| 摘要: |
| 目的：分析三维能量多普勒超声(3DPDUS)诊断高级别鳞状上皮内病变(HSIL)的价值及其与血管内皮生长因子(VEGF)、微血管密度(MVD)的相关性分析。方法：选取2018年1月至2020年5月本院收治的疑似宫颈病变患者120例。根据病理诊断分为HSIL 组58例, LSIL 组36例,S非CIN组 26例。观察3DPDUS的诊断效能,对比三组患者VEGF、MVD表达的差异,并进行相关性分析。结果：3DPDUS诊断HSIL符合病理50例(89.66%)(52/58)。三组患者在RI、FI、VI、VFI、PSV存在显著差异(P<0.05),RI参数上HSIL组LSIL组>非CIN组,ROC曲线分析显示, RI、FI、VI、VFI、PSV对HSIL患者预测的AUC分别为0.713、0.888、0.981、0.974、0.754,均具有准确性；以ROC曲线靠左上方约登指数的最大切点作为最佳临界值,该点预测敏感度、特异度：RI为93.1%、54.8%；FI为86.2%、87.1%；VI为91.4%、100.0%；VFI为100.0%、91.9%；PSV为50.0%、100.0%,预测具有一定价值。三组患者在MVD、免疫组化积分、阳性率上存在显著差异(P<0.05),HSIL组>LSIL组>非CIN组,Spearman相关性显示： 3DPDUS血管参数中 FI、VI、VFI、PSV与MVD、VEGF呈显著正相关,RI与MVD、VEGF呈显著负相关(p<0.05)。结论：3DPDUS应用于高级别鳞状上皮内病变诊断具有良好诊断效能,其血管参数能反映患者血流状况与病情程度,且与MVD、VEGF表达相关性较高,可作为临床宫颈病变的早期筛查与治疗依据。 |
| 关键词: 高级别鳞状上皮内病变 3DPDUS 诊断效能 VEGF MVD 相关性 |
| DOI： |
| 投稿时间：2021-05-19修订日期：2021-05-19 |
| 基金项目: |
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| Diagnostic value of three-dimensional energy Doppler ultrasound and its vascular parameters in high-grade squamous intraepithelial lesions and its correlation with VEGF、MVD |
| Zhang Maochun,Guo Yuanyuan,Chen Jiao,Zhang Hongwei |
| () |
| Abstract: |
| Objective: Analysis of three-dimensional energy Doppler ultrasound and its vascular parameters in the diagnosis of high-grade squamous intraepithelial lesions and their correlation with VEGF、MVD.Methods: 120 patients with suspected cervical lesions admitted to our hospital from January 2018 to May 2020 were selected.According to pathological diagnosis, the patients were divided into HSIL group (58 cases), LSIL group (36 cases) and non-CIN Group (26 cases).The diagnostic efficacy of 3DPDUS was observed, and the differences in the expressions of VEGF and MVD in the three groups were compared, and the correlation was analyzed.Results: 3DPDUS diagnostic results: 37 patients were negative and 50 were positive, and the sensitivity specificity was 86.21%(50/58)and 75.81%(47/62). There were significant differences in RI, FI, VI, VFI and PSV among the three groups (P<0.05), RI parameters in HSIL group LSIL group>In the non-CIN group, ROC curve analysis showed that THE AUC predicted by RI, FI, VI, VFI and PSV for HSIL patients was 0.713, 0.888, 0.981, 0.974 and 0.754, respectively, which were both accurate.The maximum tangent point of The Yoden index on the upper left of ROC curve was taken as the best critical value. The predictive sensitivity and specificity of this point were as follows: RI was 93.1% and 54.8%.The FI was 86.2%, 87.1%;VI is 91.4% and 100.0%;VFI was 100.0%, 91.9%;PSV is 50.0%, 100.0%, the prediction has a certain value.There were significant differences in MVD, immunohistochemical score and positive rate among the three groups (P<0.05), HSIL group>LSIL group >Spearman correlation showed that in the non-CIN group, FI, VI, VFI and PSV were significantly positively correlated with MVD and VEGF, while RI was significantly negatively correlated with MVD and VEGF (P<0.05).Conclusion:3DPDUS has good diagnostic efficacy when applied to the diagnosis of HSIL. Its vascular parameters can reflect the patient"s blood flow status and severity of the disease, and are highly correlated with the expression of MVD and VEGF, which can be used as the basis for early screening and treatment of clinical cervical lesions. |
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