超声检测卵巢内膜样囊肿间质血流预测卵巢组织损伤的研究  

Prediction of Ovarian Tissue Injury by Sonographical Blood Flow of Ovarian Interstitia in Ovarian Endometrioid Cyst

作　　者：刘颖蕾[1] 刘曼华[2] 邱君君[2] 陈丽平[2] 张忠新[3] 刘宏斌[4] 

机构地区：[1]南京医科大学,江苏省南京市210000 [2]南通大学第二附属医院妇产科 [3]南通大学第二附属医院超声科 [4]南通大学第二附属医院病理科

出　　处：《中国全科医学》2011年第28期3246-3249,共4页Chinese General Practice

基　　金：南通市社会发展科技项目(S2010024)

摘　　要：目的探讨卵巢内膜样囊肿(OEC)间质血流变化及其与转化生长因子-β1(TGF-β1)、血小板反应蛋白-1(TSP-1)及微血管密度(MVD)的相关性,预测OEC对卵巢间质组织的损伤。方法术前应用经阴道彩色多普勒超声检测60例OEC患者(研究组)及30例卵巢良性肿瘤患者(对照组)的卵巢间质血流信号及阻力指数(RI),术后采集有血流显示的囊肿或肿瘤周边间质进行免疫组化染色,检测TGF-β1、TSP-1的表达及MVD计数。结果 (1)OEC卵巢间质内血流信号少,阻力高,RI值较对照组显著增高,差异有统计学意义(P<0.01)。(2)OEC卵巢间质内TGF-β1、TSP-1表达增高,阳性表达率分别为70.59%、66.67%,MVD表达下降,平均值为(5.87±1.44)个/400倍视野,与对照组比较差异均有统计学意义(P<0.01)。TGF-β1与TSP-1的表达呈正相关(rs=0.90,P<0.01),两者均与MVD值呈负相关(rs=-0.70、-0.76,P<0.01)。(3)超声血流RI值与MVD呈负相关(rs=-0.91,P<0.01),与TGF-β1、TSP-1的表达呈正相关(rs=0.77、0.81,P<0.01)。结论卵巢间质血流变化与TGF-β1、TSP-1和MVD表达的改变从不同角度反映了OEC的病理状态,两者相一致。超声检测卵巢间质血流可前瞻性地预测OEC对卵巢组织的损伤。Objective To investigate the change of interstitial blood flow in ovarian endometrioid cyst（OEC）,its correlation with transforming growth factor-β1（TGF-β1）,thrombospondin-1（TSP-1）,and microvessel density（MVD）,in order to predict the injury of ovarian interstitial in OEC. Methods The transvaginal colour Doppler sonography（TV-CDS） was preoperatively performed to detect the signal and resistance index of ovarian blood flow for 60 OEC patients（trial group） and 30 patients with benign ovarian tumors（control group）.The interstitial tissues of the cyst or around the tumor with blood flow were operationally collected,and then the expressions of TGF-β1 and TSP-1 of were assayed by immunohistochemical analysis.And MVD count was performed. Results（1） In the OEC group the signals of blood flow were reduced,and the RI was significantly increased as compared with that in the controls（P0.01）.（2） In the OEC group,the expressions of TGF-β1（positivity rate of 70.59%） and TSP-1（positivity rate of 66.67%） were increased,and the MVD count was reduced with a average of（5.87±1.44）/400 times of visual field,with significant differences compared with those in the controls（P0.01）.There was a positive correlation between expressions of TGF-β1 and TSP-1（rs=0.90,P0.01）.The expressions of TGF-β1 and TSP-1 were negatively correlated with MVD value（rs=-0.70,-0.76,P0.01）.（3） MVD showed a negative correlation with RI（rs=-0.91,P0.01）,a positive correlation with the expressions of TGF-β1,TSP-1（rs=0.77,0.81,P0.01）. Conclusion Changes in ovarian interstitial flow and in expressions of TGF-β1,TSP-1 and MVD reflect pathological conditions of OEC from different respects,being consistent.The sonographic blood flow of ovarian interstitia may prospectively predict the ovarian interstitial damage in OEC.

关 键 词：卵巢内膜样囊肿 经阴道彩色多普勒超声 转化生长因子-Β1 血小板反应蛋白-1 微血管密度 

分 类 号：R711.75[医药卫生—妇产科学]