TVCDS定量参数在子宫内膜癌病人肌层浸润深度及治疗效果评估中的应用价值  

Application value of TVCDS quantitative parameters in the evaluation of the depth of myometrial invasion and treatment effects in patients with endometrial cancer

作　　者：胡清荣[1] 高彩霞 李瑾[3] HU Qing-rong;GAO Cai-xia;LI Jin(Translational Medicine Research Center,Gansu Academy of Medical Sciences,Lanzhou Gansu 730050;Department of Function;The Second Ward of Radiotherapy,Gansu Cancer Hospital,Lanzhou Gansu 730050,China)

机构地区：[1]甘肃省医学科学研究院转化医学研究中心,甘肃兰州730050 [2]甘肃省肿瘤医院功能科,甘肃兰州730050 [3]甘肃省肿瘤医院放疗二病区,甘肃兰州730050

出　　处：《蚌埠医学院学报》2022年第5期656-660,共5页Journal of Bengbu Medical College

基　　金：甘肃省兰州市科技发展计划项目(2019-ZD-136)。

摘　　要：目的:探讨经阴道彩色多普勒超声(TVCDS)定量参数在子宫内膜癌(EC)病人肌层浸润深度及治疗效果评估中的应用价值。方法:选取经TVCDS检查并由病理诊断确诊为EC病人100例,其中肌层浸润82例,无肌层浸润18例。比较无肌层浸润与肌层浸润病人临床资料、TVCDS定量参数、微血管密度(MVD);比较不同手术效果病人TVCDS定量参数。分析EC病人肌层浸润影响因素,TVCDS定量参数、MVD、EC深肌层浸润深度的相关性。采用ROC曲线评价TVCDS定量参数与手术疗效的关系。结果:无肌层浸润与肌层浸润病人的组织学分级、临床分期和淋巴转移差异均有统计学意义(P<0.05~P<0.01)。肌层浸润组病人脉动指数(PI)、阻力指数(RI)、RI均低于无肌层浸润组(P<0.05),MVD高于无肌层浸润组(P<0.05)。深肌层组PI、RI均低于浅肌层组(P<0.05),MVD高于浅肌层组(P<0.05)。Logistic回归分析结果显示,组织学分级、临床分期、淋巴结转移、PI、RI、MVD均为EC病人肌层浸润的影响因素(P<0.05)。TVCDS定量参数PI、RI均与EC病人肌层浸润深度呈负相关关系(r=-0.719、-0.662,P<0.05),MVD与肌层浸润呈正相关关系(r=0.578,P<0.05),PI、RI与MVD均呈负相关关系(r=-0.575、-0.520,P<0.05)。术效果良好病人PI、RI均明显高于手术效果不佳病人(P<0.01)。ROC曲线分析显示,PI、RI预测手术疗效的AUC分别为0.782、0.759,PI与RI联合应用于手术疗效预测的AUC为0.863,高于PI、RI单独预测的诊断价值。结论:EC病人TVCDS定量参数PI、RI在肌层浸润深度、组织学分级、临床分期、淋巴转移及手术效果评估中具有重要应用价值,可为EC诊断及术前、预后评估提供重要参考信息。Objective:To explore the application value of the quantitative parameters of transvaginal color Doppler sonography(TVCDS)in the evaluation of the depth of myometrial invasion and treatment effects in patients with endometrial cancer(EC).Methods:A total of 100 EC patients diagnosed by TVCDS examination and pathology,which included 82 cases with muscular infiltration and 18 cases without muscular infiltration.The clinical data,quantitative parameters of TVCDS and microvascular density(MVD)between patients with and without muscle layer infiltration and muscle layer infiltration were compared.The quantitative parameters of TVCDS among patients with different surgical outcomes were compared.The influencing factors of muscle layer infiltration in EC patients were analyzed,and the correlation between quantitative parameters of TVCDS,MVD and depth of deep muscle layer infiltration in EC patients was analyzed.The ROC curve was used to evaluate the relationship between TVCDS quantitative parameters and surgical efficacy.Results:The differences of the histological grade,clinical stage,and lymphatic metastasis were statistically significant between two groups(P<0.05).The perfusion index(PI)and resistance index(RI)in muscle layer infiltration group were lower than those in non-muscular layer infiltration group(P<0.05),and the MVD in muscle layer infiltration group was higher than that in non-muscular layer infiltration group(P<0.05).The perfusion index and resistance index in deep muscle layer group were lower than those in superficial muscle layer group(P<0.05),and the MVD in deep muscle layer group was higher than that in superficial muscle layer group(P<0.05).The results of logistic regression analysis showed that the hhistological grade,clinical stage,lymph node metastasis,PI,RI and MVD were the influencing factors of muscle layer infiltration in EC patients(P<0.05).The TVCDS quantitative parameters PI and RI were negatively correlated with the depth of muscle layer infiltration(r=-0.719,-0.662,P<0.05),the MVD was positiv

关 键 词：子宫内膜癌 经阴道彩色多普勒超声 搏动指数 阻力指数 微血管密度 肌层浸润深度 

分 类 号：R455.1[医药卫生—运动医学]