Preliminary Study On Travenous Ultrasound Contrast And Serum Proteomic Spectra In Diagnosis Of Ovarian Cancer

PART 1:Research on blood perfusion when rabbit tumor VX2's growing by using travenousultrasound contrastObjective The growth of neoangiogenesis and the relationship between MVD and the size of tumor will be analyzed by using travenous ultrasound contrast and immunohistochemistry. To discuss the value of diagnosing malignancy under the help of travenous ultrasound contrast.Method: 14 rabbits were needed in the experiment. VX2 with the diameter of about 3-4mm was embedded into the muscular layer of the buttocks of the rabbits. The lesions were altogether 56, with 4 points for each rabbit. As a result, 48 lesions were observed because eight of them were excluded. Observation was done every 24 hours after tumor was embedded. Each time, normal ultrasound test was done on all rabbits under experiment, and the size of tumor and the blood supply were recorded. Thereafter, two rabbits were selected randomly, and anesthetized with intramuscular. As a beginning, ultrasound contrast agents SonoVue was injected through ear-vein at the speed of 0.2ml/Kg. Then 5ml saline was used to wash up by rapid injection. The enhancement of focuses after the injection of the ultrasound contrast agents was analyzed by using the time-intensity curve of contrast agent Wash-in/Wash-out software. The two rabbits were killed after the contrast, and the tumor was analyzed, and the expression of VEGF and MVD in the tumor were observed. The characteristics of neoangiogenesis in the tumor and the relationship between contrast and MVD were analyzed, and the ultrasound contrast was contrasted to the sensitivity of blood flow inside the tumor.Result 1. Some microvasculars were formed in the process of the growth of tumor. The vessel wall of microvasculars of the tumor was thin, and had a bad differentiation. The endothelial cells of the microvasculars were infantile, and the basement membrane with the shape of flakes was immature and orderless. The blood vessels of tumor were form at the outer edge and gradually grow inward the tumor before large amount of newly-grown blood vessels were formed. 2. The travenous contrast ultrasound of tumor and the surrounding normal muscular tissues showed a dynamic enhancement with the change of time. Comparing with the surrounding normal tissue, the ET was faster, and the MTT was longer without the significance of statistics(P>0.05). The PIT was earlier, and the PSI was higher, which had the significance on statistics (P<0.05) . 3. Comparing with CDFI, the ultrasound contrast had a much more sensitivity for neoangiogenesis in the tumor (P<0.05). 4. The percentage of enhancement of ultrasound contrast and the value of MVD had a better dependability than that of CDFI. 5. The volume of the tumor and the value of MVD hada dependability .The volume increased with the increasing of the value of MVD.Conclusion The growth of tumor depends on forming of microvessels. The sensitivity of ultrasound contrast towards microvessel is better than routine ultrasound CDFI. The travenous ultrasound contrast can provide information of the dynamic blood perfusion continuously, and catch some minute and rapid differences of perfusion. The quantitative analysis on the time-intensity curve can be shown after the forming of microvessels, so it has a better relativity with the value of MVD inside the tumor, and has a significance in the diagnosis of malignancy.PART 2Research diagnosis of ovary tumor by using travenous ultrasound contrast and serumproteomic spectraObjective To analyze the ultrasound expression of ovary benign tumor and malignancy, the sufficiency of contrast agent through applied acoustics contrast, and the differences of hemodynamics features and blood supply of benign tumor would be discussed. Matrix-assisted Laser Desorption lonization Time of Flight Mass Spectrometry (MALDI-TOF-MS) would be used to do the inter group analysis among the normal group, benign group and malignant group and do the inner group analysis inside the normal group according to ages. The serum sample curve of each case would be set up, and the protein spectrum would be analyzed on healthy people at different ages. The diagnostic cast would be built on benign tumor and ovary malignancy after comparing the differences among three samples and finding the tumor-marker protein. The relationship between blood supply of ovary benign tumor and malignancy, tumor marker CA-125, and the genetic fingerprint features would be analyzed, so as to get a convenient and effective diagnosis of ovary malignancy.Method 32 adnexal masses were made ultrasound contrast through vagina, and the time-intensity curve analysis and protein spectrum analysis would be done. The serum of patients before operation was collected and tested with CA-125 and protein spectrum. The diagnosis of each patient will be proved by pathology and follow-up analysis. Furthermore, 22 common people were tested with CA-125 and protein spectrum. The group of common people were divided into three groups according to ages ( under 40 years old, 40-60 years old, above 60 years old). Comparison was done among benign group, malignant group and the common group. The relationship between the pathology after operation, CA-125, protein spectrum and ultrasound contrast would be analyzed.Result 1 .In the 34 patients, 23 cases were benign tumor, 11 cases were diagnosed as ovarian endometriosis, 2 cases as inflammatory masses of ovarian appendages, 1 case as fibroma of ovary,2case as fabroma theca cell tumor of ovary,6 cases as dermoid tumor, 1 case as ovarian tuberculosis. 11 cases were malignant tumor, 1 case was diagnosed as borderline seropapillary cyst adenoma, 10 cases as ovarian cancer. 2.The analysis of the ultrasound contrast of the benign group and the malignant group showed that the upslope of the time-intensity curve of the contrast was steep, and the decent for benign tumors were quick while that of malignant tumor is slow. The ET, the PIT were earlier and the PSI was higher than the benign tumors (P<0.05 ) . The MTT was shorter than the benign tumors (P<0.05) . 3.In the protein spectrum test, the curves of all three groups were all significant on statistics. A peak value 3238m/z was found to distinguish these three groups. At last, the sensitivity, specificity and accuracy of serum CA-125,protein spectrum and travenous ultrasound contrast test were 87.5%, 69.2% and 76.2%; 87.5%, 92.5% and 86.4%; 100%. 94.4% and 95.7%,respectively. However, the sensitivity, specificity and accuracy of the combined test of travenous ultrasound contrast, protein spectrum and CA-125 reached 100%.Conclusion The combined application of travenous ultrasound contrast test, protein spectrum test and CA-125 test will make diagnosis of the ovary malignancy more accurate.