Transvaginal Power Doppler Analysis Of Vegf And Cervical Lesions

BackgorundCervical cancer is the second common malignancies in both of incidence and mortality rates in worldwide, which seriously threaten the health of most women.To improve the survival rate of cervical cancer patients, the key is early diagnosis and rational treatment.Cervical intraepithelial neoplasia (CIN) refers to the cervical precancerous lesions to carcinoma in situ of the continuous process. Various levels of CIN has a tendency to develop into invasive carcinoma. Early diagnosis and treatment of cervical precancerous lesions, can effectively prevent and treat cervical cancer, to improve the prognosis of patients with cervical cancer.The characteristic of its vascular distribution and blood supply are important in the diagnosis,therapy and prognosis of cervical cancer and Cervieal Intraepithelial NeoplasiaⅢ(CINⅢ).TO study the blood of cervical cancer and CINIII with color Doppler flow image(CDFI),color Doppler energy,(CDE),puls wave Doppler(PW), the blood supply was reflected,hemodynamic parameters of cervical cancer and CINIII were compared to Vascular endothelial growth factor(VEGF) derived from immunohistochemistry by the characteristics of blood supply and their hemodynamics.The relationship between tumural vascularity with Doppler sonogrpahy and the expression of VEGF in Vascular endothelial growth factor was investigated,so as to provide a objective evidence for the treatment and assessment of prognosis.Materials and MethodsFrom January 2009 to February 2010,an analysis was performed of 26 women with cervical carcinoma and 41 women with CINⅢat First Hospital of ShanXi Medical University. During the study Period,20 women with normal uterine cervix agreed to undergo Color power Angio examinations and were selected as controls.All the patients underwent Color power Angio examination during one to three days prior to surgery.An unhomogeneous mass was found in the cervix of eaeh patient by Transvaginal ultrasound (TVS).All patients underwent radical abdominal hysterectomy and pelvic lymph node dissection as the initial treatment.Transvaginal power Doppler ultrasound was performed to search of blood flow signals of the tumor before surgery.The resistance index(RI),peak systolie velocity (PSV).All clinicopathologic data were obtained.All the cervical tissue samples were obtained after operation. VEGF of the tissue samples was assassed by immunohistochemieal method(SPmethod).The aim of the present study was to evaluate whether differ prognosis cervical intraepithelial neoplasm(CIN) and in normal controls;and to find the correlation between tumor angiogenesis as assessed by color Doppler energy ultrasound and VEGF in cervical carcinoma.Result1.Significant differences between means for CINIII and cervical carcinoma were found for following parameters:RI,PSV. The RI in cervieal carcinoma was signifieantly lower than that in normal tissues and CINIII.Significantly higher PSV was noted in cervical careinoma compared with CINIII.2.The positive immunostaining rate of VEGF in 60 cases was 69.0%,and it associated with histologic grade and pelvic lymph node metastasis,The positive rate in stage G1 is significant lower than that in stageG2 and G3,P<0.05.There were no relations between the expression of VEGF and surgical stage,,pathologic type,P>0.05.3.ROC curve showed PSV values 7.41cm/s was superior to any other standards in CINⅢ.The sensitivity of this cut off value was 71.4%,and the specificity was 70.6%;ROC curve showed PSV values 9.89cm/s was superior to any other standards in cervical carcinoma.The sensitivity of this cut off value was 69.2%,and the specificity was 69.2%;ROC curve showed PSV values 11.11cm/s was superior to any other standards in pelvic lymph node metastasis.The sensitivity of this cut off value was 62.5%,and the specificity was 61.3%.ConclusionsThe angiogenesis character of cervical carcinoma can be showed by RI,PSV and VEGF from different angle and they had some inherent connections with clinicopathologic parameters of cervical carcinoma,which indicating that we can supply some new theory for curing cervical carcinoma and predicting prognosis of patients.