子宫内膜病变组织血流参数测定在良恶性病变鉴别中的价值  

The value of measuring blood flow parameters of endometrial lesions in the differentiation of benign and malignant lesions

作　　者：冯金凤[1] 武艳娇 陈宝霞[1] 高敏 Feng Jinfeng;Wu Yanjiao;Chen Baoxia;Gao Min(Department of Ultrasonic, the Second Hospital Affiliated to Hebei North University, Hebei Province,Zhangjiakou 075100,China)

机构地区：[1]河北北方学院附属第二医院功能科,075100

出　　处：《疑难病杂志》2021年第8期807-810,815,共5页Chinese Journal of Difficult and Complicated Cases

基　　金：河北省医学科学研究重点课题(20190865)。

摘　　要：目的检测子宫内膜病变组织中血流参数,并分析其在良恶性病变鉴别中的价值。方法选取2017年1月—2019年6月河北北方学院附属第二医院收治并经组织病理学确诊为子宫内膜癌患者(恶性组)61例及子宫内膜增生患者(良性组)19例,比较2组患者及恶性组不同病理分期患者子宫内膜病变组织血流阻力指数(RI)、搏动指数(PI)及内膜组织微血管密度(MVD)计数,分析RI、PI与MVD水平的相关性。ROC曲线分析RI、PI对鉴别子宫内膜病变性质的价值。结果恶性组患者子宫内膜病变组织PI、RI明显低于良性组,而MVD则明显高于良性组,2组间比较差异具有统计学意义(t=7.234、12.605、12.834,P<0.01);子宫内膜癌患者子宫内膜病变组织PI、RI随FIGO分期增高而呈下降趋势(Ⅰ期>Ⅱ期>Ⅲ期),而MVD则随FIGO分期增高而呈上升趋势(Ⅰ期<Ⅱ期<Ⅲ期),差异均有统计学意义(F=9.862、31.021、12.556,P<0.01);Pearson相关性分析显示,子宫内膜癌患者子宫内膜病变组织PI、RI与MVD水平呈负相关性(r=-0.683、-0.677,P<0.05);ROC分析表明,RI、PI鉴别子宫内膜病变性质的曲线下面积为0.898、0.894。结论子宫内膜癌患者子宫内膜病变组织中RI、PI与MVD值呈负相关,RI、PI可为子宫内膜良、恶性病变判定提供依据。Objective To detect blood flow parameters in endometrial lesions and analyze their value in the differentiation of benign and malignant lesions.Methods From January 2017 to June 2019,61 patients with endometrial cancer(malignant group)and 19 patients with endometrial hyperplasia(benign group)were admitted and diagnosed by histopathology in the Second Affiliated Hospital of Hebei North University.The blood flow resistance index(RI),pulsatility index(PI)and microvessel density(MVD)counts of endometrial lesions in the 2 groups and malignant groups with different pathological stages,and the correlation between RI,PI and MVD levels were analyzed.ROC curve analysis of the value of RI and PI in identifying the nature of endometrial lesions.Results The PI and RI of endometrial lesions in the malignant group were significantly lower than those in the benign group,while the MVD was significantly higher than that in the benign group.The difference between the two groups was statistically significant(t=7.234,12.605,12.834,P<0.01).The PI and RI of endometrial lesions in patients with endometrial cancer showed a downward trend with the increase of FIGO staging(stageⅠ>stageⅡ>stageⅢ),while MVD showed an upward trend with the increase of FIGO staging(stageⅠ<stageⅡ<StageⅢ),the difference was statistically significant(F=9.862,31.021,12.556,P<0.01).Pearson correlation analysis showed that PI,RI and MVD levels of endometrial lesions in patients with endometrial cancer were negatively correlated(r=-0.683,-0.677,P<0.05).ROC analysis showed that the area under the curve for RI and PI to distinguish the nature of endometrial lesions was 0.898 and 0.894.Conclusions RI and PI in endometrial lesions of patients with endometrial cancer are negatively correlated with MVD values.RI and PI can provide a basis for judging benign and malignant endometrial lesions.

关 键 词：子宫内膜病变 经阴道彩色多普勒超声 血流阻力指数 搏动指数 微血管密度计数 

分 类 号：R711.74[医药卫生—妇产科学]