三维能量多普勒血管成像测量子宫内膜容积及血流参数筛查子宫内膜癌的价值探究

Exploration on the value of measured EV and blood flow parameters by 3D-PDA in screening EC

目的:分析三维能量多普勒血管成像(3D-PDA)测量子宫内膜容积(EV)及血流参数筛查子宫内膜癌(EC)的价值。方法:选择医院收治的245例子宫内膜病变患者,将其中130例围绝经期反复阴道出血患者纳入围绝经期组(其中良性病例107例,恶性病例23例),115例绝经后反复阴道出血或无症状子宫内膜增厚患者纳入绝经后组(其中良性病例74例,恶性病例41例),收集两组患者年龄、体质量指数(BMI)以及孕(产)次数等临床资料。所有患者行3D-PDA检查,计算子宫内膜厚度(ET)、EV、血管指数(VI)、血流指数(FI)以及血管-血流指数(VFI)水平。采用受试者工作特征(ROC)曲线分析3D-PDA在诊断EC的价值。结果:两组患者年龄、BMI、孕(产)次数等差异无统计学意义。围绝经期组患者子宫内膜病变发生率为17.69%,明显低于绝经后组(35.65%),其差异有统计学意义(χ^(2)=10.198,P<0.05)。围绝经期组中的恶性病例ET、EV、VI、FI及VFI水平明显高于良性病例(t=3.825,t=10.308,t=10.180,t=5.645,t=10.496;P<0.05);绝经后组的恶性病例ET、EV、VI、FI及VFI水平明显高于良性患者(t=5.975,t=8.584,t=6.031,t=4.762,t=3.469;P<0.05)。ROC曲线分析显示,ET、EV、VI、FI和VFI诊断子宫内膜癌的ROC曲线下面积(AUC)分别为0.751、0.816、0.805、0.796和0.775,诊断灵敏度分别为69.85%、74.52%、82.64%、74.98%和76.35%,特异度分别为71.25%、79.52%、79.66%、78.64%和78.91%;3D-PDA诊断EC的AUC为0.876。结论:3D-PDA测量EV及血流参数在围绝经期及绝经后期EC中异常表达,3D-PDA在诊断围绝经期及绝经后期EC具有一定价值。

Objective:To analyze the value of measured endometrial volume(EV)and blood flow parameters by three-dimensional power Doppler angiography(3D-PDA)in screening endometrial cancer(EC).Methods:A total of 245 patients with endometrial lesion who admitted to hospital were selected,and 130 patients with recurrent vaginal bleeding during perimenopause were divided into perimenopause group(107 cases of them were benign cases,and 23 cases of them were malignant cases),and 115 patients with recurrent vaginal bleeding after menopause or with endometrial thickness(ET)without symptom were divided into post menopause group(74 cases of them were benign cases,and 41 cases of them were malignant cases).The clinical data included age,body mass index(BMI),the times of pregnancy(delivery)were collected.All patients underwent 3D-PDA examination to calculate the levels of ET,EV,vascular index(VI),blood flow index(FI)and vascular-blood flow index(VFI).The receiver operating characteristics(ROC)curve was used to analyze the value of 3D-PDA in diagnosing EC.Results:There were no significant differences in age,BMI,the times of pregnancy(delivery)between the two groups.The incidence of endometrial lesions in perimenopause group was 17.69%,which was significantly lower than that in post menopause group(35.65%)(χ^(2)=10.198,P<0.05).In perimenopause group,the levels of ET,EV,VI,FI and VFI of the malignant cases of were significantly higher than those of the benign cases(t=3.825,t=10.308,t=10.180,t=5.645,t=10.496,P<0.05),respectively.In the post menopause group,the levels of ET,EV,VI,FI and VFI in the malignant cases were significantly higher than those in the benign cases(t=5.975,t=8.584,t=6.031,t=4.762,t=3.469,P<0.05),respectively.ROC curve analysis showed that the AUCs of ET,EV,VI,FI and VFI were 0.751,0.816,0.805,0.796 and 0.775 in diagnosing the endometrial cancer,and the diagnostic sensitivities of them were 69.85%,74.52%,82.64%,74.98%and 76.35%,respectively.The specificities of them were 71.25%,79.52%,79.66%,78.64%and 78.91%,respectively.The AUC of 3D-PDA was 0.876 in diagnosing EC.Conclusion:3D-PDA measurement indicates abnormal expression of EV and blood flow parameters in perimenopausal and postmenopausal endometrial cancer,which has a certain of value in diagnosing perimenopausal and postmenopausal EC.