经阴道彩色多普勒超声检查对宫颈癌盆腔淋巴结转移的诊断价值
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摘要
目的探讨经阴道彩色多普勒超声检查对宫颈癌盆腔淋巴结转移的诊断价值。方法选取2015年1月至2017年12月本院收治的行经阴道彩色多普勒超声检查的70例宫颈癌患者为研究对象,将其血流信号和血流动力学参数与手术病理结果进行对照,分析经阴道彩色多普勒超声检查对宫颈癌盆腔淋巴结转移的诊断价值。结果经阴道彩色多普勒超声诊断盆腔淋巴结转移患者41例,其中,宫颈癌分期Ⅱ期32例、Ⅲ期7例、Ⅳ期2例。以病理检查结果作为金标准,经阴道彩色多普勒超声检出盆腔淋巴结转移的准确率为91.11%(41/45),敏感度为97.37%(37/38),特异度为87.50%(28/32)。在有盆腔淋巴结转移患者中,血流丰富患者占29.27%,高回声患者占21.95%;而在无淋巴结转移患者中,血流丰富患者仅占3.45%,无高回声患者,两组比较差异均具有显著性(P_均<0.05);有盆腔淋巴结转移患者的阻力指数显著低于无盆腔淋巴结转移患者(P <0.05)。结论经阴道彩色多普勒超声可以清晰显示宫颈癌患者盆腔淋巴结转移的范围和侵犯程度,具有重要的诊断价值。
Objective To evaluate the diagnostic value of transvaginal color Doppler ultrasonography in pelvic lymph node metastasis of cervical cancer. Method From January 2015 to December 2017, 70 patients with cervical cancer who underwent transvaginal color Doppler ultrasonography were enrolled in this study. The blood ?ow signals and hemodynamic parameters were compared with the surgical pathological results, in order to analyze the diagnostic value of transvaginal color Doppler ultrasonography for pelvic lymph node metastasis of cervical cancer. Result Transvaginal color Doppler ultrasound was used to diagnose 41 patients with pelvic lymph node metastasis, including 32 cases with stage Ⅱ, 7 cases with stage Ⅲ, and 2 cases with stage Ⅳ. Taking the results of pathological examination as the gold standard, the accuracy of ultrasonography in the diagnosis of pelvic lymph node metastasis was 91.11%(41/45), the sensitivity was 97.37%(37/38), and the specificity was 87.50%(28/32). Among patients with pelvic lymph node metastasis, 29.27% had abundant blood ?ow and 21.95% had hyperechoic blood ?ow; among patients without lymph node metastasis, only 3.45% had abundant blood ?ow and no hyperechoic patients. There were signi?cant differences between the two groups(P_(all)< 0.05). The resistance index of patients with pelvic lymph node metastasis was signi?cantly lower than that of patients without pelvic lymph node metastasi(P < 0.05). Conclusion Transvaginal color Doppler ultrasonography can clearly show the extent and extent of pelvic lymph node metastasis in patients with cervical cancer, and has important diagnostic value.
Objective To evaluate the diagnostic value of transvaginal color Doppler ultrasonography in pelvic lymph node metastasis of cervical cancer. Method From January 2015 to December 2017, 70 patients with cervical cancer who underwent transvaginal color Doppler ultrasonography were enrolled in this study. The blood ?ow signals and hemodynamic parameters were compared with the surgical pathological results, in order to analyze the diagnostic value of transvaginal color Doppler ultrasonography for pelvic lymph node metastasis of cervical cancer. Result Transvaginal color Doppler ultrasound was used to diagnose 41 patients with pelvic lymph node metastasis, including 32 cases with stage Ⅱ, 7 cases with stage Ⅲ, and 2 cases with stage Ⅳ. Taking the results of pathological examination as the gold standard, the accuracy of ultrasonography in the diagnosis of pelvic lymph node metastasis was 91.11%(41/45), the sensitivity was 97.37%(37/38), and the specificity was 87.50%(28/32). Among patients with pelvic lymph node metastasis, 29.27% had abundant blood ?ow and 21.95% had hyperechoic blood ?ow; among patients without lymph node metastasis, only 3.45% had abundant blood ?ow and no hyperechoic patients. There were signi?cant differences between the two groups(P_(all)< 0.05). The resistance index of patients with pelvic lymph node metastasis was signi?cantly lower than that of patients without pelvic lymph node metastasi(P < 0.05). Conclusion Transvaginal color Doppler ultrasonography can clearly show the extent and extent of pelvic lymph node metastasis in patients with cervical cancer, and has important diagnostic value.
引文
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[17]茅晶晶,郑孟女,胡炳真,等.不同年龄宫颈癌及癌前病变患者临床分析[J].中国临床医生杂志,2018,46(2):218-219.
[18]徐莹莹,孙志霞,杨艳艳,等.彩色多普勒超声与多层螺旋CT在诊断宫颈癌中的对比分析[J].中国实验诊断学,2014,18(2):278-280.
[19]段旭艳.盆腔淋巴结转移与宫颈癌临床病理特征的关系研究[J].标记免疫分析与临床,2016,23(4):425-427.
[20]林小琼,观志强.经阴道彩色多普勒超声检查对宫颈癌的诊断价值[J].现代诊断与治疗,2016,27(4):596-598.
[2]张志红.液基薄层细胞学检查联合阴道镜在检测宫颈病变中的诊断价值分析[J].中国社区医师,2015,31(13):97-97,99.
[3]郑薇薇,杨静,张秀芳,等.经阴道超声在宫颈癌髂内淋巴转移诊断中的价值[J].中国医药导报,2017,14(31):874-879.
[4]张晓磊,彭娟,郑建华.宫颈癌FIGO分期的修订及治疗[J].国际生殖健康/计划生育杂志,2011,30(2):153-154.
[5]程静新,姚立丽,李贺月,等.5766例宫颈癌临床特征分析[J].实用妇产科杂志,2014,30(10):768-772.
[6]邓丽慧,符淳.宫颈癌和子宫内膜癌诊疗中盆腔淋巴结状态的检测及意义[J].国际妇产科学杂志,2016,43(2):151-155.
[7]李秀芳,马媛,林丽红,等.宫颈癌淋巴结转移风险的临床及预后分析[J].现代肿瘤医学,2015,23(10):1424-1427.
[8]朱昀恒,徐军,李华萍.PAX1检测对宫颈上皮内瘤变和宫颈癌HPV感染的临床诊断价值[J].中国医学前沿杂志(电子版),2017,9(9):63-67.
[9]左拥军,史丽静,谢雁.MRI扫描技术对诊断宫颈癌的临床研究[J].中国临床医生杂志,2017,45(2):83-86.
[10]张航.多普勒超声与多层螺旋CT诊断宫颈癌淋巴结转移对比分析[J].西南国防医药,2017,27(9):988-991.
[11]周慧丽,米婉琴,向红.经阴道彩色多普勒超声在宫内妊娠及异位妊娠中的诊断价值[J].中国医刊,2016,51(8):68-72.
[12]林洁.经阴道彩色多普勒超声对宫内占位性病变的诊断价值[J].中国医学前沿杂志(电子版),2015,7(9):111-113.
[13]汪侠,李振华,解宝江.彩色多普勒超声对宫颈癌盆腔淋巴结转移的诊断价值[J].实用癌症杂志,2016,31(6):1009-1011.
[14]杨虹,刘轩.经阴道彩色多普勒超声诊断宫颈癌及评估病灶内血管情况价值分析[J].中国妇幼保健,2016,31(24):5491-5493.
[15]潘静,潘庆春.中晚期宫颈癌应用经阴道彩色超声诊断的临床观察[J].实用妇科内分泌杂志(电子版),2017,4(21):97.
[16]刘华艳,杨宗利,房世保,等.宫颈癌超声造影特征与预后因素的关系[J].中华超声影像学杂志,2015,24(9):800-804.
[17]茅晶晶,郑孟女,胡炳真,等.不同年龄宫颈癌及癌前病变患者临床分析[J].中国临床医生杂志,2018,46(2):218-219.
[18]徐莹莹,孙志霞,杨艳艳,等.彩色多普勒超声与多层螺旋CT在诊断宫颈癌中的对比分析[J].中国实验诊断学,2014,18(2):278-280.
[19]段旭艳.盆腔淋巴结转移与宫颈癌临床病理特征的关系研究[J].标记免疫分析与临床,2016,23(4):425-427.
[20]林小琼,观志强.经阴道彩色多普勒超声检查对宫颈癌的诊断价值[J].现代诊断与治疗,2016,27(4):596-598.