ABSTRACT
On basis of ultrasonographic structural criteria and Doppler flowmetry in a group of 76 patients with ovarian cancer, benign lesions were discovered in 59 patients and malignant lesions in 17 patients (77.6% and 22.4%, respectively). Surgical intervention was indicated according to the clinical findings and following of the trend of organ-specific oncomarkers in 32 out of 76 patients (42.1%). The stratification involved 17 patients with sonomorphologically/Doppler-flowmetry - diagnosed malignancy as well as 15 patients with sonographically diagnosed benign ovarian tumor. The clinical findings were histologically verified in all 32 patients. Histology confirmed malignant tumor in 16 patients, 1 histologically borderline malignancy and 15 benign tumors. The Doppler-flowmetry showed 94.1% sensitivity, 93.3% specificity, 93.3% positive predictive value, and 93.75% accuracy.
Subject(s)
Laser-Doppler Flowmetry , Ovarian Neoplasms/diagnostic imaging , Biomarkers, Tumor/analysis , Cystadenoma/diagnostic imaging , Cystadenoma/pathology , Cystadenoma/surgery , Diagnosis, Differential , Female , Humans , Middle Aged , Neoplasms, Adnexal and Skin Appendage/diagnostic imaging , Neoplasms, Adnexal and Skin Appendage/pathology , Neoplasms, Adnexal and Skin Appendage/surgery , Ovarian Cysts/diagnostic imaging , Ovarian Neoplasms/pathology , Ovarian Neoplasms/surgery , Predictive Value of Tests , Reproducibility of Results , Sensitivity and Specificity , UltrasonographyABSTRACT
The sonopathomorphology of the menopausal endometrium was investigated by measuring the endometrium thickness using the Doppler flowmetry technique. The endometrium thickness extending five millimeters has been considered critical, indicating possible neoplastic disorders. Such clinical status has been discovered in 21 out of 58 post-menopausal patients inspected (36.2%). Furthermore, the Doppler blood-flow analysis, based on the evaluation of the resistance indices (RI) in the ascendent branches of uterine arteries bilaterally, and - in case of the vascularization analysis - in the edometrial and perimetrial regions, has been performed. These investigations brought evidence indicating full capacity of the method in detecting blood flow through the uterine arteries, while significant differences in the endometrial flow-through parameters were detected only in 14 (66.7%) patients. In all 21 patients with endometrium thickness extending 5 millimeters, bioptic examination followed by histology confirmed endometrial cancer in 9 patients, epidermoid cancer in 3 patients, and cystic hyperplasia in 3 patients, respectively. The remaining 6 patients showed either secretory or quiet endometrium (5 cases), or necrotic endometrial regions (1 case). In all 12 cases of malignant endometrial cancer and in 2 out of 3 cases of histologically verified benign hyperplasia, intra- and periendometrial vascularization has been confirmed. It is to note that the mean RI values measured in the intra- and periendometrial vessels in case of endometrial cancer were significantly lower than in patients with benign cystic hyperplasia of the endometrium. Our results brought evidence indicating that the estimation of differences in the RI values in patients with detectable intra- and periendometrial vascularization has a significant relevance in the distinction of endometrial cancer from nonmalignant endometrial lesions, predominantly the benign atypical hyperplasia. The reliability of the test was 100%, however - in case of malignant disorders - a significant decrease in the RI values has been seen in the intratumoral vs. peritumoral vascularization.
