卵巢肿瘤的三维彩色血管能量成像与病理微血管密度对比研究

目的：探讨上皮性卵巢肿瘤的三维彩色血管能量成像（three-dimensional color power angio,3D－CPA)特点及其血管病理学基础，评价3D－CPA鉴别卵巢肿瘤的临床应用价值。方法：对67例上皮性卵巢肿瘤患者（40例卵巢癌，27例良性上皮性卵巢肿瘤）术前应用3D－CPA检测肿瘤的血管分布类型并计算肿瘤血管指数（vascularity index,VI)，术后分别应用抗血管内皮生长因子（VEGF）、抗CD34单克隆抗体对组织进行免疫组织化学染色，计数肿瘤的微血管密度（microvessel density,MVD)及VEGF染色强度。结果：卵巢癌的MVD及VEGF表达强度均显著高于良性上皮性卵巢肿瘤（P＜0．05）。以3D－CPA血管指数＞0．02条／cm^3诊断卵巢癌敏感性77．5％，特异性81．5％。卵巢癌的血管指数与MVD呈等级相关（rs= 0.503,P＜0．01）。结论：3D－CPA可用于术前间接评价肿瘤的血管生成，为卵巢肿瘤的诊断及鉴别提供有价值的信息。

Contrast Study Between Three-dimensional Color Power Angio and MicrovesselDensity in Ovarian Tumors

Objective:To evaluate the clinical value of 3D CPA in differentiating epithelial ovarian tumors by studying tumors vascular pathology.Methods:Sixty seven epithelial ovarian tumors(40 ovarian carcinomas,27 benign epithelial ovarian tumors)were examined preoperatively with 3D CPA.The vascular pattern and vascularity index(VI)of the tumor were assessed respectively.Tumors' vascular endothelial growth factor(VEGF)protein and microvessels were stained immunohistochemically by using anti VEGF and anti CD 34 antibody respectively after operation.Both the microvessel density(MVD)and the intensity of VEGF staining were analyzed.Results:The MVD and the intensity of VEGF staining in ovarian carcinomas were significantly stronger than those in benign ovarian tumors( P <0 05).When 0 02 counts/cm 3 was considered as the cutoff of vascularity index,the sensitivity and specificity of vascularity index in detecting ovarian carcinoma were 77 5% and 81 5%,respectively.The vascularity index was correlated with MVD in ovarian carcinomas.Conclusions:3D CPA may by used to evaluate the angiogenesis in ovarian carcinoma before operation and could provide valuable information for the differential diagnosis of epithelial ovarian tumors.