三维能量多普勒超声在诊断和鉴别内生型宫颈癌和宫颈肌瘤中的临床价值  

Clinical value of three-dimensional power Doppler ultrasound in diagnosis and identification of endogenous cervical cancer and cervical leiomyoma

作　　者：徐晓燕[1] 魏伶羽 丁淑萍 蔡敏[1] 曾祯[1] 刘燕燕[1] 陈汉平[1] 杨薇[1] XU Xiao-Yan, WEI Ling-Yu, DING Shu-Ping, et al.(Department of Gynecology and Obstetrics, Tongji Hospital Affiliated to Ton~i Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, Chin)

机构地区：[1]华中科技大学同济医学院附属同济医院妇产科,武汉湖北430030

出　　处：《中国妇幼保健》2018年第7期1613-1616,共4页Maternal and Child Health Care of China

基　　金：国家自然科学基金青年基金(81501530);华中科技大学自主创新研究基金资助项目(2015ZHYX009)

摘　　要：目的探讨三维能量多普勒超声(3D PDUS)在鉴别内生型宫颈癌和宫颈肌瘤的价值,为早期发现和减少漏诊率提供重要的参考依据。方法选取2013年2月-2017年2月入住该院的25例内生型宫颈癌为宫颈癌组,25例宫颈肌瘤患者为宫颈肌瘤组,同时随机选取25例健康人群作为对照组,3组受试者均行3D PDUS检查。比较3组受试者血管化指数(VI)、血流指数(FI)、血管形成-血流指数(VFI)和血流分级差异,评估患者肿瘤体积与血流参数之间的相关性,并判断3种参数诊断宫颈癌及宫颈肌瘤的能力。同时采用ROC曲线评估VI,FI,VFI参数在诊断宫颈癌和宫颈肌瘤中的能力。结果 3组受试者组间VI、FI、VFI参数比较差异有统计学意义(F值分别为8.142,12.247,10.613,均P<0.05),宫颈癌组VI、FI、VFI均高于宫颈肌瘤组(q值分别为8.752,7.248,2.642,均P<0.05),宫颈肌瘤组VI、FI、VFI均高于对照组(q值分别为3.411,18.989,3.486,均P<0.01);两组患者血流分级比较差异有统计学意义(Z=-4.588,P=0.000);宫颈癌组FI参数与肿瘤体积存在相关性(r=0.624,P=0.001),而肿瘤体积与VI、VFI无相关性;宫颈肌瘤组VI、FI、VFI与肿瘤体积无相关性(r值分别为0.052,0.193,0.164,均P>0.05)。此外,VI、FI、VFI参数在诊断宫颈癌的ROC曲线下面积分别为0.844、0.858、0.842(均P<0.05),且FI诊断宫颈癌的敏感度和特异性均高于VI和VFI;而VI、FI、VFI在诊断宫颈肌瘤的ROC曲线下面积分别为0.727、0.838、0.819(均P<0.05)。结论 3D PDUS诊断和鉴别内生型宫颈癌和宫颈肌瘤具有重要的临床价值,有利于临床医生对内生型宫颈癌的早期发现,并减少漏诊率。Objective To explore the value of three-dimensional power Doppler ultrasound in identification of endogenous cervical cancer and cervical leiomyoma, provide an important reference basis for early detection and reduction of missed diagnosis rate. Methods Twenty-five patients with endogenous cervical cancer and 25 patients with cervical leiomyoma who were enrolled in the hospital from February 2013 to February 2017 were selected as cervical cancer group and cervical leiomyoma group, respectively. Twenty-five normal healthy women were randomly selected as control group. Three-dimensional power Doppler ultrasonography was performed in the three groups. The blood flow parameters in the three groups were compared, including vascularization index （VI）, flow index （FI）, vascularization-flow index （VFI） , and blood flow classification. The correlations between tumor volume and blood flow parameters were evaluated. The abilities of three parameters in diagnosis of cervical cancer and cervical leiomyoma were judged. ROC was used to evaluate the abilities of VI, FI, and VFI in diagnosis of cervical cancer and cervical leiomyoma. Results There were statistically significant differences in VI, FI, and VFI among the three groups （F= 8. 142, 12. 247, 10. 613, all P〈0. 05） . VI, FI, and VFI in cervical cancer group were statistically significantly higher than those in cervical leiomyoma group （q=8. 752, 7. 248, 2. 642, all P〈0. 05） . VI, FI, and VFI in cervical leiomyoma group were statistically significantly higher than those in control group （ q = 3.411, 18. 989, 3.486, all P〈0. 01 ） . There was sta- tistically significant difference in blood flow classification between the two groups （Z=-4. 588, P=0. 000） . In cervical cancer group, FI was positively correlated with tumor volume （r=0. 624, P=0. 001 ）, while VI and VFI were not correlated with tumor volume. In cervical leiomyoma group, VI, FI, and VFI were not correlated with tumor volume （r=0. 052, 0. 193, 0. 164, all P〉0. 05） . The

关 键 词：三维能量多普勒超声 内生型宫颈癌 宫颈肌瘤 鉴别诊断 

分 类 号：R737.33[医药卫生—肿瘤]