目的：探讨经阴道彩色多普勒超声病灶内微血管情况与早期宫颈癌预后的相关性。方法回顾性分析了46例早期宫颈浸润癌患者，利用Mann-Whitney检验和Pearson相关分析探讨早期宫颈癌病灶内血管生成情况与经手术治疗的早期宫颈癌临床病理参数的关系，为早期宫颈癌诊断与治疗提供新的判断依据。结果对比分析早期宫颈癌患者的病灶血流情况与宫颈癌预后因素的相关性可以发现宫颈癌病灶内血管数量与淋巴结转移、间质浸润深度≥10mm、脉管受累、病灶大小≥18．0mm及宫旁浸润等宫颈癌预后因素有关（ P ＜0．05）。中、高风险患者在术后需要接受放、化疗，其中大部分患者在术前的彩色多普勒超声提示病灶内血管丰富。另外，中、高风险组的术前彩色多普勒超声检查显示PI值（0．51±0．30）与低风险组（0．97±0．52）比较明显下降，且差异具有统计学意义（ t ＝11．25， P ＜0．05）。受试者工作特征（ROC）曲线提示搏动指数（PI）值在0．82作为最佳临界点。结合术前超声宫颈癌病灶血流情况及血流动力学参数PI与风险分组进行相关性分析发现术前超声宫颈癌病灶血流丰富或PI≤0．82者与中、高风险呈现相关性（ P ＜0．05）。结论经阴道彩色多普勒超声显示早期宫颈癌病灶的血管生成情况与宫颈癌患者预后存在相关性。术前经阴道彩色多普勒超声病灶内血管丰富及PI≤0．82与患者是否需要术后治疗有相关性。%Objective To investigate the relationship between focal microvascular situation and prognosis of early cervical cancer with transvaginal color Doppler ultrasound .Methods The study retrospectively analyzed the data of 46 patients with early invasive cervical cancer ,who accepted the diagnosis and treatment in our hospital from August 2010 to March 2013 .The relationship between the angiogenesis in early cervical cancer foci and clinical pathological parameters was ex-plored using Mann-Whitney test and Pearson analysis so as to provide new evidence for the diagnosis and treatment for the early cervical cancer .Results Through the comparative analysis of the relationship between the focal microvascular status and factors relevant to the prognosis of early cervical cancer ,it was found that the focal microvascular amount was closely correlated with these parameters in terms of lymph node metastasis ,depth of stromal invasion (>10 mm) ,vascular in-volvement asion ,tumor size (≥18 .0 mm) ,parametrial invasion ,pathological types ,ect .,which were all the key factors for the prognosis for cervical cancer ( P<0 .05) .In patients with moderate or high risk ,who needed to receive radiother-apy and/or pre-operative Doppler ultrasound examination revealed that the blood vessels in lesions were rich in majority of these patients .In addition ,the preoperative color Doppler ultrasonography showed that PI value was 0 .51 ± 0 .30 in high risk group and 0 .97 ± 0 .52 in low risk group and ,statistically ,the decrease in PI value was significantly different ( t =11 .25 ,P <0 .05) .Receiver operating characteristic (ROC) curve suggested the the pulsatility index (PI) value of 0 .82 was considered as the best critical point .The correlation analyses ,which were combined the blood flow situation and he-modynamic parameters of PI from the preoperative ultrasonography with grouping risk degree ,showed that the rich blood vessels or PI value ≤ 0 .82 was significantly associated with the moderate or high risk in patients with cervical carcinoma ( P<0 .05) .Conclusion Preoperative transvaginal color Doppler ultrasound can show the correlation between angiogene-sis and prognosis in patients with cervical cancer .The rich blood vessels in lesion and PI ≤0 .82 by preoperative transvagi-nal color Doppler ultrasound were correlated to whether patients need to accept postoperative treatment .
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