经阴道彩色多普勒超声检查病灶内微血管情况与早期宫颈癌患者临床特征及预后的关系

Relationship between the microvessel conditions in the lesions examined by transvaginal color Doppler ultrasonography and the clinical characteristics and prognosis of patients with early cervical cancer

目的探讨经阴道彩色多普勒超声检查病灶内微血管情况与早期宫颈癌患者临床特征及预后的关系。方法选择进行经阴道彩色多普勒超声检查的76例早期宫颈癌患者和80例慢性宫颈炎患者,分别作为观察组和对照组。比较两组患者的微血管情况[阻力指数(RI)、搏动指数(PI)、血流情况],分析病灶内微血管情况与早期宫颈癌患者临床特征的关系,比较不同血流情况早期宫颈癌患者的RI、PI。对早期宫颈癌患者进行2年随访,采用Logistic回归模型分析早期宫颈癌患者预后的影响因素。结果观察组患者的RI、PI均明显低于对照组,微血管内的血流丰富程度明显高于对照组,差异均有统计学意义(P﹤0.01)。有淋巴结转移、间质浸润深度≥10 cm早期宫颈癌患者的RI、PI均低于无淋巴结转移、间质浸润深度﹤10 cm的患者(P﹤0.05);不同淋巴结转移情况、间质浸润深度、脉管受累情况、病灶直径、宫旁浸润情况、临床分期早期宫颈癌患者微血管内的血流情况比较,差异均有统计学意义(P﹤0.05)。血流不丰富、不明显早期宫颈癌患者的RI、PI均高于血流丰富的患者,血流不明显早期宫颈癌患者的RI、PI均高于血流不丰富的患者,差异均有统计学意义(P﹤0.05)。Logistic回归分析结果显示,有淋巴结转移、间质浸润深度≥10 cm、有脉管受累、病灶直径≥18 cm、有宫旁浸润、临床分期为Ⅱ期、RI≤0.82、PI≤1.62、血流丰富均是早期宫颈癌患者预后的独立危险因素(P﹤0.05)。结论早期宫颈癌病灶内微血管血流情况及血流动力学参数RI、PI均与患者的临床特征有关,且RI、PI越低,血流越丰富,患者预后不佳的风险越高。

Objective To explore the relationship between the microvessel conditions in the lesions examined by transvaginal color Doppler ultrasonography and the clinical characteristics and prognosis of patients with early cervical cancer.Method 76 patients with early cervical cancer and 80 patients with chronic cervicitis who underwent transvaginal color Doppler ultrasonography were selected as the observation group and the control group,respectively.The microvessels conditions[resistance index(RI),pulsatility index(PI),blood flow conditions]between the two groups were compared.The relationship between the microvessel conditions in the lesions and the clinical characteristics of patients with early cervical cancer were analyzed.The RI and PI of patients with different blood flow conditions were compared.The patients were followed up for 2 years,and Logistic regression analysis was used to analyze the factors affecting their prognosis.Result The RI and PI of the observation group were significantly lower than those of the control group,and the richness of blood flow in the microvessels of the observation group were significantly more than those of the control group,the differences were statistically significant(P<0.01).The RI and PI of patients with lymph node metastasis and interstitial invasion depth≥10 cm were lower than those of patients without lymph node metastasis and interstitial invasion depth<10 cm,the differences were statistically significant(P<0.05).There were significant differences in microvessel blood flow among patients with different lymph node metastasis,interstitial invasion depth,vascular involvement,lesion diameter,parauterine invasion,clinical stage,and the differences were statistically significant(P<0.05).The RI and PI of early cervical cancer patients with poor and unconspicuous blood flow were higher than those of patients with abundant blood flow,and the RI and PI of early cervical cancer patients with unconspicuous blood flow were higher than those of patients with poor blood flow,the differences were statistically significant(P<0.05).The Logistic regression analysis results showed that lymph node metastasis,interstitial infiltration depth≥10 cm,vascular involvement,lesion diameter≥18 cm,parauterine infiltration,clinical stage II,RI≤0.82 and PI≤1.62 and abundant blood flow were all independent risk factors that affect the prognosis of patients with early cervical cancer(P<0.05).Conclusion The microvessel blood flow condition and hemodynamic parameters RI and PI in lesions of patients with early cervical cancer are all related to the clinical characteristics of the patient.Early cervical cancer patients may have poor prognosis when the PI and RI are low and the the blood flow is abundant.