【摘要】 目的探讨卵巢肿瘤经阴道彩色多普勒超声检查(TVCDU)的血管病理学基础,评价其鉴别卵巢良、恶性肿瘤的临床应用价值及与临床分期的关系。方法对61例卵巢肿瘤(38例恶性肿瘤,5例交界性肿瘤,18例良性肿瘤)患者术前行TVCDU检查,计测血流定量指标RI。术后应用免疫组织化学方法对病理组织切片进行微血管染色,计数微血管密度(MVD)。确定卵巢恶性肿瘤临床分期。统计分析RI与MVD的相关性及其与临床分期的关系。结果38例卵巢恶性肿瘤动脉血流RI值(0.44±0.13),明显低于18例良性组(0.58±0.11,P<0.05)。临床Ⅲ、Ⅳ期的卵巢恶性肿瘤RI值(0.39±0.05),明显低于Ⅰ、Ⅱ期(0.45±0.13,P<0.05)。以RI≤0.5诊断卵巢恶性肿瘤敏感性89.5%,特异性78.3%。卵巢恶性肿瘤MVD(37.5±18.22)/400倍视野,明显高于良性组(14.85±8.02)/400倍视野(P<0.05)。Ⅲ、Ⅳ期卵巢恶性肿瘤MVD(43.29±12.2)/400倍视野,明显高于Ⅰ、Ⅱ期(27.86±9.9)/400倍视野(P<0.05)。卵巢恶性肿瘤RI与MVD呈负相关(rs=-0.412,P<0.01)。结论TVCDU能反映卵巢肿瘤内血管生成状况,为临床诊断和鉴别提供可靠依据。更多还原

【Abstract】 Objective To study the clinical value of vascular pathology of transvaginal color Doppler ultrasonography (TVCDU) in differentiating benign and malignant ovarian tumors and analyzing the relations of tumor blood supply to clinical stages. Methods Sixty-one ovarian tumors (38 malignant, 5 borderling tumors, 18 benign) were examined preoperatively with TVCDU. The blood flow indices (RI) were measured quantitatively. After operation, all the slices of tumor tissue specimens were stained immunohistochemistry with anti-34 antibody, and microvessel density (MVD) was calculated. The malignant ovarian tumors were staged. The relations between the indices (RI and MVD) and clinical stages were also done statistically. Results RI in 38 malignant ovarian tumors (0.44±0.13) was lower than that in 18 benign tumors (0.58± 0.11)(P<0.05). Using RI≤0.5 as a cutoff, the sensitivity and specificity in detecting malignant ovarian tumors were 89.5% and 78.3% respectively. RI in stage Ⅲ and Ⅳ (0.39±0.05) was lower than that in stageⅠ and Ⅱ (0.45±0.13)(P< 0.05). MVD in 38 malignant ovarian tumors ([37.5±18.22]/400 magnification) was higher than that in 18 benign ovarian tumors ([14.85±8.02]/400 magnification) (P<0.05). MVD in stage Ⅲ and Ⅳ ([43.29±12.20]/400 magnification) was higher than that in stage Ⅰ and Ⅱ([27.86±9.90]/400 magnification)(P<0.05). There were significant negative relations between RI and MVD in malignant ovarian tumors (r_s=-0.412, P<0.01). Conclusion TVCDU can evaluate the angiogenesis in ovarian tumors before operation and provide valuable evidence for the clinical diagnosis and differential diagnosis.更多还原