Institute of Clinical Sciences Lund, Department of Obstetrics and Gynecology, University of Lund, Lund University Hospital, Lund, Sweden.
Ultrasound Obstet Gynecol. 2010 Oct;36(4):512-6. doi: 10.1002/uog.7638.
The objective of this study was to describe the sonographic characteristics of squamous cell cancer (SCC) and adenocarcinoma (AC) of the cervix using transvaginal ultrasound.
Women with early stage cervical cancer undergoing transvaginal ultrasound examination before surgery were prospectively included. The sonographic characteristics were assessed with regard to tumor morphology, vascularization, size, extension and location. Histological assessment of tumor subtype, size, growth pattern, extension and location was performed. Both sonographic and histological assessments were carried out according to a standardized protocol.
Fifty-five women were recruited. Ten were excluded because no tumor was seen on ultrasound examination and five were excluded because radical surgery was aborted as a result of positive lymph nodes, detected using the sentinel node technique. Among the remaining 40 women, 20 had AC and 20 had SCC. At pathological examination, 34 women had tumors confined to the cervix, three had parametrial invasion and three had vaginal invasion. Hypoechogenicity was associated with SCC in 73% (11/15) of the women, while isoechogenicity indicated AC in 68% (13/19) of the women (P = 0.03). Mixed echogenicity (n = 4) showed a non-significant association with larger tumor volume (P = 0.23). Hyperechogenicity was found in two women, both of whom had the less malignant villoglandular AC. Color Doppler signals were found in all cases of AC and in 90% (18/20) of cases of SCC, compared with most normal cervical tissue in which virtually no detectable vascularization was found.
We found that the sonographic appearance of SCC and AC differs. This knowledge should be useful in the clinical evaluation of cervical tumors.
本研究旨在通过经阴道超声描述宫颈鳞癌（SCC）和腺癌（AC）的超声特征。
前瞻性纳入术前接受经阴道超声检查的早期宫颈癌患者。评估肿瘤形态、血管化、大小、扩展和位置等超声特征。根据标准化方案进行肿瘤亚型、大小、生长模式、扩展和位置的组织学评估。同时进行超声和组织学评估。
共招募 55 名女性。10 名因超声检查未见肿瘤而被排除，5 名因前哨淋巴结技术检测到阳性淋巴结而中止根治性手术而被排除。在剩余的 40 名女性中，20 名患有 AC，20 名患有 SCC。在病理检查中，34 名女性的肿瘤局限于宫颈，3 名女性有宫旁侵犯，3 名女性有阴道侵犯。低回声与 SCC 相关，在 15 名女性中占 73%（11/15），等回声提示 AC，在 19 名女性中占 68%（13/19）（P = 0.03）。混合回声（n = 4）与较大的肿瘤体积无显著相关性（P = 0.23）。2 名女性表现为高回声，均为恶性程度较低的绒毛状腺性 AC。AC 所有病例均可见彩色多普勒信号，90%（18/20）的 SCC 病例也可见彩色多普勒信号，而大多数正常宫颈组织几乎检测不到血管化。
我们发现 SCC 和 AC 的超声表现不同。这一知识在宫颈肿瘤的临床评估中应该是有用的。
