超声检测卵巢内膜样囊肿间质血流预测卵巢组织损伤的研究

摘要

Objective To investigate the change of interstitial blood flow in ovarian endometrioid cyst ( OEC ), its correlation with transforming growth factor - β1 ( TGF - β1 ), thrombospondin - 1 ( TSP - 1 ), and microvessel density ( MVD ). in order to predict the injury of ovarian interstitial in OEC. Methods The transvaginal colour Doppler sonography ( TV-CDS ) was preoperatively performed to detect the signal and resistance index of ovarian blood flow for 60 OEC patients ( trial group ) and 30 patients with benign ovarian tumors ( control group ). The interstitial tissues of the cyst or around the tumor with blood flow were operationally collected, and then the expressions of TGF - β1 and TSP - 1 of were assayed by immunohistochemical analysis. And MVD count was performed. Results ( 1 ) In the OEC group the signals of blood flow were reduced, and the RI was significantly increased as compared with that in the controls ( P＜0.01 ). ( 2 ) In the OEC group, the expressions of TCF -β1 ( positivity rate of 70.59％ ) and TSP - 1 ( positivity rate of 66.67％ ) were increased, and the MVD count was reduced with a average of ( 5.87 ± 1.44 ) /400 times of visual field, with significant differences compared with those in the controls (P＜0.01). There was a positive correlation hetween expressions of TGF - β1 and TSP - 1 ( rs = 0.90, P＜0.01 ). The expressions of TGF-β1 and TSP -1 were negatively correlated with MVD value ( rs =-0.70, -0.76, P＜0.01 ). ( 3 ) MVD showed a negative correlation with RI ( rs=-0.91 , P＜0.01 ), a positive correlation with the expressions of TGF - β1 , TSP -1 ( rs=0.77,0.81, P＜0.01 ) . Conclusion Changes in ovarian interstitial flow and in expressions of TGF- β1 , TSP-1 and MVD reflect pathological conditions of OEC from different respects, being consistent. The sonographic blood flow of ovarian interstitia may prospectively predict the ovarian interstitial damage in OEC.%目的 探讨卵巢内膜样囊肿(OEC)间质血流变化及其与转化生长因子-β1(TGF-β1)、血小板反应蛋白-1(TSP-1)及微血管密度(MVD)的相关性,预测OEC对卵巢间质组织的损伤.方法 术前应用经阴道彩色多普勒超声检测60例OEC患者(研究组)及30例卵巢良性肿瘤患者(对照组)的卵巢间质血流信号及阻力指数(RI),术后采集有血流显示的囊肿或肿瘤周边间质进行免疫组化染色,检测TGF-β1、TSP-1的表达及MVD计数.结果 (1)OEC卵巢间质内血流信号少,阻力高,RI值较对照组显著增高,差异有统计学意义(P＜0.01).(2)OEC卵巢间质内TGF-β1、TSP-1表达增高,阳性表达率分别为70.59%、66.67%,MVD表达下降,平均值为(5.87±1.44)个/400倍视野,与对照组比较差异均有统计学意义(P＜0.01).TGF-β1与TSP-1的表达呈正相关(rs=0.90,P＜0.01),两者均与MVD值呈负相关(rs=-0.70、-0.76,P＜0.01).(3)超声血流RI值与MVD呈负相关(rs=-0.91,P＜0.01),与TGF-β1、TSP-1的表达呈正相关(rs=0.77、0.81,P＜0.01).结论 卵巢间质血流变化与TGF-β1、TSP-1和MVD表达的改变从不同角度反映了OEC的病理状态,两者相一致.超声检测卵巢间质血流可前瞻性地预测OEC对卵巢组织的损伤.