ObjectiveTo explore the application value of the quantitative parameters of transvaginal color Doppler sonography(TVCDS) in the evaluation of the depth of myometrial invasion and treatment effects in patients with endometrial cancer(EC).
MethodsA total of 100 EC patients diagnosed by TVCDS examination and pathology, which included 82 cases with muscular infiltration and 18 cases without muscular infiltration.The clinical data, quantitative parameters of TVCDS and microvascular density(MVD) between patients with and without muscle layer infiltration and muscle layer infiltration were compared.The quantitative parameters of TVCDS among patients with different surgical outcomes were compared.The influencing factors of muscle layer infiltration in EC patients were analyzed, and the correlation between quantitative parameters of TVCDS, MVD and depth of deep muscle layer infiltration in EC patients was analyzed.The ROC curve was used to evaluate the relationship between TVCDS quantitative parameters and surgical efficacy.
ResultsThe differences of the histological grade, clinical stage, and lymphatic metastasis were statistically significant between two groups(P < 0.05).The perfusion index(PI) and resistance index(RI) in muscle layer infiltration group were lower than those in non-muscular layer infiltration group(P < 0.05), and the MVD in muscle layer infiltration group was higher than that in non-muscular layer infiltration group(P < 0.05).The perfusion index and resistance index in deep muscle layer group were lower than those in superficial muscle layer group(P < 0.05), and the MVD in deep muscle layer group was higher than that in superficial muscle layer group (P < 0.05).The results of logistic regression analysis showed that the hhistological grade, clinical stage, lymph node metastasis, PI, RI and MVD were the influencing factors of muscle layer infiltration in EC patients(P < 0.05).The TVCDS quantitative parameters PI and RI were negatively correlated with the depth of muscle layer infiltration(r=-0.719, -0.662, P < 0.05), the MVD was positively correlated with the muscle layer infiltration(r=0.578, P < 0.05), and the PI, RI were negatively correlated with MVD in EC patients(r=-0.575, -0.520, P < 0.05).The PI and RI of patients with good operation results were significantly higher than those with poor operation results(P < 0.01).The ROC curve analysis showed that the area under curve(AUC) of PI and RI in predicting surgical efficacy were 0.782 and 0.759, respectively.The AUC of PI combined with RI in predicting surgical efficacy were 0.863, which was higher than that of the diagnostic value of PI and RI alone.
ConclusionsThe quantitative parameters PI and RI of TVCDS in EC patients have important application value in the depth of myometrial invasion, histological grade, clinical staging, lymphatic metastasis and evaluation of surgical effect, which can provide important reference information in the diagnosis of EC and evaluation of preoperative and prognosis.
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