子宫内膜癌超声造影参数与盆腔淋巴结转移的相关性

Correlation of contrast enhanced ultrasound parameters and pelvic lymph node metastasis of endometrial carcinoma

目的探讨子宫内膜癌原发灶的超声造影(CEUS)参数与盆腔淋巴结转移之间的相关性。方法收集术前接受CEUS检查的84例子宫内膜癌,根据术后病理将其分为淋巴结转移组(12例)和无淋巴结转移组(72例),比较2组CEUS参数[到达时间(AT)、达峰时间(TTP)、平均通过时间(MTT)、峰值强度(PI)]及临床病理特征(年龄、瘤体大小、肌层浸润程度、病理分型、组织分化程度及脉管浸润),对组间差异具有统计学意义的因素进行Logistic回归分析。结果 AT、MTT、瘤体大小(≥2 cm)、肌层浸润程度(≥1/2肌层)和脉管浸润(有)对盆腔淋巴结转移有所影响(P均<0.05);AT(OR=2.308,P=0.003)、MTT(OR=4.380,P=0.049)、瘤体大小(OR=1.575,P=0.032)及脉管浸润(OR=5.962,P=0.021)为盆腔淋巴结转移的独立危险因素。结论子宫内膜癌CEUS参数结合临床病理资料对提示是否有盆腔淋巴结转移有重要意义,可用于术前评估盆腔淋巴结转移风险。

Objective To explore the correlation of contrast enhanced ultrasound(CEUS)parameters and pelvic lymph node metastasis of endometrial carcinoma.Methods Eighty-four patients with endometrial carcinoma who underwent preoperative CEUS examination were collected and divided into lymph node metastasis group(n=12)and non-lymph node metastasis group(n=12)according to postoperative pathology.CEUS parameters,including arrival time(AT),time to peak(TTP),mean transit time(MTT),and peak intensity(PI),as well as clinicopathological features(age,tumor size,degree of myometrial invasion,pathological type,degree of tissue differentiation and vascular invasion)were analyzed and compared between groups.Logistic regression analysis was performed on the selected factors being statistical different between groups.Results AT,MTT,tumor size(≥2 cm),degree of myometrial invasion(≥1/2 muscularis)and vascular invasion(yes)had impact on pelvic lymph node metastasis(all P<0.05).AT(OR=2.308,P=0.003),MTT(OR=4.380,P=0.049),tumor size(OR=1.575,P=0.032)and vascular invasion(OR=5.962,P=0.021)were independent risk factors for pelvic lymph node metastasis.Conclusion CEUS parameters of endometrial carcinoma combined with clinicopathological data were of great significance for indicating pelvic lymph node metastasis,which could be used to preoperatively evaluate the risk of pelvic lymph node metastasis of endometrial carcinoma.