Di Vagno G, Cormio G, Vimercati A, Nacci G, Greco P, Lepera A, Loverro G, Selvaggi L
Istituto di Patologia Ostetrica e Ginecologica R, Università degli Studi,Bari.
Minerva Ginecol. 1996 Nov;48(11):463-7.
Changes in blood flow characteristics, observed with transvaginal color-Doppler ultrasonography have recently been reported in patients with advanced cervical cancer. In order to evaluate the reliability of TVCDUS in monitoring the response to neoadjuvant chemotherapy in patients with locally advanced cervical cancer, a prospective study was undertaken on the blood flow characteristics of the cervical vessels. Pulsatility Index (PI) and Resistance Index (RI) of the uterine and cervical arteries of 12 patients with histologically proven advanced cervical cancer, scheduled for neoadjuvant chemotherapy were evaluated at diagnosis, during every cycle of chemotherapy and before surgery. A significantly lower value of mean PI and RI between cervical and uterine arteries was observed in patients with cervical cancer (PI = 1.671 +/- 0.18 vs 2.159 +/- 0.24)-(RI = 0.43 +/- 0.17 vs 0.72 +/- 0.22). Mean RI and mean PI of the descending branches of the uterine arteries were significantly lower in patients with cervical cancer, compared to healthy control women. No difference in blood flow parameters could be detected between stage I vs stage II-III, and between left and right cervical artery in patients with cervical cancer. Both RI and PI values appeared strictly related to the tumor response to chemotherapy. In fact in 8 patients in which treatment resulted in tumor regression, evaluated by pelvic examination and MR imaging, a significant (p < 0.01) increase of resistance indices was observed (PI = 1.671 +/- 0.18 vs 2.158 +/- 0.22)-(RI = 0.43 +/- 0.17 vs 0.79 +/- 0.16). On the other side 4 patients not responding to chemotherapy, had stable values of both PI and RI. Transvaginal color-Doppler ultrasonography might be useful in monitoring the response to neoadjuvant chemotherapy in patients with locally advanced cervical carcinoma.
近期有报道称，经阴道彩色多普勒超声检查观察到晚期宫颈癌患者的血流特征发生了变化。为了评估经阴道彩色多普勒超声在监测局部晚期宫颈癌患者新辅助化疗反应中的可靠性，对宫颈癌患者宫颈血管的血流特征进行了一项前瞻性研究。对12例经组织学证实为晚期宫颈癌且计划接受新辅助化疗的患者，在诊断时、化疗的每个周期以及手术前评估其子宫和宫颈动脉的搏动指数（PI）和阻力指数（RI）。宫颈癌患者宫颈动脉与子宫动脉的平均PI和RI值显著较低（PI = 1.671±0.18 vs 2.159±0.24；RI = 0.43±0.17 vs 0.72±0.22）。与健康对照女性相比，宫颈癌患者子宫动脉下行支的平均RI和平均PI显著较低。在宫颈癌患者中，I期与II - III期之间以及左右宫颈动脉之间的血流参数没有差异。RI和PI值似乎都与肿瘤对化疗的反应密切相关。事实上，通过盆腔检查和磁共振成像评估，8例治疗后肿瘤消退的患者，其阻力指数显著升高（p < 0.01）（PI = 1.671±0.18 vs 2.158±0.22；RI = 0.43±0.17 vs 0.79±0.16）。另一方面，4例对化疗无反应的患者，其PI和RI值均保持稳定。经阴道彩色多普勒超声检查可能有助于监测局部晚期宫颈癌患者对新辅助化疗的反应。
