The Relationship Between Ultrasound Blood Flow Dynamics And VEGF,MVD In Osteosarcoma

Objective: To evaluate the clinical application of ultrasound hemodynamic parameters in the diagnosis of osteosarcoma (OS), and the relationship with expression of vascular endothelial growth factor (VEGF), microvessel density (MVD).Methods: The two-dimensional ultrasound (2DUS) and Doppler ultrasound were used in 26 cases of osteosarcoma and 9 patients with benign bone tumors. The sonographic characteristics of lesions, blood flow distribution and blood flow parameters were observed. Pulsed Wave Doppler (PW) measured flow parameters which included peak systolic velocity (PSV), end diastolic velocity (EDV), resistance index (RI). The expression of VEGF and MVD in all cases was tested by immunohistochemistry (IHC). We analyzed the relation among VEGF, MVD, PSV and RI.Results: 1. There was statistical significance between benign bone tumor and osteosarcoma in flow grade (P<0.05). 2. The levels of PSV and EDV of osteosarcoma group were higher than those of benign bone tumor group, and RI values were lower (P<0.05). 3. Positive expression rates of VEGF and MVD counting in the osteosarcoma group and benign bone tumor group were 76.9% (20/26, 69.53±24.77) and 22.2% (2/9, 22.33±10.99) respectively, two groups had statistically significance (P <0.05). 4. Single factor analysis variance results: the difference of PSV among all stages of osteosarcoma was significant, and stageⅢ> stageⅡ,stage I(P <0.05) ; While the difference in pathological type was not (P > 0.05). Differences of RI in clinical stages and pathologic type were no significant difference (P > 0.05). Both the positive expression rate of VEGF and MVD counting have positive correlation with clinical stages (P <0.05), instead of to gender, age and pathological types (P > 0.05). 5. Correlation analysis showed that VEGF and MVD counting were significantly positively correlated (r= 0.554, P <0.05). PSV and RI were negatively correlated (r = -0.435, P <0.05). PSV were positively correlated with VEGF (r =0.596, P<0.05), and with MVD (r = 0.618, P <0.05). However, RI had no correlation with VEGF and MVD (all P> 0.05).Conclusion: PSV, EDV, RI between osteosarcoma and the control group measured by Doppler ultrasound were statistically significant, which could provide hemodynamic information for the early diagnosis of osteosarcoma. Compared with the control group, both the rate of VEGF positive expression and the numbers of MVD in osteosarcoma were statistically increased. VEGF has positive correlation with MVD and the clinical stage, suggesting that VEGF, MVD play a crucial role in the development of osteosarcoma blood vessels. PSV in osteosarcoma and pathological VEGF, MVD was positively correlated, suggesting that PSV can be used for preoperative evaluation of the angiogenesis status of osteosarcoma.