彩色超声检测微血管与宫颈癌转移关系分析

Analysis of relationship between microvessels and cervical cancer metastasis detected by color Doppler ultrasonography

目的探讨彩色超声检测微血管与宫颈癌转移的关系。方法选择宫颈癌患者60例,先接受彩色超声诊断,再进行手术治疗。术后记录扫除的淋巴结个数并进行病理检测,检测并记录宫颈癌类型、血管累及、宫旁浸润和间质浸润深度。分析宫颈癌病灶血流丰富程度与宫颈癌类型、血管累及、宫旁浸润和间质浸润深度的关系,应用Logistic多元回归分析法分析宫颈癌转移的危险因素。结果经手术及术后病理检查共发现盆腔淋巴转移29例(48.3%)。彩色超声检查共发现盆腔转移25例(41.7%),其检查的敏感度82.76%、特异度96.77%、准确度90.00%、阳性预测值96.00%、阴性预测值85.74%。出现宫旁浸润、血管累及、间质浸润深度≥10 cm和淋巴结转移者较宫旁无浸润、血管未累及、间质浸润深度<10 mm和淋巴结未转移者血流丰富(P<0.05)。Logistic回归分析结果显示宫旁浸润、血管累及、间质浸润、淋巴转移是引起宫颈癌血流丰富的高危因素。结论彩色超声显示宫颈癌患者淋巴转移与病理结果具有较好的一致性,并且淋巴转移联合血流丰富程度检测对宫颈癌转移具有较好的诊断价值。

Objective To investigate the relationship between microvessels and cervical cancer metastasis detected by color Doppler ultrasound.Methods Sixty patients with cervical cancer were selected in this study.All patients were diagnosed by color Doppler ultrasound imaging and then treated with surgery.The number of lymph nodes removed after operation was recorded and the pathological examination was performed.The type of cervical cancer,vascular involvement,parametrial infiltration and interstitial infiltration depth were detected and recorded.The relationship between the blood flow richness of cervical cancer lesion and the type of cervical cancer,vascular involvement,parauterine infiltration and interstitial infiltration depth was analyzed.The logistic multiple regression analysis was used to analyze the risk factors of cervical cancer metastasis.Results A total of 29 cases(48.3%)of pelvic lymphatic metastasis were found by operation and postoperative pathological examination.A total of 25 cases(41.7%)of pelvic metastasis were found by color Doppler ultrasonography.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of color Doppler ultrasound were 82.76%,96.77%,90.00%,96.00%and 85.74%,respectively.Compared with those without parametrial infiltration,no vascular involvement,interstitial infiltration depth(<10 mm)and no lymph node metastasis,the blood flow was abundant in patients with parametrial infiltration,vascular involvement,interstitial infiltration depth(≥10 cm)and lymph node metastasis.The logistic regression analysis showed that parametrial infiltration,vascular involvement,interstitial infiltration and lymphatic metastasis were the high risk factors for cervical cancer with abundant blood flow.Conclusion The color Doppler ultrasound imaging system has a good consistency with pathological results in lymphatic metastasis of cervical cancer patients,and lymphatic metastasis combined with the detection of blood flow richness has a good diagnostic value for cervical cancer metastasis.