Combination of serum FOXR2 and transvaginal three-dimensional power Doppler ultrasonography in the diagnosis of uterine lesions.

BACKGROUND: Cervical carcinoma and endometrial carcinoma are the most common gynecologic cancers worldwide. Forkhead-box R2 (FOXR2) plays an important role in the progression of various malignant tumors. However, the effects of FOXR2 on the development of uterine lesions remain unclear. OBJECTIVES: This prospective observational study aimed to investigate the diagnostic performance of FOXR2 and transvaginal three-dimensional power Doppler ultrasonography (3D-PDU) for malignant uterine lesions. MATERIAL AND METHODS: This study included 404 uterine lesion patients and 200 healthy individuals who visited the hospital for a physical examination from April 2014 to May 2016. All patients received FOXR2 detection and 3D-PDU examination at admission. The demographic data and clinical data, including age, body mass index (BMI), and the International Federation of Gynecology and Obstetrics (FIGO) stage, were collected. All the patients were followed up for 5 years. The overall survival (OS) was analyzed using Kaplan-Meier (K-M) curve analysis. The diagnostic value of FOXR2 and 3D-PDU was evaluated using receiver operating characteristic (ROC) curves. RESULTS: Serum levels of FOXR2 mRNA were upregulated in patients with malignant uterine lesions. Patients with high expression of FOXR2 showed a higher expression of the cancer biomarkers CA125, CA199, CEA, and SCCA. It was also found that FOXR2 expression was associated with the clinical outcomes of patients with malignant uterine lesions. Moreover, higher expression of FOXR2 predicted a poor prognosis. The combined use of FOXR2 and 3D-PDU showed favorable potential for the diagnosis of malignant uterine lesions, especially for cervical carcinoma and endometrial carcinoma. CONCLUSIONS: The combination of serum FOXR2 and transvaginal 3D-PDU has a potential in the diagnosis of uterine lesions.

Three-dimensional power Doppler ultrasound in the early assessment of response to concurrent chemo-radiotherapy for advanced cervical cancer.

Background Three-dimensional power Doppler ultrasound (3D-PDU) imaging has been widely applied to the differentiation of benign and malignant cervical lesions; however, its potential value for predicting response to chemo-radiotherapy has not been fully explored. Purpose To investigate the feasibility of 3D-PDU imaging in predicting treatment response in patients receiving concurrent chemo-radiotherapy (CCRT) for advanced cervical cancer. Material and Methods Fifty-two patients with advanced cervical cancer who received CCRT underwent 3D-PDU examinations at four timepoints: pre-therapy (baseline), 1 week and 2 weeks during, as well as immediately post CCRT. Final tumor response was determined by change in tumor size using magnetic resonance imaging (MRI). Cervical tumor volumes and vascular indices were calculated and compared with the clinical outcome. Results Of the 52 patients, 32 patients who completed all four examinations were included in the analyses: 21 were classified as complete response (CR) and 11 as partial response (PR). During the treatment, the CR group showed that 3D vascular indices (VI and VFI) significantly increased at 1 week ( P = 0.028, P = 0.017, respectively) then decreased at 2 weeks and obviously decreased at therapy completion (both P < 0.001), whereas tumors significantly decreased in volume at 2 weeks after therapy initiation ( P < 0.05). However, no significant differences in 3D vascular indices values were seen in the PR group during the treatment course (all P > 0.05). Conclusion Prospective longitudinal 3D-PDU imaging may have potentials in monitoring early therapeutic response to CCRT in patients with cervical cancer.

Value of three dimensional color power Doppler ultrasound in diagnosis of placenta accrete / 医疗卫生装备

Objective To explore the diagnostic value of three-dimensional color Doppler ultrasonography (3D-PDU) three-dimensional reconstruction technique for placenta accrete. Methods Totally 65 cases of suspected patients with placenta implantation underwent 3D-PDU examination, then the examination results were compared with those by clinical or pathological method, and the results by clinical or pathological method were used as the gold standard. Results There were no significant differences between the results by 3D-PDU and the gold standard (P=0.754), and there was consistency between the two methods (Kappa=0.661,P<0.001). Conclusion 3D-PDU combined with 3D reconstruction technique contributes to displaying lesion structure, blood perfusion and etc and provides quantitative indexes to determine the depth and size of the accreted placenta, and thus is of great significance for the early diagnosis and treatment planning of the placenta accrete.