恶性滋养细胞肿瘤早期彩色多普勒血流显像诊断及化疗监测

目的探讨彩色多普勒血流显像(CDFI)检测在恶性滋养细胞肿瘤早期诊断及化疗监测中的应用价值。方法应用CDFI对46例恶性滋养细胞肿瘤的血管形态学改变进行了观察及分型,对其峰值血流速度及阻力指数进行了测定,定量测量血绒毛膜促性腺激素(β-HCG)水平监测化疗反应,33例葡萄胎清宫术后恢复正常患者作为对照组。结果滋养细胞肿瘤血流图分为三型:弥漫型、血窦型及实质型。14例获病理诊断,包括3例弥漫型及7例血窦型结果为恶性葡萄胎,4例实质型,3例为绒毛膜癌,1例为化疗后变性坏死物。结论不同类型血流图与血β-HCG、子宫血流动力学改变及化疗的反应相关性好。CDFI作为一种无创,可重复的方法,不仅可对恶性滋养细胞肿瘤进行早期诊断,而且可用于观察化疗效果,判断疾病预后转归。

Early diagnosing with color Doppler flow imaging and monitoring chemotherapy response for gestational trophoblastic tumors

Objective To investigate the value of color Doppler flow imaging (CDFI)examination in early diagnosis and monitoring chemotherapy response for gestational trophoblastic tumors.Methods CDFI was used in diagnosis of 46 patients with gestational trophoblastic tumors.The vascular morphologic manifestations were recorded, and the peak systolic velocity and resistance index of uterine artery were calculated. Serum beta human chorionic gonadotropin (HCG)levels were measured periodically to monitor chemotherapy response.The 33 uneventful postmole uterine were enrolled as controls.Results The gestational trophoblastic tumors were categorized as diffuse type,lacunar type, and compact type according to their vascular patterns. Histopathologic diagnosis was available for 14 lesions. They were invasive mole in 7 lacunar type and 3 diffuse type lesions, 3 choriocarcinoma and 1 tissue degeneration and necrosis in four compact type lesions.Conclusion Vascular morphologic patterns of gestational trophoblastic tumors are correlated well with beta-HCG levels, uterine hemodynamics and chemotherapy. CDFI are useful for early diagnosis of the gestational trophoblastic tumors, for evaluating chemotherapeutic results and disease prognosis.