CAJ | 학술논문

目的：探讨初诊宫颈癌超声特征及与病理参数之间的相关性。方法选取2014年1～11月南京军区福州总医院初诊宫颈癌患者100例为研究对象，患者均于入院后3 d内行女性盆腔超声检查，并通过组织病理学检查对病变组织内微血管密度（ MVD）进行计数。观察初诊宫颈癌超声声像图特征，多普勒血流特征及不同分期病变间的差异。结果超声声像图显示宫颈形态正常或轻度增厚（Ⅰ期）；宫颈不均匀增厚，体积增大（Ⅱ期）；宫颈病变累及宫颈管、宫体或宫旁组织（Ⅲ期）。病变回声增强，呈点条状，多普勒技术显示点状血流（Ⅰ期）；不均匀回声范围增大，多普勒技术显示点条状及网状血流（Ⅱ期）；宫颈病变累及宫颈管、宫体或宫旁组织，多普勒技术显示血流丰富（Ⅲ期）。宫颈鳞癌与宫颈腺癌间，多普勒超声阻力指数（ RI）值、MVD 值比较差异无统计学意义[（0.45±0.07）比（0.45±0.06），（32.76±6.87）比（31.43±7.43），P ＞0.05]。在伴有淋巴结转移患者多普勒超声RI值、MVD值显著低于未伴有淋巴结转移患者[（0.41±0.06）比（0.47±0.07），（33.54±7.65）比（28.87±5.77），P ＜0.01]。随着宫颈癌分期的增加，其 RI 值逐渐降低（Ⅰ期：0.47±0.05；Ⅱ期：0.44±0.06；Ⅲ期：0.39±0.04）， MVD 值逐渐升高（Ⅰ期：25.36±5.61；Ⅱ期：30.52±4.72；Ⅲ期：33.51±3.91），分期间比较，差异均有统计学意义（P＜0.05）。经Pearson相关分析，宫颈癌RI值与MVD值间呈显著负相关（r＝－0.518，P＝0.014）。结论多普勒超声检查可以清晰显示宫颈癌病变的特征，随病变分期增加，其声像图及多普勒血流特征存在差异。
목적：탐토초진궁경암초성특정급여병리삼수지간적상관성。방법선취2014년1～11월남경군구복주총의원초진궁경암환자100례위연구대상，환자균우입원후3 d내행녀성분강초성검사，병통과조직병이학검사대병변조직내미혈관밀도（ MVD）진행계수。관찰초진궁경암초성성상도특정，다보륵혈류특정급불동분기병변간적차이。결과초성성상도현시궁경형태정상혹경도증후（Ⅰ기）；궁경불균균증후，체적증대（Ⅱ기）；궁경병변루급궁경관、궁체혹궁방조직（Ⅲ기）。병변회성증강，정점조상，다보륵기술현시점상혈류（Ⅰ기）；불균균회성범위증대，다보륵기술현시점조상급망상혈류（Ⅱ기）；궁경병변루급궁경관、궁체혹궁방조직，다보륵기술현시혈류봉부（Ⅲ기）。궁경린암여궁경선암간，다보륵초성조력지수（ RI）치、MVD 치비교차이무통계학의의[（0.45±0.07）비（0.45±0.06），（32.76±6.87）비（31.43±7.43），P ＞0.05]。재반유림파결전이환자다보륵초성RI치、MVD치현저저우미반유림파결전이환자[（0.41±0.06）비（0.47±0.07），（33.54±7.65）비（28.87±5.77），P ＜0.01]。수착궁경암분기적증가，기 RI 치축점강저（Ⅰ기：0.47±0.05；Ⅱ기：0.44±0.06；Ⅲ기：0.39±0.04）， MVD 치축점승고（Ⅰ기：25.36±5.61；Ⅱ기：30.52±4.72；Ⅲ기：33.51±3.91），분기간비교，차이균유통계학의의（P＜0.05）。경Pearson상관분석，궁경암RI치여MVD치간정현저부상관（r＝－0.518，P＝0.014）。결론다보륵초성검사가이청석현시궁경암병변적특정，수병변분기증가，기성상도급다보륵혈류특정존재차이。
Objective To investigate the ultrasound characteristics of newly diagnosed cervical cancer and the correlation with pathological parameters.Methods A total of 100 patients with newly diagnosed cer-vical cancer patients from Fuzhou General Hospital of Nanjing Military Region during Jan .and Nov.2014 were chosen as the research objects.All patients underwent pelvic ultrasonography and histopathological examination of lesions and microvessel density(MVD) was counted.The ultrasonographic features of newly diagnosed cervical cancer were observed,and Doppler flow characteristics in different stages of disease were compared.Results Ultrasonography showed normal or mild thickening of the cervical morphology ( phaseⅠ);irregular cervical thickening,increase in size (Ⅱ);cervical lesions involving the cervix,uterine body or parametrial tissue (Ⅲ).The lesion showed echo enhancement,in spot or strip,Doppler showed poor blood flow ( phaseⅠ);inhomogeneous echo range increases,Doppler showed spot strip and mesh flow (Ⅱ);cervi-cal lesions involving the cervix,uterine body or parametrial tissue,Doppler showed rich blood flow (Ⅲ). Between cervical squamous carcinoma and adenocarcinoma,the Doppler RI value(0.45 ±0.07 vs 0.45 ± 0.06),MVD value(32.76 ±6.87 vs 31.43 ±7.43),had no significant difference(P >0.05).Between patients with and without lymph node metastasis of cervical cancer,the Doppler resistance index (RI) value (0.41 ±0.06 vs 0.47 ±0.07),MVD value(33.54 ±7.65 vs 28.87 ±5.77) had statistically significant difference(P<0.01).With the increase of staging of cervical carcinoma,the value of RI decreased gradually (stageⅠ:0.47 ±0.05; stageⅡ:0.44 ±0.06;stage Ⅲ:0.39 ±0.04),the MVD value increased gradually (stageⅠ:25.36 ±5.61; stage Ⅱ:30.52 ±4.72;stage Ⅲ:33.51 ±3.91),the differences were statistically significant (P<0.05).The Pearson correlation analysis showed that the value of RI was significantly nega-tively correlated with MVD value (r=-0.518,P=0.014) in cervical cancer.Conclusion Doppler ultra-sonography can clearly show the characteristics of cervical lesion,with the increase of pathological staging,the ultrasound and Doppler flow characteristics are different.