance, PI and MVD assumes the remarkable inverse correlation.
Conclusion:
1、Transvaginal color Doppler ultrasound detection of early stage cervical canal tumor within the parameters of RI, PI and the control group were significantly different; and early stage cervical canal tumor blood flow signal changes, for the early detection of cervical canal tumor has provided a new imaging information.
2、Transvaginal color doppler detection of early cervical cancer of the blood parameters of PI and postoperative cervical pathology MVD was significantly negatively correlated, suggesting that transvaginal color Doppler ultrasound can be used for quantitative analysis of preoperative assessment of early stage cervical canal tumor in tumor angiogenesis.
将经阴道彩色多谱勒超声测定早期宫颈管内癌变血流动力学参数(PI.RI)与检测早期宫颈管内癌变病理标本中的微血管密度(MVD),二者联合用于对早期宫颈管内癌变的分析,有助于判断宫颈癌的临床分期及术前周围转移情况,对宫颈癌,尤其是宫颈管内癌变的早期发现、早期诊断、提供了新的诊断信息,对临床有较大意义,并为临床诊断,治疗提供有价值的超声影像学信息。
研究方法：
采用临床试验,连续收集2008年6月～2010年2月在本院入住妇科0-Ⅱa的早期宫颈管内癌变病人20例作为研究对象,选择同期因子宫良性病变行子宫全切术病人20例为对照组。全部研究对象在手术前1-3天内接受经阴道二维彩色多普勒超声检查,观查宫颈的血流情况并记录所测血流学参数搏动指数(PI)和阻力指数(RI)。手术后,宫颈病理组织切片,采用常规S-P免疫组化法染色,鼠抗人CD34相关抗原为血管标记物,用已知阳性片作为阳性对照,以PBS代替一抗做阴性对照,显微镜下微血管密度计数。对实验所得数据进行分析,计量资料以均数±标准差表示,两变量间的关系采用直线相关分析,计量资料间的比较拟采用t检验,以P<0.05为有统计学意义。
结果：
1、经阴道超声探查早期宫颈管内恶性肿瘤病例组的宫颈宽度与正常对照组宫颈宽度相比明显增宽
2、彩色多普勒超声(CDFI)探及早期宫颈管内恶性肿瘤病例组血流明显比正常对照组血流丰富
3、经阴道彩色多普勒超声检查测定的病例组的血流指数与正常对照组所得数值比较,RI、PI值均有显著性差异,病例组RI值与正常对照组比较有降低趋势；病例组PI值于正常对照组比较有下降趋势。
4、术后病理组织免疫组化法测定MVD统计学分析,病例组与对照组相比有显著差异。阻力指数(RI)与MVD无相关性,PI与MVD呈显著负相关。
结论：
1、经阴道彩色多普勒超声检测早期宫颈管内恶性肿瘤的血流参数RI,PI与对照组均有显著差异；以及早期宫颈管内肿瘤血流信号的变化,为宫颈管内恶性肿瘤的早期发现提供了新的影像学信息。
2、经阴道彩色多谱勒超声检测早期宫颈管内恶性肿瘤的血流学参数PI与术后宫颈病理组织MVD呈显著负相关,提示经阴道彩色多普勒超声定量分析可用于术前活体评估早期宫颈管内恶性肿瘤的血管生成。
Objective:Will be measured by transvaginal color Doppler ultrasound hemodynamic parameters of early cervical cancer (PI.RI) and detecting early stage cervical canal tumor of pathology specimens microvessel density (MVD) in combination, used for the analysis of early cervical cancer. Help to determine the clinical stage of cervical cancer and pre-operative around the transfer situation, cervical cancer, especially cervical canal lesions of early detection, early diagnosis, provide a new diagnostic information, to have greater clinical significance, and clinical diagnosis and treatment of ultrasound imaging provide valuable information.
Metheds:Using clinical trials, continuous collecting 20 cases of early cervical cancer patients been in shanxi medical first hospital in June 2008～February 2010 as an object of study, selected the same period were because of benign uterine lesions hysterectomy patients 20 cases were the control group. All cases before surgery, within 1 to 3 days received transvaginal two-dimensional color Doppler ultrasound to watch blood condition and record the measured parameters of blood flow pulsatility index (PI) and resistance index (RI). After the operation, cervical pathology biopsy,immunohistochemistry staining method, mouse anti-human CD34-related antigen-positive blood vessel marker sheet used as a positive control known to PBS instead of a negative control anti-doing, microvessel density count under the microscope. The experimental analysis of the data, measurement data to mean±standard deviation indicated that the relationship between two variables using linear correlation analysis, a comparison between the measurement data to be used "t" tests to P<0.05 as statistically significant.
Results:
1、Transvaginal ultrasound detecting early stage cervical canal tumor group cervical width and the width of the normal control group, compared with obviously enlarged cervix uteri.
2、Transvaginal color Doppler ultrasound (CDFI) detection and early cervical canal tumor group than the normal control group, blood flow markedly enriched.
3、Transvaginal color Doppler ultrasound examined early cervical canal tumor blood flow index group compared with the normal control group, RI, PI values were significantly different. Early cervical cancer group of RI values compared with the normal control group had lower trend; early cervical cancer group PI values in normal control group had a downward trend.
4、After the surgery, the pathology tissue immunohistochemistry detected MVD, statistics analysis, the case group and the control group compare have the remarkable difference. The drag index (RI) with the MVD were not relevance, PI and MVD assumes the remarkable inverse correlation.
Conclusion:
1、Transvaginal color Doppler ultrasound detection of early stage cervical canal tumor within the parameters of RI, PI and the control group were significantly different; and early stage cervical canal tumor blood flow signal changes, for the early detection of cervical canal tumor has provided a new imaging information.
2、Transvaginal color doppler detection of early cervical cancer of the blood parameters of PI and postoperative cervical pathology MVD was significantly negatively correlated, suggesting that transvaginal color Doppler ultrasound can be used for quantitative analysis of preoperative assessment of early stage cervical canal tumor in tumor angiogenesis.
引文
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[2]乐杰等主编.妇产科学.第七版,北京：人民卫生出版社,2006.314
[3]UjimotoJ, SaguchiH, HiroseR, HiroseRetal.Angjoenes in endometriesis and angiogenic factor.Gynecol Obstet Invest,1999,48(1):14-20
[4]PaPettiM, Herman IM. Mechanisms of normal and tumor-derived angiogenesisAM J Physiol Cell Phyiol,2002,282(5):947-970
[5]WeidnerN.IntratumormierovesseldensityasaPrognostiefaetorineaneer.AmJPathol.1995; 147:9—15.
[6]袁文华,张武,简文豪主编.超声诊断基础与检查规范.北京：科学技术文献出版社,2001．182,.364
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