彩色多谱勒结合VEGF、MVD对卵巢上皮性肿瘤诊断的意义

The diagnosis significance of epithelial ovarian tumors with Color Doppler Sonography integrating VEGF and MVD

目的:探讨彩色多谱勒结合血管内皮生长因子(VEGF)、微血管密度(MVD)对卵巢上皮性肿瘤的早期诊断和鉴别诊断的价值。方法:术前彩色多谱勒检查拟诊,经手术-病理证实为卵巢上皮性肿瘤62例(良性组31例、恶性组31例),观察卵巢肿瘤的形态结构和血流动力学特点;术前应用ELISA法检测患者血VEGF水平;术后标本采用免疫组化法检测肿瘤内MVD。结果:卵巢恶性肿瘤以囊实混合性回声多见,瘤内血流信号丰富,且以低阻力的动脉血流为主;卵巢良性肿瘤以囊性回声或边界规则的实性回声多见,以周边分布的高阻力血流信号为主,良、恶性肿瘤血流阻力指数(RI)的比较差异有统计学意义(P<0.01)。恶性组血VEGF水平明显高于良性组,差异有统计学意义(P<0.01)。良性组MVD低于恶性组,差异有统计学意义(P<0.01)。RI<0.4组血VEGF水平明显高于RI≥0.4组,差异有统计学意义(P<0.01);RI<0.4组MVD水平明显高于RI≥0.4组,差异有统计学意义(P<0.01)。结论:彩色多谱勒结合VEGF、MVD对卵巢上皮性肿瘤的早期诊断和鉴别诊断有重要意义,有可能为卵巢癌的早期诊断、评估预后开辟新的途径。

Objective： To study the significance of early diagnosis and differential diagnosis of epithelial ovarian tumors with Color Doppler Sonography integrating vascular endothelial growth factor （VEGF） and microvessel density （MVD） . Methods： Sixty - two pa- tients with clinically suspected epithelial ovarian neoplasm were evaluated by Color Doppler sonography, and were confirmed by operation and pathology. Of the total, epithelial ovarian cancer （ the malignant group, n = 31 ） and ovarian benign tumors （ the optimum group, n = 31 ）, were observed for the characteristic of morphologic construction and hemodynamics of ovarian tumors. The expression of VEGF was measured by enzyme linked immunosorbent assay （ELISA） before operation. Tumors＇ MVD were examined by immunization histological chemistry after operation. Results： Malignant tumors were more likely to have either complex or solid echogenic pattern, in which color flow was abundantly found in the tumors and was main of arterioles with low impedance. Benign tumors were more likely to have cystic echogenic pattern or solid echogenic pattern with regular borders, and the dominance was blood flow with high impedance around the tumors. There were significant differences with resistent index （ RI ） between malignant group and benign group （ P 〈 0. 01 ） . The expression of serum VEGF in the malignant group was significantly higher than the benign group （P 〈 0.01 ） . The malignant groups＂ MVD were higher than the benign groups＂ （P 〈0. Ol ） . The expression of serum VEGF in the groups of RI 〈0. 4 was obviously higher than the RI≥0. 4 group （P 〈 0. 01 ） . The RI 〈 0. 4 groups＇MVD was significantly higher than the RI I〉0. 4 groups （ P 〈 0. 01 ） . Conclusion ： Color Doppler Sonography integrating VEGF and MVD has important significance in early diagnosis and differential diagnosis of epithelial ovarian tumors. It is possibly to develop a new way of diagnosis and prognosis of epithelial ovarian carcinoma.