Wu Y C, Yuan C C, Hung J H, Chao K C, Yen M S, Ng H T
Department of Obstetrics and Gynecology, Veteran General Hospital-Taipei, 201, Section 2, Shih-Pai Road, Taipei, Taiwan, Republic of China.
Gynecol Oncol. 2000 Nov;79(2):181-6. doi: 10.1006/gyno.2000.5889.
The aim of this study was to investigate the effectiveness of transvaginal power Doppler angiography in predicting cervical malignancy by detecting intratumoral blood flow and to understand the relationship between squamous cell carcinoma (SCC) serum levels and intratumoral blood flow analysis of invasive cervical carcinoma before treatment.
Thirty-eight patients with cervical carcinoma (35 with stages Ia to IVb invasive carcinoma, 3 with cervical carcinoma in situ) were enrolled for the evaluation of tumor flow using transvaginal ultrasound accompanied with power Doppler angiography before surgery. The pulsatility, resistance index, and vascular index of tumor flow were measured. Thirty patients with proven healthy cervices were used as the control group. Pretreatment SCC serum levels were obtained in 34 women with cervical carcinoma.
The pulsatility index and resistance index were significantly lower in the study group than in the control group (P < 0.0001). The vascular index was also significantly lower in the study group than in the control group (P < 0.0001). There were no significant differences among patients with SCC type and non-SCC type cervical carcinoma (P > 0.05) among the six parameters. There was no significant correlation between the pretreatment SCC serum levels with any of the six parameters obtained from the intratumoral blood flow analysis in the SCC group.
Transvaginal ultrasound with power Doppler angiography is a valuable diagnostic tool for differentiating benign tumors of the cervix from malignant ones. Intratumoral blood flow of the cervix supplied us with practical diagnostic information before surgery and may aid in early prediction and management of cervical carcinoma. The use of transvaginal ultrasound with power Doppler angiography in the grading of vascularity ratio within cervical masses provided more sonographic characteristics among the different subclassifications of cervical cancer and is more useful than color Doppler imaging in the visualization of sonographic morphology.
本研究旨在通过检测肿瘤内血流来探讨经阴道能量多普勒血管造影术在预测宫颈恶性肿瘤方面的有效性，并了解鳞状细胞癌（SCC）血清水平与治疗前浸润性宫颈癌肿瘤内血流分析之间的关系。
38例宫颈癌患者（35例Ia至IVb期浸润性癌，3例原位癌）在手术前行经阴道超声联合能量多普勒血管造影术评估肿瘤血流。测量肿瘤血流的搏动指数、阻力指数和血管指数。选取30例经证实宫颈健康的患者作为对照组。34例宫颈癌女性患者术前检测SCC血清水平。
研究组的搏动指数和阻力指数显著低于对照组（P < 0.0001）。研究组的血管指数也显著低于对照组（P < 0.0001）。SCC型和非SCC型宫颈癌患者的六个参数之间无显著差异（P > 0.05）。SCC组术前SCC血清水平与肿瘤内血流分析得到的六个参数中的任何一个均无显著相关性。
经阴道超声联合能量多普勒血管造影术是区分宫颈良性肿瘤和恶性肿瘤的有价值的诊断工具。宫颈肿瘤内血流为术前提供了实用的诊断信息，可能有助于宫颈癌的早期预测和管理。经阴道超声联合能量多普勒血管造影术用于宫颈肿块内血管比率分级，在宫颈癌不同亚分类中提供了更多的超声特征，比彩色多普勒成像在超声形态可视化方面更有用。
