Contrast-Enhanced Ultrasound Experimentand Clinical Application Research Of Cervical Cancer

Objective:By studying the correlation between TIC parameters of CEUS at different growth times of cervical cancer heterotopic transplantationtumors,the application value of TIC parameters of CEUS in cervical cancer diagnosis and treatment was explored.Methods: Twenty-one nude mice were selected to establish cervical cancer heterotopic tumor models.They were divided into three groups on average,and CEUS was performedon the 7th,14 th,and 21 st days after transplantation to obtain the CEUS ultrasonogram performance,TIC curve characteristics and TIC parameters of the tumor(including AT,PI,TTP,HT,Grad,AUC).The transplanted tumor tissue of nude mice was dissected and processed by immunohistochemistry Envision method,and the MVD was measured by CD34 staining,and the positive expression percentage of VEGF and ki-67 were also determined.The differences between TIC parameters,MVD counts,the positive expression percentage of VEGF and ki-67 of CEUS at transplanted tumors of nude mice at different time points was compared;Pearson test was used to analyze the correlation between TIC parameters and MVD,VEGF and the positiveexpressionpercentage ofki-67 of CEUS.Results: On the 7th and 14 th day after transplantation,the distribution of ultrasound contrast agent in the transplanted tumor of nude mice was mostly uniformly enhanced,while on the21 st day,mostof them were non-uniformly enhanced;the directionality of CEUS enhancement at different growth time points is mainly centripetal enhancement;The boundary of CEUS is gradually unclear with the extension of tumor growth time;contrast perfusion defects gradually increase with the extension of tumor growth time;The enhancement intensity of CEUS at different growth time points was mainly high enhancement.Most of the TIC curves of CEUS at the transplanted tumors of nude mice at different growth time points are mainly "fast in and fast out".The 7th day group had the highest MVD count,VEGF and the positive expression percentage of ki-67(P<0.05),while the 21 st dayhad the lowest MVD count,VEGF and the positive expression percentage of ki-67.The PI of the 7th day group 14 th day groupand 21 st day group was gradually decreased(P<0.05).AT,TTP and HT increased gradually with the extension of tumor growth time(P<0.05).MVD count,VEGF and the positive expression percentage of ki-67 were positively correlated with PI(P<0.05);MVD and Grad were also positively correlated(P<0.05);MVD count,VEGF and the positive expression percentage of ki-67 were negatively correlated with AT,TTP and HT(P<0.05).Conclusions: The TIC parameters of CEUS were correlated with the tumor microangiogenesis characteristics and cancer cell proliferation at different growth times of heterotopic transplant tumors in cervical cancer.The TIC parameters of CEUS could reflect the microangiogenesis of the tumor and the proliferation of cancer cells.The results could be applied to the study of blood perfusion of heterotopic transplantation tumors in cervical cancer.The TIC parameters of CEUS indifferent growth time of cervicalcancer heterotopic tumor have certain correlation with tumor microangiogenesis characteristics and can cer cellpro lif er ation.TIC p ar amet ers o f CEUS canr efl ecttu mor microangiogenesis and cancercell proliferation,and have application valueinthe study of blood flow perfusion of cervical cancer heterotopic tumors.Objective:To explore the application value of colposcopy,TVCEUS and MRI in the diagnosis and staging of cervical cancer.Methods:100 patients with suspected cervical cancer were selected for colposcopy,TVCEUS and MRI examination.Compare the the CEUS ultrasonogramperformance,TIC curve morphological characteristics and TIC blood flow parameters of different types of cervical lesions;The receiver operating characteristic curve analysis software was used to evaluate the authenticity and reliability of TIC parameters as a cervical cancer screening test.Compare the detection rate of benign or malignant cervical lesions by TVCEUS and colposcopy examination.For the cases whose pathological results have been diagnosed as cervical cancer,compare the diagnostic results of tumor diameter ? 2cm,vaginal invasion,parauterine involvement,lymph node metastasis by TVCEUS,MRI,and TVCEUS combined with MRI inspection.Compare the detection rates of cervical cancer with different clinical stages by TVCEUSand MRI examination.Results:100 patients with suspected cervical cancer were diagnosed by histopathological biopsy or postoperative pathological results,of which 14 cases were diagnosed with cervicitis,12 cases were CIN I-II,8 cases were CIN III,62 cases were cervical cancer,and 1 case was submucosal fibroids.3 cases was endometrial cancer.The difference of TVCEUS perfusion characteristics between any two groups of the cervicitis group,the CIN I-II group,and the CINIII group was not statistically significant(P>0.05).Compared with the cervical cancer group respectively,the difference of TVCEUS perfusion characteristics of the cervicitis group,the CIN I-II group,and the CINIII group was statistically significant(P<0.05).TVCEUS perfusion characteristics of Cervicitis group,CIN I-II group,CINIIIgroup mainly showed uniformity,eccentricity,clear boundary,medium-low enhancement,no perfusion defects;TVCEUS perfusion characteristics of cervical cancer group mainly showedunevenness,centrality,unclearborders,highenhancement,andperfusion defects in some cases.The difference of TIC curve of contrast-enhanced ultrasound characteristics between any two groups of the cervicitis group,the CIN I-II group,and the CINIII group was not statistically significant(P>0.05).Compared with the cervical cancer group respectively,the difference of TIC curve of contrast-enhanced ultrasound characteristics of the cervicitis group,the CIN I-II group,and the CINIII group was statistically significant(P<0.05).The TIC curvecharacteristicsof contrast-enhanced ultrasound ofcericitis group,CIN I-II group,CINIII group are mainly "slow in and slow out",while cervical cancer is mainly "fast in and fast out".There was no statistically significant difference in TIC curve parameters of cervicitis group and CINI-II group(P>0.05).Compared with cervicitis group and CIN I-II group,AT,TTP,and HT were shorter in CIN III group and PI was higher(P<0.05).Compared with the cervicitis group,CINI-II group,and CIN III group,the AT,PT,and HT in the cervical cancer group were shorter,and the PI increased more significantly(P<0.01).Among the contrast –enhanced ultrasound parameters,the most valuable parameter for diagnosing cervical cancer is TTP,whose critical value is 30.5,sensitivity is 85.4%,specificity is 88.3%,and Youden index is 73.7%.In the detection rate of benign or malignant cervical lesions,the difference between TVCEUS and colposcopy was statistically significant(P<0.05).In terms of tumor diameter ?2cm,there was no statistically significant difference between TVCEUS and MRI examinations(P>0.05);in terms of parauterine involvement,the Youden index of TVCEUS was higher than MRI,and the difference was statistically significant(P<0.05);in terms of vaginal invasion,the Youden index of MRI is higher than that of TVCEUS,andthe difference is statistically significant(P<0.05);in terms of lymph node metastasis,there is no statistical difference between TVCEUS and MRI examination(P>0.05);the sensitivity and Youden index of TVCEUS combined with MRI examination for tumor diameter?2cm,parauterine involvement,vaginal invasion,lymph node metastasis are higher than single TVCEUS examination or MRI examination.In terms of detection rate of stage IA cervical cancer,TVCEUS is superior to MRI examination,the difference is statistically significant(P<0.05).In terms of detection rates of stage IB,IIA,and IIB cervical cancer,there was no statistically significant difference between TVCEUS and MRI(P>0.05).In terms of detection rates of stage III and stage IV cervical cancer,MRI is superior to TVCEUS,and the difference is statistically significant(P<0.05).Conclusion:TVCEUS,colposcopy,and MRI have their own advantages.The combined examination of them can better reflect the characteristics of cervical cancer,improve the diagnosis rate,and make the clinical stage clearer.Objective:To explore the application of TVCEUS in evaluating the efficacy of neoadjuvant chemotherapy for cervical cancer.Methods:Fifty patients with cervical cancer who received neoadjuvant chemotherapy were selected.TVCEUS examination was performed before and after chemotherapy to observe changes in tumor size and shape,blood perfusion characteristics and contrast parameters including AT,PI,TTP,and HT.Compare TVCEUS characteristics and TIC parameters before and after chemotherapy;compare the TIC parameters of the effective group and the ineffective group after chemotherapy.Results: 36 cases were effective in chemotherapy.There was no statistically significant difference in age,bodymassindex,tumor aximumdiameter(Dmax),FIGOstage,pathologicalclassification,andpathologica l grade between the chemotherapy-effective group and the ineffective group(P>0.05).The difference of TVCEUS enhancement intensity and perfusiondefect Increase in cervical cancer patients before and after chemotherapy was Statistically significant(P<0.05).There was no statistically significant difference In the uniformity,directionandboundary of TVCEUS perfusion in cervical cancer patientsbeforeandafterchemotherapy(P>0.05).Compared with before chemotherapy,cervical cancer patients had lower PI after chemotherapy,while AT and TTP were prolonged(P<0.05).The change of HT before and after chemotherapy was not obvious and had no statistical significance(P>0.05).Compared with the ineffective group,the PI in the effective group was lower after chemotherapy,while the AT and TTP were longer,and the difference was statistically significant(P<0.05).There was no significant difference in HT between the effective group and the ineffective group,and no statistical significance(P>0.05).Conclusion:TIC parameters of TVCEUS can evaluate the efficacy of neoadjuvant chemotherapy for cervical cancer and can be used as a monitoring method for cervical cancer chemotherapy.Objective:To explore the relationship between TVCEUS characteristics of cervical cancer and prognostic factors.Methods:60 patients with cervical cancer confirmed by pathology were selected for TVCEUS to obtain ultrasound contrast perfusion characteristics and TIC parameters,including AT,PI,TTP and HT.Immunohistochemical Envision method was used to obtain the expression of VEGF and ki-67.Analyze the relationship between contrast-enhanced ultrasound perfusion characteristics and lymph node metastasis,pathological grade,tumor size,VEGF,ki-67.To compare TIC parameters of lymph node metastasis(yes or not),pathological grade(low or high differentiation),tumor size(diameter <2.0 cm or diameter ? 2.0 cm),VEGF(positive or negative expression),ki-67(positive or negative expression).Results:Tumors with a diameter of ?2.0 cm,a low degree of differentiation,and a positive expression of VEGF showed that its non-uniformity is enhanced and the probability of blood perfusion defect is significantly increased(P<0.05),the positive expression of ki-67,the degree of enhancement and the probability of enhancementmethod were significantly increased(P<0.05);There is no obvious relationship between whether there is lymph node metastasis,high degree of differentiation,tumor diameter <2.0cm,positive expression of VEGF,negative expression of ki-67 and enhancement degree,enhancement boundary clear or notand enhancement method(P>0.05).Cervical cancer,with lymph node metastasis and tumor diameter ?2.0cm,whose pathological grade was low differentiation,had higher PI,but AT,TTP,and HT shortened,the difference was statistically significant(P<0.05);compared with those with negative VEGF expression,HT with positive VEGF expression was significantly shortened,and the difference was statistically significant(P<0.05).Compared with those with negative ki-67 expression,those with positive ki-67 expression had significantly higher PI and shorter TTP and the difference was statistically significant(P<0.05).Conclusion:TVCEUS characteristics and TIC parameters of cervical cancer have a certain relationship with prognostic factors,and the prognosis of cervical cancer can be assessed non-invasively from both qualitative and quantitative aspects.