早期宫颈癌灶血供均衡性的数字化研究  

A digital study of blood supply balance in early stage cervical cancer lesions

作　　者：周静[1] 段慧[1] 陈春林[1] 刘萍[1] 李鹏飞[1] 赵春梅[1] 王雪芹[1] 廖科丹[1] 龚时鹏[1] 

机构地区：[1]南方医科大学南方医院妇产科,广州510515

出　　处：《广东医学》2015年第22期3457-3461,共5页Guangdong Medical Journal

基　　金：国家科技支撑计划项目(编号:2014BAI05B03);国家自然科学基金资助项目(编号:81272585;61190120);广州市科技计划项目(编号:201508020264)

摘　　要：目的采用在体子宫动脉血管网数字化三维重建方法,探讨早期宫颈癌灶血供均衡性与术后病理学指标之间的相关性。方法收集术前行盆腔CTA扫描的FIGO分期Ⅰb1期、Ⅱa1期宫颈癌手术患者87例。将CTA数据集导入Mimics软件行子宫动脉血管网数字化三维重建,并立体分割计算双侧宫颈癌灶血管网体积。根据宫颈癌灶血供一侧占双侧的比例分为均衡型（40%-60%）和非均衡型（〈40%或〉60%）2种血供类型。分析2种血供类型与术后病理学指标包括病理学类型、肿瘤最大径、组织分化程度、宫颈浸润深度、脉管间隙浸润、宫旁浸润、宫体浸润、阴道浸润、盆腔淋巴结转移的相关性。结果 87例患者中宫颈癌灶血供均衡型29例,非均衡型58例。有阴道浸润的血供均衡型比例更高（P=0.003）。其他病理学指标与血供均衡性无相关性（P〉0.05）。结论早期宫颈癌灶以血供非均衡型为主,呈偏向性生长;阴道浸润可增强对侧子宫动脉对宫颈癌灶供血。Objective To investigate the correlation between the type of tumor blood supply balance and postoperative pathological factors in early stage cervical cancer through in vivo three - dimensional reconstruction of the uterine artery network. Methods A total of 87 cases of FIGO stages I bl and 11 al cervical cancer, with preoperative scan of computed tomography angiography （CTA） , were enrolled in the study. The uterine artery network model of each case was reconstructed from the preoperative CTA data using the software Mimics. Space partitioning was performed before calculation of the volume of tumor arterial network on either side of the lesion. A definition was made for the types of tumor blood supply balance ： balanced type, in which the ratio of the volume of arteries of one side to that of both sides of the cervical cancer was between 40% and 60% ; unbalanced, in which the ratio of the volume of arteries of one side to that of both sides was less than 40% or higher than 60%. The correlation between the type of blood supply and various postoperative pathological indices, including pathological type, maximal tumor diameter, degree of differentiation, depth of invasion in cervix, lymph -vascular space invasion, parametrial infiltration, endometrial invasion, vaginal invasion and pelvic lymph node metastasis were analyzed. Results Out of the 87 cases enrolled, 29 were of the balanced type and 58 were of the unbalanced type. Cases with vaginal invasion had higher proportion of balanced type （P = 0. 003 ）. No statistically significant difference was found between the blood supply balance type and other pathological indices （ P 〉 0. 05 ）. Conclusions The majority of early stage cervical cancer cases are of the unbalanced type, which suggests that tumor growth deflects towards one side of the cervix. Vaginal invasion enhances blood supply to the cancer lesion from the contralateral uterine artery

关 键 词：宫颈癌 血供均衡性 子宫动脉血管网 三维重建 阴道浸润 

分 类 号：R737.33[医药卫生—肿瘤]