卵巢肿瘤经阴道超声三维血管定量与病理微血管密度相关研究  

Correlation between transvaginal three-dimensional angiography quantity and pathological microvessel density in ovarian tumors

作　　者：齐铮琴[1] 赵玉珍[1] 纪晓惠[1] 杨漪[1] 薛逊[1] 

机构地区：[1]河北医科大学第四医院超声科

出　　处：《中华超声影像学杂志》2005年第11期840-843,共4页Chinese Journal of Ultrasonography

基　　金：河北省科委重点研究项目:No:00276305D

摘　　要：目的探讨经阴道超声三维彩色能量血管成像(transvaginal three-dimensional color power angiography,TV3D-CPA)检测卵巢肿瘤的血管病理学基础,评价TV3D-CPA鉴别卵巢良、恶性肿瘤的临床应用价值及其与临床分期的关系。方法术前应用TV3D-CPA技术检测61例卵巢肿瘤患者(38例卵巢恶性肿瘤,5例卵巢交界性肿瘤,18例卵巢良性肿瘤),观测肿瘤内血管分布类型,计算肿瘤内血管指数(vascu laryindex,VI)。术后应用抗CD34单克隆抗体对病理切片进行免疫组织化学染色,计数肿瘤微血管密度(micro vessel density,MVD),确定卵巢恶性肿瘤临床分期。分析VI与MVD的相关性及其与临床分期的关系。结果卵巢恶性肿瘤血管分布Ⅲ型30例(78.9%),明显高于良性肿瘤(1例,5.6%),以3D-CPAⅢ型诊断卵巢恶性肿瘤敏感性78.9%,特异性86.9%。卵巢恶性肿瘤VI与MVD均明显高于卵巢良性肿瘤(P<0.05),以VI≥0.035条/cm3诊断卵巢恶性肿瘤敏感性84.2%,特异性70.0%。卵巢恶性肿瘤Ⅲ、Ⅳ期VI及MVD均明显高于Ⅰ、Ⅱ期(P<0.05)。38例卵巢恶性肿瘤VI与MVD呈正相关(r=0.684,P<0.01)。结论TV3D-CPA可术前评价卵巢肿瘤血管的生成,为卵巢良恶性肿瘤的鉴别及肿瘤恶性程度的术前评估提供有价值的信息。Objective The vascular pathologic basis of transvaginal three-dimensional color power angiography（TV3D-CPA） was studied to evaluate its value in identifying and staging ovarian tumors. Methods Sixty-one ovarian tumors （38 malignant ovarian tumors,5 borderline ovarian tumors, 18 benign ovarian tumors） were examined preoperatively with TV3D-CPA. The vascularity type and vasculary index （Ⅳ） were assessed respectively. The specimens were stained immunohistochemically with anti-34 antibody and microvessel density （MVD） was calculated. The malignant ovarian tumors were staged according to FIGO,2000 standard. The relation between the indices （VI and MVD） and clinical stages were analyzed. Results Type Ⅲ of vascularity type were found in 78.9% （30/38） malignant ovarian tumors and （5.6%, 1/18） benign ovarian tumors （ P 〈0. 05）, The sensitivity and specificity of using type Ⅲ to diagnose malignant ovarian tumors were 78.9% and 86.9%, respectively. Ⅵ and MVD in 38 malignant ovarian tumors were significiantly higher than those in benign tumors（ P 〈0.05）. Using Ⅵ≥0. 035 counts/cm^3 as a cutoff,the sensitivity and specificity in detecting malignant ovarian tumors were 84.2% and 70.0% respectively. Ⅵ and MVD in stage Ⅲ ,ⅣV were higher than that in stage Ⅰ , Ⅱ （ P 〈0. 05）. There was significant positive correlation between Ⅵ and MVD in 38 malignent ovarian tumors（ r = 0. 684, P 〈0. 01 ）. Conclusions TV3D-CPA can be used to evaluate the angiogenesis in ovarian tumors and provides valuable information to identify malignant ovarian tumors and tumor grade.

关 键 词：超声检查 卵巢肿瘤 血管指数 微血管密度 

分 类 号：R737.31[医药卫生—肿瘤]