彩色超声检测微血管与宫颈癌转移关系分析
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摘要
目的探讨彩色超声检测微血管与宫颈癌转移的关系。方法选择宫颈癌患者60例,先接受彩色超声诊断,再进行手术治疗。术后记录扫除的淋巴结个数并进行病理检测,检测并记录宫颈癌类型、血管累及、宫旁浸润和间质浸润深度。分析宫颈癌病灶血流丰富程度与宫颈癌类型、血管累及、宫旁浸润和间质浸润深度的关系,应用Logistic多元回归分析法分析宫颈癌转移的危险因素。结果经手术及术后病理检查共发现盆腔淋巴转移29例(48.3%)。彩色超声检查共发现盆腔转移25例(41.7%),其检查的敏感度82.76%、特异度96.77%、准确度90.00%、阳性预测值96.00%、阴性预测值85.74%。出现宫旁浸润、血管累及、间质浸润深度≥10 cm和淋巴结转移者较宫旁无浸润、血管未累及、间质浸润深度<10 mm和淋巴结未转移者血流丰富(P<0.05)。Logistic回归分析结果显示宫旁浸润、血管累及、间质浸润、淋巴转移是引起宫颈癌血流丰富的高危因素。结论彩色超声显示宫颈癌患者淋巴转移与病理结果具有较好的一致性,并且淋巴转移联合血流丰富程度检测对宫颈癌转移具有较好的诊断价值。
Objective To investigate the relationship between microvessels and cervical cancer metastasis detected by color Doppler ultrasound. Methods Sixty patients with cervical cancer were selected in this study. All patients were diagnosed by color Doppler ultrasound imaging and then treated with surgery. The number of lymph nodes removed after operation was recorded and the pathological examination was performed. The type of cervical cancer, vascular involvement, parametrial infiltration and interstitial infiltration depth were detected and recorded. The relationship between the blood flow richness of cervical cancer lesion and the type of cervical cancer, vascular involvement, parauterine infiltration and interstitial infiltration depth was analyzed. The logistic multiple regression analysis was used to analyze the risk factors of cervical cancer metastasis. Results A total of 29 cases(48.3%) of pelvic lymphatic metastasis were found by operation and postoperative pathological examination. A total of 25 cases(41.7%) of pelvic metastasis were found by color Doppler ultrasonography. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of color Doppler ultrasound were 82.76%, 96.77%, 90.00%, 96.00% and 85.74%, respectively. Compared with those without parametrial infiltration, no vascular involvement, interstitial infiltration depth(<10 mm) and no lymph node metastasis, the blood flow was abundant in patients with parametrial infiltration, vascular involvement, interstitial infiltration depth(≥10 cm) and lymph node metastasis. The logistic regression analysis showed that parametrial infiltration, vascular involvement, interstitial infiltration and lymphatic metastasis were the high risk factors for cervical cancer with abundant blood flow. Conclusion The color Doppler ultrasound imaging system has a good consistency with pathological results in lymphatic metastasis of cervical cancer patients, and lymphatic metastasis combined with the detection of blood flow richness has a good diagnostic value for cervical cancer metastasis.
Objective To investigate the relationship between microvessels and cervical cancer metastasis detected by color Doppler ultrasound. Methods Sixty patients with cervical cancer were selected in this study. All patients were diagnosed by color Doppler ultrasound imaging and then treated with surgery. The number of lymph nodes removed after operation was recorded and the pathological examination was performed. The type of cervical cancer, vascular involvement, parametrial infiltration and interstitial infiltration depth were detected and recorded. The relationship between the blood flow richness of cervical cancer lesion and the type of cervical cancer, vascular involvement, parauterine infiltration and interstitial infiltration depth was analyzed. The logistic multiple regression analysis was used to analyze the risk factors of cervical cancer metastasis. Results A total of 29 cases(48.3%) of pelvic lymphatic metastasis were found by operation and postoperative pathological examination. A total of 25 cases(41.7%) of pelvic metastasis were found by color Doppler ultrasonography. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of color Doppler ultrasound were 82.76%, 96.77%, 90.00%, 96.00% and 85.74%, respectively. Compared with those without parametrial infiltration, no vascular involvement, interstitial infiltration depth(<10 mm) and no lymph node metastasis, the blood flow was abundant in patients with parametrial infiltration, vascular involvement, interstitial infiltration depth(≥10 cm) and lymph node metastasis. The logistic regression analysis showed that parametrial infiltration, vascular involvement, interstitial infiltration and lymphatic metastasis were the high risk factors for cervical cancer with abundant blood flow. Conclusion The color Doppler ultrasound imaging system has a good consistency with pathological results in lymphatic metastasis of cervical cancer patients, and lymphatic metastasis combined with the detection of blood flow richness has a good diagnostic value for cervical cancer metastasis.
引文
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[2] Akita S,Mitsukawa N,Kuriyama M,et al.Comparison of vascularized supraclavicular lymph node transfer and lymphaticovenular anastomosis for advanced stage lower extremity lymphedema[J].An Plast Surg,2015,74(5):573-579.
[3] Iden M,Fye S,Li K,et al.The lncRNA PVT1 contributes to the cervical cancer phenotype and associates with poor patient prognosis[J].PLoS One,2016,11(5):e0156274.
[4] Kyung MS,Kim HB,Seoung JY,et al.Tumor size and lymph node status determined by imaging are reliable factors for predicting advanced cervical cancer prognosis[J].Oncol Lett,2015,9(5):2218-2224.
[5] 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):1009-1011,1014.
[6] 王亚凡,刘晓旭,莫中福,等.河北省部分农村妇女宫颈癌、乳腺癌筛查结果分析[J].河北医科大学学报,2016,37(2):154-157.
[7] 舒桐,白萍,张蓉,等.106例Ⅰa～Ⅱb期宫颈癌肺转移患者的临床特点和预后影响因素[J].中华肿瘤杂志,2014,36(9):703-707.
[8] Sulo E,Hartiala P,Viitanen T,et al.Risk of donor-site lymphatic vessel dysfunction after microvascular lymph node transfer[J].J Plast Reconstr Aesthet Surg,2015,68(4):551-558.
[9] Joseph WJ,Aschen S,Ghanta S,et al.Sterile inflammation after lymph node transfer improves lymphatic function and regeneration[J].Plast Reconstr Surg,2014,134(1):60-68.
[10] 高义军,李娜,刘春兰,等.MRI与经阴道彩超在早期宫颈癌术前评估中对照研究[J].临床放射学杂志,2017,36(1):91-94.
[11] 高义军,李晓伟,王建六.核磁共振联合阴道彩超评估早期子宫颈癌病情的价值初探[J].现代妇产科进展,2014,14(7):538-540,544.
[12] Zheng RR,Huang M,Jin C,et al.Cervical cancer systemic inflammation score:a novel predictor of prognosis[J].Oncotarget,2016,7(12):15230-15242.
[13] 李平,王学梅,宋鉴清,等.三维能量多普勒超声检测宫颈癌的血流与miR-455表达的相关性研究[J].现代肿瘤医学,2014,22(4):892-895.
[14] 谷小乐,石岩,郝怀海,等.肿瘤标志物、微血管密度与血流参数检测宫颈癌和宫颈上皮内瘤样病变的相关性及临床意义[J].中国地方病防治杂志,2016,16(11):1278,1282.
[15] 文国慧,肖潇,杜学文,等.三维彩色多普勒超声定量血流分析在早期宫颈癌筛查诊断中的应用[J].实用医院临床杂志,2017,14(4):143-145.