宫颈癌超声造影特征与预后因素的关系

The relationship between characteristics of cervical cancer at contrast-enhanced ultrasound and prognostic factors

目的探讨宫颈癌超声造影特征与预后因素的关系。方法回顾性分析35例经病理证实为宫颈癌患者的超声造影增强特征和时间一强度曲线参数的特点，并与细胞核增殖抗原ki-67的表达、肿瘤大小、淋巴结转移及病理分级进行比较。结果（1）与周围正常组织相比，宫颈癌病灶达峰时间（timetopeak，TTP）明显缩短，峰值强度（peakintensity，PI）显著增高，差异具有统计学意义（P〈0．05）；（2）血流灌注缺损及非均匀性增强的比率在ki-67表达阳性、直径≥2．0cm及低分化的肿瘤中较高（P〈0．05）；（3）与ki-67表达阴性者比较，ki-67表达阳性者TTP明显缩短，PI显著升高，差异具有统计学意义（P〈0．05）；（4）与高一中分化宫颈癌比较，低分化者PI明显升高，差异具有统计学意义（P〈0．05）。结论宫颈癌超声造影特征与预后因素有一定的关系，有助于无创性评估宫颈癌的预后。

Objective To evaluate the relationship between characteristics of cervical cancer at contrast-enhanced ultrasound and prognostic factors. Methods Thirty-five patients with pathologically confirmed cervical cancer were enrolled in this retrospective analysis. All the patients accepted ＇contrast- enhanced ultrasound examination before the surgery. Relationships between the characters of contrast- enhanced ultrasound and the expression of ki-67 antigen（cel.l proliferation marker）, tumor diameter,lymph node metastasis and histologic grade were studied. Results （1）Compared to the surrounding normal tissue, the cervical cancer had statistically significant differences in time to peak and peak intensity（ P〈0.05） ,the former was shortened, and the latter was increased. （2）The ratio of perfusion defect and heterogeneous enhancement were significantly higher in tissues, including the ki-67 positive expression tissue, poorly differentiated or larger tumors （≥2.0 cm in diameter） （ P 〈0.05）. （3）Compared to the ki-67 negative expression group, time to peak of the ki-67 positive expression group was shorter and the peak intensity was higher, the differences were statistically significant （P 〈 0.05）. （4） The peak intensity of poorly differentiated cervical cancers was significantly higher than that of the other groups （ P 〈0.05）. Conclusions Enhancement patterns and parameters of contrast-enhanced ultrasound were associated with prognosis, which may be useful in noninvasive prediction of the patients with cervical cancers.