初诊宫颈癌超声特征及与病理参数相关性分析  

The Ultrasonic Characteristics and Its Correlation with Pathological Parameters of Newly Diagnosed Cervical Cancer

作　　者：翁亮[1] 柯友森[2] 

机构地区：[1]南京军区福州总医院超声诊断科,福州350025 [2]南京军区福州总医院体检中心,福州350025

出　　处：《医学综述》2015年第20期3779-3781,共3页Medical Recapitulate

摘　　要：目的探讨初诊宫颈癌超声特征及与病理参数之间的相关性。方法选取2014年1～11月南京军区福州总医院初诊宫颈癌患者100例为研究对象，患者均于入院后3d内行女性盆腔超声检查，并通过组织病理学检查对病变组织内微血管密度（MVD）进行计数。观察初诊宫颈癌超声声像图特征，多普勒血流特征及不同分期病变间的差异。结果超声声像图显示宫颈形态正常或轻度增厚（I期）；宫颈不均匀增厚，体积增大（Ⅱ期）；宫颈病变累及宫颈管、官体或宫旁组织（m期）。病变回声增强，呈点条状，多普勒技术显示点状血流（Ⅰ期）；不均匀回声范围增大，多普勒技术显示点条状及网状血流（Ⅱ期）；宫颈病变累及宫颈管、官体或宫旁组织，多普勒技术显示血流丰富（Ⅲ期）。宫颈鳞癌与宫颈腺癌间，多普勒超声阻力指数（RI）值、MVD值比较差异无统计学意义[（0．45±0．07）比（0．45±0．06），（32．76±6．87）比（31．43±7．43），P〉0．05]。在伴有淋巴结转移患者多普勒超声RI值、MVD值显著低于未伴有淋巴结转移患者[（0．41±0．06）比（0．47±0．07），（33．54±7．65）比（28．87±5．77），P〈0．01]。随着宫颈癌分期的增加，其RI值逐渐降低（Ⅰ期：0．47±0．05；Ⅱ期：0．44±0．06；Ⅲ期：0．39±0．04），MVD值逐渐升高（Ⅰ期：25．36±5．61；Ⅱ期：30．52±4．72；Ⅲ期：33．51±3．91），分期间比较，差异均有统计学意义（P〈0．05）。经Pearson相关分析，宫颈癌RI值与MVD值间呈显著负相关（r=-0．518，P：0．014）。结论多普勒超声检查可以清晰显示宫颈癌病变的特征，随病变分期增加，其声像图及多普勒血流特征存在差异。Objective To investigate the ultrasound characteristics of newly diagnosed cervical cancer and the correlation with pathological parameters. Methods A total of 100 patients with newly diagnosed cer- vical cancer patients from Fuzhou General Hospital of Nanjing Military Region during Jan. and Nov. 2014 were chosen as the research objects. All patients underwent pelvic ultrasonography and histopathological examination of lesions and microvessel density （MVD） was counted. The ultrasonographic features of newly diagnosed cervical cancer were observed, and Doppler flow characteristics in different stages of disease were compared. Results Ultrasonography showed normal or mild thickening of the cervical morphology （ phase I ） ;irregular cervical thickening, increase in size （ Ⅲ） ; cervical lesions involving the cervix, uterine body or parametrial tissue （ Ⅲ ）. The lesion showed echo enhancement, in spot or strip, Doppler showed poor blood flow （ phase Ⅰ ） ; inhomogeneous echo range increases, Doppler showed spot strip and mesh flow （ Ⅱ ） ; cervi- cal lesions involving the cervix, uterine body or parametrial tissue, Doppler showed rich blood flow （ Ⅲ ） Between cervical squamous carcinoma and adenocarcinoma, the Doppler RI value （0.45 ± 0.07 vs 0.45 ± 0. 06）, MVD value （32.76 ± 6.87 vs 31.43 ± 7.43 ）, had no significant difference （ P 〉 0.05 ）. Between patients with and without lymph node metastasis of cervical cancer,the Doppler resistance index （RI） value （0.41 ± 0.06 vs 0. 47 ± 0.07）, MVD value （ 33.54 ± 7.65 vs 28.87 ± 5.77 ） had statistically significant difference （P 〈 0.01 ）. With the increase of staging of cervical carcinoma, the value of RI decreased gradually （ stage Ⅰ ：0. 47 ± 0. 05 ; stage Ⅱ ：0.44 ± 0.06 ; stage Ⅲ ：0.39 ± 0.04 ）, the MVD value increased gradually （stage Ⅰ ：25.36 ± 5.61 ; stage Ⅱ：30.52 ± 4.72 ;stage Ⅲ ：33.51 ± 3.91 ） ,the differences were statistically significant （ P 〈 0. 05

关 键 词：宫颈癌 微血管密度 多普勒超声 恶性肿瘤 

分 类 号：R737.33[医药卫生—肿瘤]