建立兔舌癌颈淋巴结转移模型的多普勒超声动态监测

Doppler ultrasound in the detection of neck lymph node metastasis of tongue carcinoma in rabbits

目的:应用多普勒超声动态监测不同时期兔舌VX2癌瘤颈部淋巴结的超声图像表现,分析舌体肿瘤及颈部淋巴结转移的发生规律,评估多普勒超声对于转移淋巴结的诊断价值。方法:将VX2瘤块接种于30只实验兔舌缘,根据超声检查的时间随机分为1周组、3周组及5周组(每组10只),动态观察舌癌不同时期颈部淋巴结的超声图像并诊断,然后行舌体肿瘤及颈深区肿大淋巴结的病理学检查,完成超声诊断实验评价。结果:瘤块接种1周后舌体成瘤,超声未见颈部淋巴结影像;3周时出现反应性淋巴结,超声图像多形态均匀,皮、髓质结构正常;5周时出现淋巴结转移,超声图像多形态不均,结构紊乱,其最大横径与反应性淋巴结间有统计学差异(P=0.000)。3组实验兔处死时的体质量间有统计学差异(P=0.005)。超声诊断的灵敏度及特异度分别为85%及83%,受试者工作特征曲线下面积达0.84(P=0.001)。结论:兔舌VX2癌与人舌鳞癌表现相似。不同性质的淋巴结具有特异的多普勒超声图像特征,用于舌癌颈部淋巴结诊断的灵敏度、特异性及准确度均可。

Objective：To dynamically detect the occurrence regularity of the rabbits＇ VX2 tongue carcinoma and cervical lymph node metastases in different periods according to Doppler uhrasound and to evaluate its diagnostic value. Methods：Intact VX2 rabbits＇ hepatic tumor tissues were transplanted to the lateral border of tongues of 30 rabbits and the rabbits were divided into 3 groups（n=l0） based on the time of receiving ultrasound detection. Ultrasound images of cervical lymph nodes of tongue carcinoma in different peri- ods were observed. Specimens of transplanted carcinomas and cervical lymph nodes in the rabbits were examined pathologically. Then evaluation on the ultrasound diagnostic test was made. Results：Tongue carcinoma was formed at one week after transplantation, but no ultrasonic image for cervical lymph node was observed. Lymph nodes reacted after 3 weeks and ultrasonic image showed that the nodes had high uniformity and normal structure of cortex and medulla. After 5 weeks,lymph nodes with uneven form and disordered structure were metastatic, maximum diameter of which was statistically different from that of reacting lymph nodes （P=0.000）. There were statistical differences among 3 groups in terms of death weight（P=0.005）. Diagnostic sensitivity of Doppler ultrasound was 85% and specificity was 94% while the area under receiver operating characteristic curve was 0.84（P=0.001）. Couclusions：VX2 tongue carcinoma is similar to squamous cell carcinoma of human tongue. Reacting and metastasizing lymph nodes showed their characteristic images by Doppler ultrasound, which is accurate, specific and sensitive in the diagnosis of lymph nodes metastases.