Effects of Transvaginal Color Doppler Ultrasound Measurements on Microvessel Density Assessment in Ovarian Tumors

doi:10.3877/cma.j.issn.1673-5250.2009.05.107

Objective

To explore the dependability between transvaginal color Doppler ultrasound(TV-CDU) vascular blood flow indices and microvessel density (MVD) in ovarian tumor.

Methods

From January 2004 to December 2005, transvaginal color and pulsed Doppler ultrasound sonography were performed before surgical procedure in 82 women with ovarian tumors. Blood flow indices [pulsatility index (PI), resistive index (RI), peak systolic velocity(Vps), vessels number(VN)] were measured. Microvessel density was identified by Immunohistochemical staining of endothelial cell for CD₃₄.

Results

There were statistically significant differences in microvessel density between histopathology rank of ovarian cancer. Also, a significant correlation was found between microvessel density and low resistance to blood flow as measured by the resistive index or vessels number (P<0.05). However, no statistically significant correlation was found between microvessel density and pulsatility index or peak systolic velocity. The differences of resistive index and vessels number in benign and malignant ovarian tumor or lymph node metastases group and non-lymph node metastases group of ovarian cancer were statistically significant (P<0.01), but no statistically significant differences were found between International Federation of Gynecology and Obstetrics (FIGO) stage Ⅰ and other stages (P>0.05). Statistically significant differences in vessels number were found between histopathology ranks, but resistive index was not found.

Conclusion

Low resistive index and high vessels number may reflect high microvessel density in ovarian cancer and correlate with its histopathology rank and lymph node metastases.

Key words: ovarian tumor, transvaginal color doppler ultrasound (TV-CDU), microvessel density(MVD), resistive index (RI), vessels number(VN)

图1　CD₃₄免疫组化染色肿瘤间质内可见数个大小不等的呈棕黄色染色的微血管(×100)

图2　浆液性乳头状囊腺癌血流及其频谱（与图1为同1例患者）

	1　Folkman J, Merler E, Abernathy C, et al. Isolation of a tumor factor responsible for angiogenesis. J Exp Med, 1971, 133(2): 275–288.
	2　Guo LK, Qi ZQ, Zhao YZ. Application of Doppler ultrasonography in diagnosing blood supply and vascular pathology of ovarian tumor. J China Clin Med Imag, 2006，17 (1)：45–47.[郭丽魁，齐铮琴，赵玉珍．多普勒超声技术在卵巢肿瘤血供及血管病理诊断中的应用. 中国临床医学影像杂志，2006，17(1): 45–47.]
	3　Gasparini G, Bonoldi E, Viale G, et al. Prognostic and predictive value of tumour angiogenesis in ovarian carcinomas. Int J Cancer, 1996, 69(3): 205–211.
	4　Abulafia O, Triest WE, Sherer DM. Angiogenesis in primary and metastatic epithelial ovarian carcinoma. Am J Obstet Gynecol, 1997, 177(3): 541–547.
	5　Schelling M, Braun M, Kuhn W, et al. Combined transvaginal B–mode and color Doppler sonography for differential diagnosis of ovarian tumors: Results of a multivariate logistic regression analysis. Gynecol Oncol, 2000, 77(1): 78–86.
	6　Takae I. Role of preoperative transvaginal sonography, color flow imaging, and Doppler waveform analysis in predicting lymph node metastases in patients with ovarian cancer. Gynecol Oncol, 1998, 71(2): 211–218.
	7　Emoto M, Iwasaki H, Mimura K, et al. Differences in the angiogenesis of benign and malignant ovarian tumors, demonstrated by analyses of color Doppler ultrasound, immunohistochemistry, and microvessel density. Cancer, 1997, 80(5): 899–907.
	8　Wang XL, Shi TM. Quantification of ovarian tumor vascularity by 3D power doppler ultrasonography. Chin J Ultrasound Med, 2006, 22(8): 628–630.[王鑫璐，史铁梅. 三维能量多普勒定量研究卵巢肿物血管的价值．中国超声医学杂志，2006, 22(8): 628–630.]
	9　Liang RB, Yu SJ, Shi TM. The clinical comparison study about 3D color power angiography and pathological microvascular density in the differentiation of benign and malignant ovarian tumor. Chin J Pract Gynecol Obstet, 2008, 24(3): 40–42.[梁若冰，于诗嘉，史铁梅. 三维彩色血管能量成像与微血管密度对比诊断卵巢肿瘤的价值研究. 中国实用妇科与产科杂志，2008, 24(3)：40–42.]

[1]	Ju Lu, Sheng Zhao, Jianhua Fan, Yanduo Gao. Performance of IOTA simple rules, GI-RADS, and O-RADS in differentiating between benign and malignant adnexal lesions[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2024, 21(05): 484-490.
[2]	Mingsong Liu, Yuefang Ren, Yan Jin, Huifeng Wang, Tingting Cai, Jingying Fei. Effects of International Ovarian Tumor Analysis simple rules used by non-gynecological ultrasound doctors in evaluation of ovarian masses[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2021, 18(03): 296-300.
[3]	Huan Li, Xiaoqin Li, Xiuhua Wu, Yanyun Shi. Diagnostic value of ADNEX model combined with Copenhagen index in differentiating benign from malignant ovarian tumors[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2020, 17(12): 1213-1219.
[4]	Wei Liu, Changhong Li, Yingqi Lin, Qinying Zhou, Linxue Qian. The research on clinical and ultrasonographic features of ovarian clear cell carcinoma[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2018, 15(08): 616-619.
[5]	Yang Li, Dan Zhang, Xueqin Guo, Yandong Li. Comparative study of ultrasonic and pathologic features of ovarian teratoma[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2017, 14(11): 824-828.
[6]	Fang Lei, Yali Zhao. Clinical values of serum carcinoembryonic antigen 125 and plasma fibrinogen levels in differential diagnosis of benign and malignant ovarian tumors[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2018, 14(03): 337-342.
[7]	Xingmei Feng. Evaluation of serum inflammatory cytokines in the diagnosis of ovarian cyst torsion[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2015, 11(4): 467-470.
[8]	Hui-zhu CHEN, Gang NING, Hai-bo QU, Chuan YE, Xue-shen LI, Zu-li WANG. Location Value of the Ovarian Vascular Pedicle Sign on Multidetector CT in Female With Large Pelvic Masses[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2011, 07(06): 540-545.
[9]	Fang QIU, Xin TAN, Yu-jue WANG, Xue-mei GAO. Reproductive Prognosis After Conservative Treatments of Borderline Ovarian Tumors and Malignant Ovarian Tumors[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2010, 06(01): 58-61.
[10]	Xiao-yan HAN, Yue CHEN, Min-min HOU, Jian ZHANG, Xiao-li WAN, Kai-xuan YANG, Ming-rong QIE. A Study on the Expression and Clinical Significance of AIB1 Protein in Ovarian Borderline Epithelial Tumor[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2008, 04(03): 186-190.
[11]	Tingxiu Liu, Xinmin Liu, Ying Liu, Juan Sui, Yu Wu, Yujing Zhao, Hong Bi, Xuemei Sun, Xiuhua Fan. Discuss the safety and feasibility of laparoscopic oophorectomy approach after abdominoplasty[J]. Chinese Journal of Laparoscopic Surgery(Electronic Edition), 2024, 17(03): 189-192.
[12]	Wenxian Li, Hang Yu, Fang Wen, Wenwen Zhao, Dan Zi. Application of transvaginal natural orifice endoscopic surgery in the treatment of giant benign ovarian tumors[J]. Chinese Journal of Laparoscopic Surgery(Electronic Edition), 2022, 15(06): 357-363.
[13]	Ge Zhang, Zhenwei Jin, Ying Li, Teng Liu, Xiaoying Yang, Xiaomeng Xu, Yingchun Ma. Comprehensive staging operation for giant malignant ovarian tumor through transumbilical single-port laparoscopy plus one port[J]. Chinese Journal of Laparoscopic Surgery(Electronic Edition), 2022, 15(01): 58-61.

Viewed

Full text

Abstract

Please choose a citation manager

Content to export