| Objective: Study the value of three-dimensional sonography in the diagnosis of endometrial carcinoma, specially the value of three-dimensional measurement of endometrial volume and three-dimensional power Doppler.Methods: Subjects for this investigation were 97 patients who were evaluated by two-dimensional sonography and three-dimensional sonography preoperatively. They were postmenopausal or premenopausal women. We examined the size of uterus, endometrial thickness, morphology, echo and volume by two- and three-dimensional sonography and analyzed blood flow by transvaginal pulsed Doppler and two- and three-dimensional power Doppler sonography. The area under ROC of endometrial volume and endometrial thickness for the diagnosis of endometrial carcinoma was compared. The area under ROC of color pixel density by 2D-TVS and vascularity index by 3D-TVS were also compared. According to former literature, endometrial malignancy was diagnosed by combined indexes of 2D-TVS and 3D-TVS respectively. The sensitivity and specificity were compared.Results: The area under ROC of endometrial volume for the diagnosisof carcinoma was significantly different from that of endometrial thickness. The point which is corresponding with the biggest sum of sensitivity and specificity is regarded as optimal cut-off. Then we got the optimal cut-off of endometrial thickness and endometrial volume for diagnosis of endometrial carcinoma which was ≥5.0mm and ≥12.5ml respectively. The area under ROC of VI by 3D-TVS was significantly bigger than that of CPD by 2D-TVS. The optimal cut-off of VI and CPD was ≥0. 345 each volume and ≥9.5% respectively. With 2D-TVS examination of endometrial carcinoma, sensitivity and specificity reached 88.4% and 77.1%, respectively. While with 3D-TVS examination, sensitivity and specificity reached 96.0% and 87.7%, respectively.Conclusion: ①Endometrial volume measurement is superior to endometrial thickness in the diagnosis of endometrial carcinoma. ② VI by 3D-TVS is more useful in the diagnosis of endometrial carcinoma compared with CPD by 2D-TVS. ③ Combined indexes of 3D-TVS can contribute to a correct diagnosis of endometrial malignancy.Objective: The aim of this study was to correlate the quantitative index-VI of intratumoral blood flow as assessed by 3D power Doppler with tumor histopathologic characteristics, tumor stage, and the microcosmic indexes of blood flow MVD, VEGF.Methods: The study included 40 patients with endometrial carcinoma. Each patient was preoperatively evaluated with three-dimensional transvaginal power Doppler. The number of flow each volume (VI) was used for intratumoral blood flow analysis. All ultrasound data were verified by postoperative histopathological finding. Individual tumor characteristics evaluated were tumor growth pattern, tumor size, histological type, tumor grade, myometrial infiltration depth and lymph node metastasis. MVD and VEGF expression in endometrial carcinoma tissue were detected by SP immunohistochemical method.Results: Significantly higher VI was found in tumor with the following characteristics: grade three, infiltrating ≥50% of the myometrium, stage ≥Ⅱ, lymph node metastasis and endometrioid adenocarcinoma. MVD was also significantly different in tumor with the same characteristics. The result of MVD was consistent with VI. Significant correlation was found between Ⅵ and MVD(r=0.709). VEGF was significantly higher in tumor with infiltrating ≥50% of the myometrium and lymph node metastasis. VI was (0.52 ±0. 13) each volume in tumor with positive expression of VEGF, while (0.39 ± 0.08) each volume with negative expression of VEGF. They were different significantly (f=14. 380 P<0.01).Conclusions: The flow examined by 3D power Doppler can reflect the angiogenetic activity of endometrial carcinoma. VI has referenced value for the evaluation of tumor stage, myometrial infiltration and lymph node metastasis in endometrial carcinoma.Objective: To investigate the expression and clinical significance of an anti-apoptosis gene, survivin, in endometrial carcinoma, and to explore the correlation between angiogenesis and the expression of survivin, vascular endothelial growth factor and intratumoral blood flow assessed by VI.Methods: Subjects for this investigation were 97 patients who were evaluated by three-dimensional power Doppler sonography preoperatively. All ultrasound data were verified by postoperative histopathological finding. The protein expression of survivin and VEGF were examined by using immunohistochemical assay. The expression of survivin mRNA was investigated by RT-PCR. Making fresh tissue of endometrial carcinoma into single-cell suspension, we got proliferation indices (PI) of cells through flow cytometer (FCM). Analyzing the relationship between the expression of survivin and PI, VEGF, VI, respectively.Results: The expression of survivin protein and mRNA were significantly different from endometrial atrophy, hyperplasia and carcinoma. The positive expression rate of survivin protein was significantly higher in tumor with ≥Ⅱ stage, lymph node metastasis than that with I stage and without lymph node metastasis. Except that, there was distinct statistic significance of survivin mRNA expression among different tumor grades. The expression of survivin protein correlated significantly with that of VEGF (r=0.692). Ⅵ was (0.51±0.10) each volume in tumor with positive expression of survivin protein, while (0.41 ±0.12) each volume with negative expression of survivin protein. There was very distinct statistic significance (F=17.614 p<0.01) .Through bivariate correlate analysis, the expression of survivin mRNA was closely correlated with Ⅵ (r=0.695). The PI was significantly higher in the tumorwith positive expression of survivin than that with negative expression of survivin.Conclusions: Survivin can improve the proliferation of endometrial carcinoma cells and takes part in the occurrence of EC. Furthermore, Survivin is closely correlated with angiogenesis and metastasis.
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