子宫内膜癌患者阴道彩色多普勒超声参数与增殖基因 侵袭基因表达的相关性

Correlation between transvaginal color doppler ultrasound parameters and expression of proliferation genes and invasion genes in patients with endometrial cancer

目的探讨子宫内膜癌患者经阴道彩色多普勒超声参数与癌细胞增殖、侵袭基因表达的相关性。方法将105例子宫内膜癌患者设为研究组,102例子宫内膜增生患者设为对照组。两组均行经阴道彩色多普勒超声检查,采用受试者工作特征曲线分析经阴道彩色多普勒超声参数(阻力指数、搏动指数、微血管密度)的诊断价值,检测两组增殖基因(DJ-1、RRM2)、侵袭基因(HMGB1、DKK1)表达,分析经阴道彩色多普勒超声参数与增殖基因、侵袭基因的相关性。结果研究组阻力指数及搏动指数水平显著低于对照组(P<0.01),微血管密度水平显著高于对照组(P<0.01)。微血管密度诊断子宫内膜癌的曲线下面积最大,阻力指数、搏动指数、微血管密度联合诊断子宫内膜癌的曲线下面积为0.851,敏感度为69.5%,特异度为88.2%。不同病理分期子宫内膜癌患者阻力指数、搏动指数、微血管密度水平比较差异有统计学意义(P<0.01),DJ-1、RRM2、HMGB1、DKK1基因相对表达量比较差异有统计学意义(P<0.01)。阻力指数、搏动指数与DJ-1、RRM2、HMGB1基因相对表达量呈显著负相关(P<0.05),与DKK1基因相对表达量呈显著正相关(P<0.05);微血管密度与DJ-1、RRM2、HMGB1基因相对表达量呈显著正相关(P<0.05),与DKK1基因相对表达量呈显著负相关(P<0.05)。结论子宫内膜癌患者经阴道彩色多普勒超声参数与增殖基因、侵袭基因表达关系密切,阻力指数、搏动指数、微血管密度联合检测可进一步提高诊断效能,为疾病诊断及病理分期提供参考。

Objective To investigate the correlation between transvaginal color doppler ultrasound(TVCDS) parameters and expression of cancer cell proliferation and invasion genes in patients with endometrial cancer.Methods A total of 105 patients with endometrial cancer were set as the study group,and102 patients with endometrial hyperplasia were set as the control group.All performed TVCDS examination,and the receiver operating characteristic curve(ROC) was used to analyze the diagnostic value of TVCDS parameters [resistance index(RI),pulsatility index(PI),microvessel density(MVD)].The expressions of proliferation genes(DJ-1,RRM2) and invasion genes(HMGB1,DKK1) were detected in two groups,and the correlation between TVCDS parameters and proliferation and invasion genes was analyzed.Results The RI and PI of the observation group were significantly lower than those of the control group(P<0.01),and the MVD was significantly higher than that of the control group(P<0.01).The area under curve(AUC) for MVD diagnosis of endometrial cancer was the largest.The AUC of RI,PI and MVD combined diagnosis of endometrial cancer was 0.851,with a sensitivity of 69.5% and specificity of 88.2 %.There was significant difference in RI,PI and MVD levels among patients with endometrial cancer at different pathological stages(P<0.01),and there was significant difference in the relative expression of DJ-1,RRM2,HMGB1 and DKK1 genes(P<0.01).RI and PI were negatively correlated with DJ-1,RRM2 and HMGB1 genes(P<0.05),positively correlated with DKK1 genes(P<0.05),MVD was positively correlated with DJ-1,RRM2,HMGB1 genes(P <0.05),and negatively correlated with DKK1 genes(P <0.05).Conclusions The TVCDS parameters of patients with endometrial cancer are closely related to the expression of proliferation and invasion genes,and combined detection of RI,PI,and MVD can further improve the diagnostic efficiency and provide a reference for clinical disease diagnosis and pathological staging.