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Objective To investigate the correlation between the characteristics of the computed tomography (CT) perfusion parameters and the expression of D2-40 with lymphatic vessel density (LVD) in cervical carcinomas.Methods A total of 42 patients with cervical carcinoma was divided into two groups with and without lymph node metastasis.Patients were evaluated with CT perfusion scan before operation.Monoclonal antibody D2-40 was used for immunohistochemistry to detect the LVD in the carcinoma tissue specimen.CT perfusion parameters and LVD of two groups were compared,and their relationship was analyzed.Results CT perfusion parameters including blood flow (BF),peak enhancement image (PEI),and blood volume (BV) in the lymph node metastasis group were significantly higher than those in the no lymph node metastasis group (t =-2.206,-2.29,-2.336,P ＜ 0.05).The time to peak (TTP) was significantly lower in the lymph node metastasis group than the no node metastasis group (t =6.908,P ＜ 0.01).The LVD in the lymph node metastasis group was significantly higher than the no lymph node metastasis group (t =-5.092,P ＜ 0.01).The CT perfusion parameters (BF,PEI,BV) and LVD of cervical carcinomas had a significantly positive correlation (r =0.65,0.56,0.61,P ＜ 0.01).The TTP and LVD had a significantly negative correlation(r =-0.55,P ＜ 0.01).Conclusions CT perfusion imaging and higher LVD help to diagnose the lymph node metastasis of a cervical carcinoma,and have important guidance role in the surgical options for cervical cancers.
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Objective To study the diagnostic value of CT combined CA125 and HE4 in differentiating the ovarian cancer from the benign.Methods A case-control study included 52 ovarian cancer patients,47 patients with benign ovarian tumors,and 40 healthy control subjects.Preoperative serum levels of HE4 and CA125 were measured and CT was performed.Results The serum levels of CA125 and HE4 in the ovarian cancer groups [(264.37 ± 138.46) KU/L,(280.38 ± 135.14)pmol/L] were significantly high-er than that in the benign ovarian neoplasm group [(52.51 ±5.29) KU/L,(40.52 ± 10.34) pmol/L] and healthy control group [(10.69 ±6.15)KU/L,(37.24 ±9.84) pmol/L] (P ＜0.01).The serum levels of CA125 showed statistically significant difference between the benign ovarian neoplasm groups and healthy control groups (P ＜ 0.05).The serum levels of HE4 did not show statistically significant difference between the benign ovarian neoplasm groups and healthy control groups (P ＞ 0.05).The diagnostic sensitivity (65.4％,80.8％,75.0％),specificity (74.5％,85.1％,76.6％),and accuracy (69.7％,82.8％,75.8％) of each CA125,HE4,CT method for ovarian cancer did not show statistically significant difference (P ＞0.05).The diagnostic sensitivity (92.3％),specificity (93.6％) and accuracy (94.8％) of combination of CA125 and HE4 and CT were significantly higher and showed statistically significant difference compared with one method (x2 =7.461 18.711,P ＜ 0.01),but no significant difference compared with any two methods (P ＞ 0.05).Conclusions The serum levels of HE4 and CA125 in the ovarian cancer group were significantly higher,and CT in combination with those two serum indices improved the diagnostic sensitivity,specificity,and accuracy of ovarian cancer.
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OBJECTIVE@#To analyze the clinical pathologic characteristics of cervical intraepithelial neoplasia grade III (CINIII ) and to explore optimal surgery for CINIII patients.@*METHODS@#The clinical pathologic characteristics, surgical treatments, prognosis and history of 383 CINIII patients, who hospitalized from August 2005 to December 2010, were reviewed and analyzed. Among the patients, 213 (55.6%) received cold-knife conization surgery and 170 (44.4%) received ordinary electric knife conization surgery.@*RESULTS@#There was no significant statistic difference between cold-knife conization group and ordinary electric-knife conization group on the level of clearance of the pathologic tissues and the cervical cone diameter and cone high. Intraoperative blood loss was (13.1±5.2) mL and (25.5±17.2) mL. Bleeding of electric knife conization group, compared with that of the cold knife conization group, decreased by nearly 50%. The difference between the 2 groups was significant (P<0.01). Pathological examination after conization operation indicated that 350 out of the 383 patients didn't show pathological upgrade while 33 patients showed pathological development, among which 21 were diagnosed with invasive cervical cancer at Ia1 clincal stage, 7 atIa2 clincal stage and 5 atIb1 clincal stage. In 3 cases (14.3%) Ia1 cervical cancer patients, fertility requirements and negative margins with cervical conization were closely followed up, and one patient (4.8%) with positive margin and fertility requirements had re-conecut. The remaining 17 (80.9%) had resected the uterus outside the fascia (or plus attachments) . All the 12 patients with invasive cervical cancer at Ia2 orIb1 clinical stage received radical hysterectomy. No tumor recurrence was observed in the 383 patients.@*CONCLUSION@#Treatment optimazation of CINIII patients should be based on clinical pathological diagnosis and individual requirements. Both cervical conization surgery and total hysterectomy have been proved safe and practical for CINIII patients.