阴道彩色多普勒超声对卵巢肿瘤血管生成的预测作用

目的探讨经阴道彩色多普勒超声（transvaginalcolorDopplerultrasound，TV-CDU）血流动力学参数与卵巢肿瘤微血管密度（microvesseldensity，MVD）的相关性，预测卵巢肿瘤的良、恶性及恶性肿瘤的临床分期、组织学分级、有无淋巴结转移等。方法对2004年1月至2005年12月本院收治的82例卵巢肿瘤患者，于术前行经阴道彩色多普勒超声检查，记录血流动力学参数：搏动指数（pulsatilityindexPI）、阻力指数（resistiveindex，RI）、收缩期峰速率（peaksystolicvelocity，Vps）、血管数目（vesselsnumber，VN）。术后采集血流丰富对应区域组织标本进行免疫组化染色，检测其微血管密度。结果阻力指数、血管数目与微血管密度有相关关系（P〈0．01），阻力指数与微血管密度呈负相关，血管数目与微血管密度呈正相关。卵巢恶性肿瘤的阻力指数较良性肿瘤低，血管数目较良性肿瘤高（P〈0．05）。卵巢恶性肿瘤的组织学分级中，低分化组血管数目比高、中分化组低（P〈0．05），阻力指数比较，则差异无显著意义（P〉0．05）；在有无淋巴结转移组之间，有淋巴结转移组阻力指数低于无淋巴结转移组，血管数目则高于无淋巴结转移组（P〈0．05）。而恶性肿瘤的国际妇产科联盟（InternationalFederationofGynecologyandObstetrics，FIGO）临床分期中，Ⅰ期患者与其他较晚期患者之间阻力指数、血管数目比较，差异无显著意义（P〉0．05）。结论低阻力指数、高血管数目反映了组织内的高微血管密度状态，并且与卵巢恶性肿瘤的组织学分级、有无淋巴结转移有关。

Effects of Transvaginal Color Doppler Ultrasound Measurements on Microvessel Density Assessment in Ovarian Tumors

Objective To explore the dependability between transvaginal color Doppler ultrasound （TV-CDU） vascular blood flow indices and microvessel density （MVD） in ovarian tumor. Methods From January 2004 to December 2005, transvaginal color and pulsed Doppler ultrasound sonography were performed before surgical procedure in 82 women with ovarian tumors. Blood flow indices pulsatility index （PI）, resistive index （RI）, peak systolic velocity （Vps）, vessels number （VN）] were measured. Microvessel density was identified by Immunohistochemical staining of endothelial cell for CD34. Results There were statistically significant differences in microvessel density between histopathology rank of ovarian cancer. Also, a significant correlation was found between mierovessel density and low resistance to blood flow as measured by the resistive index or vessels number （P〈0.05）. However, no statistically significant correlation was found between mierovessel density and pulsatility index or peak systolic velocity. The differences of resistive index and vessels number in benign and malignant ovarian tumor or lymph node metastases group and non-lymph node metastases group of ovarian cancer were statistically significant （P〈0.01）, but no statistically significant differences were found between International Federation of Gynecology and Obstetrics （FIGO） stage Ⅰ and other stages （P〉0.05）. Statistically significant differences in vessels number were found between histopathology ranks, but resistive index was not found. Conclusion Low resistive index and high vessels number may reflect high mierovessel density in ovarian cancer and correlate with its histopathology rank and lymph node metastases.