摘要
目的评价子宫内膜癌(EC)患者超声造影(CEUS)检查征象及相关生物学行为.方法选取2017年1月至2018年12月本院收治的80例经手术病理明确诊断为EC患者作为EC组,选取同期80例非EC患者作为对照组,均行CEUS检查;统计两组CEUS征象特点,比较两组CEUS检查时感兴趣区域造影剂平均渡越时间(MMT)、峰值强度(Peak)、达峰时间(TTP);统计CEUS检查不同分期EC征象特点,比较EC肌层浸润CEUS检查与病理评估结果一致性、增殖凋亡蛋白(Beclin1、Bax、Survivin、Bcl-2、CDK4、CDK6)表达情况,并分析MMT、Peak、TTP与增殖凋亡蛋白相关性.结果EC组充盈模式以快速整体充盈型为主,充盈时间早于周围肌壁,大多呈现出高增强,消退方式早于周围肌壁;对照组充盈模式以周围充盈型为主,充盈时间晚于周围肌壁,大多显示低增强或等增强,消退方式与周围肌壁略早或相似;EC组MMT、Peak高于对照组,TTP低于对照组(P<0.05);CEUS显示Ⅰa期EC共41例,其中显示子宫内膜增厚不均匀中等或高增强患者27例,等增强或不均匀低增强14例,造影剂出现早于子宫肌层,内部见紊乱增粗血管,受累肌层厚度<50%,与肌层分界清,肌层呈均匀增强,见短棒状、点状血流信号;Ⅰb期EC共30例,子宫内膜增厚呈中等或高增强,分界欠清,受累肌层厚度≥50%,呈不均匀高增强,见迂曲增粗血管,造影剂消退早于周边肌层、正常内膜;Ⅱ期EC共9例,滋养血管内首先布人造影剂,宫颈与内膜病灶快速增强,呈中等或高增强,受累肌层、内膜、受侵宫颈增强与消退早于周围肌层与正常内膜;以病理结果为准,CEUS诊断Ⅰa、Ⅰb、Ⅱ期EC准确率分别为94.12%、75.68%、77.78%;与病理结果比较,CEUS检查Kappa指数为0.727(P<0.001,95%CI:0.557~0.898);EC组Beclin1、Bax低于对照组,Survivin、Bcl-2、CDK4、CDK6高于对照组(P<0.05);Beclin1、Bax与MMT、Peak呈负相关,与TTP呈正相关(P<0.05);Survivin、Bcl-2、CDK4、CDK6与MMT、Peak�
Objective To evaluate the contrast-enhanced ultrasound(CEUS)features and related biological behaviors of endometrial cancer(EC).Methods Eighty patients with EC confirmed by surgical pathology between January 2017 and December 2018 in our hospital were enrolled as the EC group.A contemporary cohort of 80 non-EC patients were recruited as the control group.All patients underwent CEUS examination.The CEUS features,the mean transit time(MTT),peak intensity(Peak),and time to peak(TTP)of the contrast agent in the region of interest during the CEUS examination were compared between groups.The CEUS features of EC at different stages,consistency between CEUS-identified myometrial invasion and pathological findings,expression of proliferating apoptotic proteins(Beclin1,Bax,Survivin,Bcl-2,CDK4,and CDK6)were examined.The correlation between MTT,Peak,TTP and proliferating apoptotic proteins was analyzed.Results The CEUS in EC group was mainly of fast filling pattern,with shorter filling time and quicker regression in the lesions compared with the surrounding muscle wall,showing hyperenhancement in most of cases.The CEUS in the control group was mainly of eccentric filling pattern,with longer filling time but earlier or similar regression in the lesions compared with the surrounding muscle wall,showing hypo-or isoenhencement in most of cases.The EC group presented more MTT and Peak but less TTP compared with the control group(P<0.05).Features of EC identified on CEUS were:(1)41 cases of stageⅠa,showing uneven,moderate enhancement or hyperenhancement(n=27),and isoenhancement or uneven,hypoenhancement(n=14)of endometrium.The contrast agent appeared earlier in endometrium than in the myometrium.The EC lesions presented disrupted and thickened vessels inside and invaded<50%of the muscle layer with a clear boundary with the latter.The muscle layer was evenly enhanced,showing short rod-like,patchy blood flow signals.(2)30 cases of stageⅠb,showing moderate or hyperenhancement of the endometrium,invading ≥50% of the muscle layer
作者
卢薇薇
郑吟诗
邬亮
李潜
Lu Weiwei;Zheng Yinshi;Wu Liang;Li Qian(Department of Ultrasound,Shangqiu First People’s Hospital,Shangqiu,Henan 476000,China)
出处
《中华生物医学工程杂志》
CAS
2019年第4期476-481,共6页
Chinese Journal of Biomedical Engineering
