彩色多普勒超声Adler分级与宫颈癌临床病理参数的相关性  

Correlation study between color Doppler ultrasound Adler grade and clinicopathological parameters of cervical cancer

作　　者：杜阳春[1] 肖艳菊[1] 郑红雨[1] 王小燕[1] 许春梅[1] 陈海宁[1] DU Yang - chun;XIAO Yan - ju;ZHENG Hong - yu;WANG Xiao - yan;XU Chun - mei;CHEN Hai - ning(Department of Ultrasound,the People's Hospital of Guangxi Zhuang Autonomous Region, Nanning 530021,Guangxi,China)

机构地区：[1]广西壮族自治区人民医院超声科

出　　处：《广东医学》2019年第11期1573-1578,共6页Guangdong Medical Journal

基　　金：广西壮族自治区卫生和计划生育委员会自筹经费科研课题(编号:Z2016761);南宁市青秀区科学研究与技术开发计划项目(编号:2015S07)

摘　　要：目的通过回顾性分析经阴道彩色多普勒超声( transvaginal color Doppler flow imaging,TV - CDFI) Adler 分级与宫颈癌患者临床病理参数[临床分期、肿块大小、病理类型、鳞癌亚型、CA125、CA199、微血管密度( microvessel density,MVD)]的相关性,探讨 Adler 分级在宫颈癌诊疗中的价值。方法选择经病理确诊的宫颈癌患者 124 例,所有患者均接受 TV - CDFI 检查,根据 Adler 分级将声像图分为 0 ~ 3 级,分析 Adler分级与临床病理参数的相关性。结果随着 Adler 分级的增加,宫颈肿块不断增大、临床分期不断增加、MVD计数不断增多;Adler 分级与临床分期、肿块大小、鳞癌亚型及 MVD 计数呈正相关,差异有统计学意义( P < 0. 05);Adler 分级与病理类型、CA125 及 CA199 水平无相关性;以临床分期为标准,Adler 分级预测宫颈癌临床分期≥Ⅱ期的受试者工作特征(ROC)曲线下面积为 0. 915,其敏感度、特异度、阳性预测值、阴性预测值、 Youden 指数分别为 99. 32%、76%、85. 98%、98. 69%、0. 75,临界值> 1;以病理结果为标准,Adler 分级预测宫颈鳞癌亚型的ROC 曲线下面积为 0. 733,其敏感度、特异度、阳性预测值、阴性预测值、Youden 指数分别为52. 38%、89. 02%、70. 99%、78. 47%、0. 41,临界值> 2。结论 Adler 分级技术为辅助诊断宫颈癌提供了便捷、有效的无创检查方法,有望广泛应用于临床实践。Objective To evaluate the significance of Adler grading in the diagnosis and treatment of cervical cancer.Methods A retrospective analysis on the correlation between transvaginal color Doppler flow imaging Adler grade and clinicopathological parameters ( clinical stage,mass size, pathological type,squamous cell carcinoma subtype, CA125,CA199,microvessel density) of cervical cancer patients was carried out on 124 patients with cervical cancer con- firmed by pathology.All patients received TV - CDFI examination.According to Adler grade,the sonogram was divided into Grade 0 - 3,and the correlation between Adler grade and clinicopathological parameters was analyzed.R esults With the increase of Adler grade,mass size,clinical stage and MVD counts were increased.Adler grade was significantly positively correlated with clinical stage,mass size,squamous cell carcinoma subtypes and MVD counts.There was no cor- relation between Adler grade and pathological type,CA125 and CA199 levels.Based on clinical staging,the area under ROC curve for predicting clinical stage (≥Ⅱ) of cervical cancer by Adler grade was 0. 915 ( P < 0. 05),with the sensi- tivity,specificity, positive predictive value,negative predictive value and Youden index of 99. 32%,76%,85. 98%, 98. 69% and 0. 75,respectively,and the cut - off value for diagnosis was over 1.Based on the pathological results,the area under ROC curve of Adler grade for predicting cervical squamous cell carcinoma subtypes was 0. 733 ( P < 0. 05), with the sensitivity,specificity,positive predictive value,negative predictive value and Youden index of 52. 38%, 89. 02%,70. 99%,78. 47% and 0. 41,respectively,and the cut - off value for diagnosis was over 2.Conclusion The technology of Adler grading provides a convenient and effective non - invasive method for assistant diagnosis of cervical cancer,and it is expected to be widely used in clinical practice.

关 键 词：宫颈癌 经阴道超声 彩色多普勒超声 Adler分级 临床病理参数 

分 类 号：R711.74[医药卫生—妇产科学] R445.1[医药卫生—临床医学]