三维能量多普勒超声检测宫颈病变血流与VEGF相关性研究

Correlation between three-dimensional color power angiography and VEGF expression in cervical carcinoma

目的探讨经阴道三维能量成像(3D-CPA)检测不同程度宫颈病变血流参数与血管内皮生长因子(VEGF)表达的关系。方法对30例慢性宫颈炎(对照组)、36例宫颈上皮内瘤变(CIN)及36例宫颈癌患者进行经阴道3D-CPA检测,判断血管分级并计算血管化指数(VI)、血流指数(FI)及血管化血流指数(VFI)数值。术后病理标本进行免疫组化染色,检测各组VEGF表达水平;同时对宫颈癌组血管参数VI、FI、VFI与VEGF进行相关性分析。结果从慢性宫颈炎、CIN到宫颈癌,VEGF的表达阳性率逐步升高,3组间两两比较差异均有统计学意义(P<0.05)。宫颈癌组VI、FI及VFI血管参数均明显高于CIN及对照组(P均<0.05);CIN组VI、VFI血管参数亦高于对照组(P<0.05),但FI值与对照组比较无统计学意义(P>0.05)。宫颈癌组血流参数FI、VI、VFI与VEGF表达均存在线性正相关关系(分别为r=0.536、0.897、0.230,P均<0.01)。结论宫颈血流参数与VEGF的表达具有相关性,应用3D-CPA检测的血流能够客观反映宫颈癌的新生血管情况。

Objective To study the correlation between three-dimensional color power angiography （3D-CPA） to detect blood flow parameters varying degrees of cervical lesions and the expression of vascular endothelial growth factor （VEGF）. Methods Totally 30 patients with chronic cervicitis, 36 with cervical intra epithelial neoplasia （CIN） and 36 with cervical carcinoma were examined preoperatively with three-dimensional color power angiography（3D- CPA）.The vascular pattern and calculate vascularization index （VI）, flow index （FI） and vascularization flow index （VFI） values were determined. The expression of VEGF in the histological samples postoperatively were employed by Immunochemistry（S-P technique）.At the same time, the relationship between the parameters of cervical cancer group VI, FI, VFI and VEGF was analyzed. Results The VEGF expression increased gradually in the rank of chronic cervicitis, CIN and cervical carcinoma （P 〈 0.05）. Cervical cancer group VI, FI, and VFI vascular parameters were significantly higher than the CIN and the control group （P 〈 0.05）. The CIN group VI, VFI vascular parameters was also higher than that in the control group （P 〈 0.05）, but there was no significantly differences of FI in CIN group and control group（P 〉 0.05）. The Spearman rank correlation analysis that the level of FI, VI, VFI was positively correlated with VEGF in cervical cancer group（r=0.536,0. 897,0.230, P 〈 0.01）. Conclusion Cervical blood flow parameters are correlated to VEGF expression level. 3D-CPA may reflect the condition of cervical vascularization.