卵巢浆液性肿瘤组织微血管密度和血管阻力及分级的特点  

The Correlative Study between Blood Flow Measurements and Microvessel Density Assessments in Ovarian Epithelial Serous Tumors

作　　者：庞玉兰[1] 薛红霞[1] 焦彤[2] 李慧东[3] 

机构地区：[1]天津中医药大学,300073 [2]天津市人民医院超声科 [3]天津市中心妇产科医院超声科

出　　处：《国际妇产科学杂志》2015年第6期626-629,I0001,共5页Journal of International Obstetrics and Gynecology

摘　　要：目的：探讨具有相似形态特征不同病理性质的卵巢浆液性肿瘤的血管阻力指数（RI）和血管分级的特点,以及两者与微血管密度（MVD）的相关性及临床参考价值.方法：回顾性分析2012年10月—2014年7月天津市人民医院和天津市中心妇产科医院收治的76例卵巢浆液性肿瘤患者,依据术后病理结果分为3组：良性组30例,病理结果为良性浆液性囊腺瘤,囊内可见分隔或乳头样实性组织,不包括单纯性浆液性囊腺瘤;交界性组24例,病理结果为交界性浆液性囊腺瘤;Ⅰ期癌组22例,病理结果为浆液性囊腺癌,国际妇产科联盟（FIGO）卵巢癌分期为Ⅰ期癌.观察经阴道彩色多普勒（TVCDU）检测RI和三维能量多普勒（3D-CPA）血管分级,评价卵巢浆液性肿瘤的血流特点,并与MVD进行相关性研究.结果：不同病理性质的卵巢浆液性肿瘤的MVD比较差异有统计学意义（F=69.08,P〈0.001）,其中Ⅰ期癌组高于良性组和交界性组（P〈0.001）;3组RI比较差异有统计学意义（F=17.36,P〈0.001）,其中良性组高于交界性组和Ⅰ期癌组（P〈0.001）,交界性组与Ⅰ期癌组比较差异无统计学意义（P〉0.05）;3组3D-CPA血管分级比较差异有统计学意义（χ2=27.263,P〈0.001）,其中良性组以Ⅰ级血流为主（63.3%）,交界性组和Ⅰ期癌组以Ⅱ、Ⅲ级血流为主（分别为70.8%、100%）,良性组与交界性组和Ⅰ期癌组比较差异有统计学意义（P〈0.017）,交界性组与Ⅰ期癌组间差异无统计学意义（P=0.034〉0.017）. 3D-CPA血管分级与MVD呈正相关（rs=0.794,P〈0.01）,RI与MVD呈负相关（r=-0.786,P〈0.01）. 结论：RI和3D-CPA可用于术前评估肿瘤血管血流特点,辅助用于具有相似形态特征的卵巢浆液性肿瘤的病理分型.Objective：To explore the resistance index（RI） and vessel class characteristics of different pathological nature of ovarian epithelial serous tumors with similar morphological characteristics, and the correlation between the two and microvessel density （MVD） and clinical reference value. Methods：To retrospectively analyse 76 cases of ovarian serous tumor patients treated in October 2012—July 2014 from Tianjin Renmin Hospital and Tianjin Central Hospital of Gynecology and Obstetrics , divided into 3 groups according to the postoperative pathologic results： benign group （30 cases）, the pathological results for benign serous cystadenoma with solid organization or nipple samples, excluding simple ovarian serous cystadenoma;border group （24 cases）, pathological results as borderline serous cystadenoma;stageⅠcarcinoma group （22 cases）, pathological results for serous cystadenocarcinoma, the International Federation of Gynecology and Obstetrics （FIGO） ovarian carcinoma stage for stageⅠ. Observed by Transvaginal Color Doppler Ultrasound （TVCDU）, vascular RI and Three-dimensional Color Power Doppler Angiography （3D-CPA） vessel class, evaluated the blood flow characteristics of ovarian serous tumors, and the correlation between MVD and the two parameters were researched. Results：There was statistically significant difference of MVD in different pathological nature of ovarian serous tumor （F=69.08, P〈0.001）, and stageⅠcarcinoma group was the highest among 3 groups （P〈0.001）;Compared RI of 3 groups, difference was statistically significant （F=17.36, P〈0.001）, the benign tumor group was higher than the border group and stageⅠcarcinoma group （P〈0.001）, the border and stageⅠcancer group without statistical difference（P〉0.05）;3D-CPA vessels class of 3 groups was different from each other, statistically significantly （χ2=27.263,P〈0.001）, of which the benign group is priority toⅠvessel class （63.3%）, border and stageⅠcarcinoma group is

关 键 词：卵巢肿瘤 肿瘤 囊性 黏液性和浆液性 超声检查 微血管 免疫组织化学 

分 类 号：R737.31[医药卫生—肿瘤]