Huang Xing Zhi, Zhou Ai Yun, Liu Min Wei, Zhang Yan, Xu Pan
Department of Ultrasonography, First Affiliated Hospital of Nanchang University, Nanchang, China.
Department of Ultrasonography, Maternal and Child Health Care Hospital of Shenzhen City, Shenzhen, China.
J Ultrasound Med. 2021 Jan;40(1):113-122. doi: 10.1002/jum.15381. Epub 2020 Jul 9.
To investigate the differences in the shear wave elasticity and collagen fiber content between low- and high-grade bladder urothelial carcinoma and study the relationship between elasticity and the content of collagen fiber.
A total of 66 patients with bladder tumors who were referred to our hospital underwent transrectal or transvaginal conventional ultrasound and shear wave elasticity examinations. After bladder urothelial carcinoma was pathologically confirmed, 34 cases of low-grade and 32 cases of high-grade carcinoma were enrolled. The specimens underwent Masson trichrome staining, and image-processing software was used to quantitatively analyze the area of collagen fiber.
Based on conventional ultrasound, the low- and high-grade groups were similar in the number, location, interior echoes, basal portion, size, and vascularity (P > .05); nevertheless, the difference in the surface condition (smooth or rough) was statistically significant (P = .03). The high-grade group had significantly higher maximum and mean elasticity than the low-grade group (P < .01). The percentage of the collagen fiber area in the high-grade group was significantly higher than that in the low-grade group (mean ± SD, 11.45% ± 1.66% versus 7.64% ± 0.70%; P = .01). There was a positive correlation between maximum elasticity, mean elasticity, and the percentage of the collagen fiber area (r = 0.75 and 0.52, respectively; P < .01).
Shear wave elasticity can be used to differentiate between low- and high-grade bladder urothelial carcinoma. The elasticity of lesions has a close correlation with the content of collagen fiber, which may have an important impact on tissue stiffness and the development of bladder cancer.
探讨低级别和高级别膀胱尿路上皮癌之间的剪切波弹性及胶原纤维含量差异，并研究弹性与胶原纤维含量之间的关系。
共有66例转诊至我院的膀胱肿瘤患者接受了经直肠或经阴道常规超声及剪切波弹性检查。膀胱尿路上皮癌经病理确诊后，纳入低级别癌34例和高级别癌32例。对标本进行Masson三色染色，并用图像处理软件定量分析胶原纤维面积。
基于常规超声，低级别组和高级别组在数量、位置、内部回声、基底部、大小及血管分布方面相似（P＞0.05）；然而，表面状况（光滑或粗糙）差异具有统计学意义（P = 0.03）。高级别组的最大弹性和平均弹性显著高于低级别组（P＜0.01）。高级别组的胶原纤维面积百分比显著高于低级别组（均值±标准差，11.45%±1.66%对7.64%±0.70%；P = 0.01）。最大弹性、平均弹性与胶原纤维面积百分比之间呈正相关（r分别为0.75和0.52；P＜0.01）。
剪切波弹性可用于鉴别低级别和高级别膀胱尿路上皮癌。病变的弹性与胶原纤维含量密切相关，这可能对组织硬度及膀胱癌的发展产生重要影响。
