卵巢肿瘤患者三维直方图血管参数与微血管密度的相关性

doi:10.3877/cma.j.jssn.2095-5820.2017.02.010

中华医学超声杂志（电子版） ›› 2017, Vol. 14 ›› Issue (02) : 122 -126. doi: 10.3877/cma.j.jssn.2095-5820.2017.02.010

所属专题：妇产科超声影像学；文献；妇产科超声；

妇产科超声影像学

卵巢肿瘤患者三维直方图血管参数与微血管密度的相关性

孙丽娟¹, 吴青青¹^,^†(

), 张铁娟¹, 姚苓¹, 马玉庆¹, 王莉¹, 段秀会¹

^1. 100026　首都医科大学附属北京妇产医院超声科

收稿日期:2016-08-03 出版日期:2017-02-01
通信作者: 吴青青
基金资助:
北京市医院管理局青年人才培养"青苗"计划(QML20151303); 北京市医院管理局"登峰"计划专项经费资助(DFL20151302)

The correlation between three-dimensional histogram vascular indexes of ovarian tumors and microvessel density

Lijuan Sun¹, Qingqing Wu¹^,^†(), Tiejuan Zhang¹, Ling Yao¹, Yuqing Ma¹, Li Wang¹, Xiuhui Duan¹

^1. Department of Ultrasound, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China

Received:2016-08-03 Published:2017-02-01
Corresponding author: Qingqing Wu
About author:
Corresponding author: Wu Qingqing, Email: wuqq2007@163.com

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目的

评价三维直方图血管参数与卵巢肿瘤患者微血管密度（MVD）的相关性。

方法

收集2008年1月至2009年12月在首都医科大学附属北京妇产医院就诊的57例囊实性或实性卵巢肿物患者，术前1周行三维能量多普勒超声检查，对肿物感兴趣区的实性部分行三维血流采集，应用虚拟器官计算机辅助分析（VOCAL）程序中的三维直方图计算血管化指数（VI）、血流指数（FI）及血管化血流指数（VFI）。术后对肿瘤病理组织切片进行免疫组化染色，计算MVD及血管内皮生长因子（VEGF）表达强度。采用2个独立样本t检验比较MVD在卵巢良、恶性肿瘤间的差异，采用秩和检验比较VEGF在卵巢良、恶性肿瘤间的差异，采用Spearman等级相关分析法评价超声血管参数与MVD的相关性。

结果

57例患者共62个卵巢肿物（5例患者为双侧），经病理证实，其中，良性22个，恶性40个（包括交界性8个）。共有54个卵巢肿瘤行免疫组化染色，卵巢恶性肿瘤组的MVD值及VEGF表达强度均明显高于良性肿瘤组，差异均有统计学意义（t=-5.255，Z=-3.868，P<0.01）。其中VI、VFI与MVD均呈正相关，差异均有统计学意义（r=0.295、0.280，P均<0.05）。

结论

三维直方图血管参数与卵巢肿瘤的MVD关系较为密切，可在术前反映卵巢肿瘤内血管的生成情况，为临床的早期诊断提供有价值的信息。

关键词: 卵巢肿瘤, 超声检查，多普勒, 微血管

Objective

To evaluate the correlation between three-dimensional histogram vascular indexes of ovarian tumors and microvessel density (MVD).

Methods

Fifty-seven patients with ovarian cystic-solid or solid masses from Beijing Obstetrics and Gynecology Hospital, Capital Medical University were evaluated by three-dimensional (3D) power ultrasound within one week before surgery from January 2008 to December 2009. We captured 3D power imaging in the interested and solid areas of tumors, and used three-dimensional histogram from virtual organ computer-aid analysis (VOCAL) to calculate vascularization index (VI), flow index (FI) and vascularization-flow index (VFI). After operation the specimens underwent immunohistochemistry staining and MVD and vascular endothelial growth factor (VEGF) were calculated. Two independent-samples t tests were used to compare MVD between ovarian benign and malignant tumors. Rank sum test was used to compare VEGF. Spearman was used to analyze the relationship between 3D PD vascular indices and MVD.

Results

Sixty-two ovarian masses in 57 patients were confirmed by pathology (5 cases were bilateral tumors), including 22 benign and forty malignant messes (including eight borderline tumors). Fifty-four tumors underwent immunohistochemistry staining. MVD and VEGF were calculated. Both of MVD and VEGF in ovarian malignant tumors were obviously higher than those in benign ones (t=-5.255, Z=-3.868, both P<0.01). Both of VI and VFI were positive correlative to MVD (r=0.295, 0.280, both P<0.05).

Conclusions

There was a positive correlation between vascular indexes and microvessel density. The vascular indexes could reflect the density of angiogenesis in ovarian tumors before surgery, and they could provide valuable information for early-stage diagnosis of ovarian cancer.

Key words: Ovarian neoplasms, Ultrasonography, Doppler, Microvessels

表1 卵巢肿瘤良、恶性组的免疫组化结果比较

组别	例数	MVD（±s）	VEGF
组别	例数	MVD（±s）	-	＋	＋＋
良性组	14	6.2±3.6	10	4	0
恶性组	40	14.6±8.0	9	17	14
统计值	?	t=-5.255	Z=-3.868
P值	?	<0.01	<0.01

表1 卵巢肿瘤良、恶性组的免疫组化结果比较

组别	例数	MVD（±s）	VEGF
组别	例数	MVD（±s）	-	＋	＋＋
良性组	14	6.2±3.6	10	4	0
恶性组	40	14.6±8.0	9	17	14
统计值	?	t=-5.255	Z=-3.868
P值	?	<0.01	<0.01

图4~6 卵泡膜细胞瘤三维能量多普勒超声与病理切片图。图4示卵巢肿瘤实性组织内部能量血流信号较少；图5示三维直方图显示肿瘤感兴趣区域的血管参数（VI、FI及VFI）值较低；图6示采用链霉素抗生物素-过氧化氢酶复合物法对组织微血管进行免疫组织化学染色证实微血管较少（×400）。术后病理诊断为卵泡膜细胞瘤

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