Study On The Correlation Between Contrast-Enhanced Ultrasound And IL-17in Staging Diagnosis Of Early Endometrial Career

Objective:Explore contrast-enhanced ultrasound in the diagnosis of early stage endometrial carcinoma. Research in patients with endometrial cancer tissue expression of IL-17and the correlation between clinical pathological features; To guide the clinical early detection treated early.Methods:Ultrasonic imaging technology was applied to40examples intrauterine membrane carcinoma,10cases intrauterine membrane benign lesions contrast-enhanced ultrasound examination; Application of immunohistochemical staining (SP method) to detect40examples intrauterine membrane carcinoma, gastric carcinoma tissues,10cases benign intrauterine membrane group, IL-17in normal endometrial tissues and the expression of CD34, use SPSS13.0statistical software package for analysis.Results:1.82.50%(33/40) of the endometrial carcinoma cases showed contrast agent since the arcuate arteries go line first to cancer nourishes the blood vessels in place of the oven, finally diffuse distribution in cancer, obviously earlier than normal surrounding muscle layer (rapid filling type Ⅰ) as a whole.17.50%(7/40) of the endometrial carcinoma cases showed contrast agent directly into the oven inside Gao Zengjiang, slightly earlier than the surrounding normal muscle layer (around filling type Ⅱ type).82.50%(33/40) of endometrial benign cases were Ⅱ type filling pattern;72.50%(29/40) of the normal uterine endometrium Ⅱ type filling pattern.2. Stage Ⅰ endometrial cancer CEUS infusion enhanced mode:60.00%(9/15) cases showed thickening of the uterine endometrium is uneven high or medium enhancements, visible dotted, short rod-like blood flow signal, enlargement, circuitous blood vessels, and muscle layer boundaries clear, the affected muscle layer is non-uniform Gao Zengjiang, lining and the affected muscle layer enhancement and fade much earlier than normal endometrium and the surrounding muscle layer. 3. Stage Ⅱ endometrial cancer CEUS infusion enhanced mode:80.00%(4/5) cases according to the contrast agent into the first nourishing blood vessels, increased rapidly after endometrial lesions and cervical lesions, uneven endometrial lesions in high or medium, is bulky, circuitous, abnormal blood vessels, and muscle layer boundary is not clear, lining and the affected muscle layer, invaded cervical enhancements and fade much earlier than normal endometrium and muscle layer.4. Contrast-enhanced ultrasound TIC characteristics malignant group77.50%(31/40) cases shows an "speed up the downhill" type of curve, wave sharply; Benign group80.00%(8/10) cases of "speed up slow down" type, wave obtuse; Control group was90.00%(9/10) cases of "rise slowly slow down" type, wave gently.5. Compared with postoperative pathology results, the sensitivity, specificity, accuracy, positive predictive value and negative predictive value of CEUS assessment for tumors confined to stage la was94.12%(16/17)、82.61%(19/23)、87.50%(35/40)、80.00%(16/20)、95.00%(19/20), stageⅠb was82.35%(14/17)、95.65%(22/23),90.00%(36/40)、93.33%(14/15)、88.00%(22/25), stage Ⅱ was80.00%(4/5)、97.14%(34/35)、95.00%(38/40、80.00%(4/5)、97.14%(34/35), respectively. Preoperative ultrasound imaging assessment of endometrial carcinoma muscular invasion and cervical invaded the total accuracy of85.00%,P<0.005, with statistical significance.6. IL-17expression in endometrial carcinoma tissue mainly distributed in the cytoplasm. IL-17in carcinoma tissue, cancer tissues were expressed as positive, weak positive, is completely no expression in normal endometrial tissue.7. IL-17in endometrial carcinoma tissue expression level in the patient’s age, growth pattern, tumor size, degree of differentiation, clinical stage, no statistical differences between groups, and in the event of lymph node metastasis group was significantly higher than in lymph node negative group (P<0.05). High expression of IL-17groups of endometrial capillaries increased production, IL-17expression level was positively correlated with MVD. There is statistical significance.(P=0.025)8. IL-17in endometrial cancer tissue in patients with high expression and ultrasonic imaging "Gao ZengQiang" model and time intensity curve was a positive correlation "speed up the downhill" type, there is statistical significance.(P<0.05)Conclusions:1. Endometrial cancer of CEUS filling pattern found in rapid filling type (type I) as a whole.2. CEUS infusion in early endometrial carcinoma enhanced mode characterized by uneven high or medium enhancement, more visible bulky, circuitous, abnormal blood vessels, much earlier than normal endometrium cancer enhancement foci and recession and muscle layer. Help the uterus the differential diagnosis of benign and malignant lesions.3. Endometrial cancer contrast-enhanced ultrasound TIC characteristics formed a "speed up the downhill" type, wave sharply. Value in the diagnosis of endometrial carcinoma.4. CEUS in stage I and stage II endometrial cancer muscularis and cervical infiltration condition and has a higher clinical value in preoperative staging. Help to formulate reasonable operation scheme.5. IL-17high expression is associated with microvascular generation, IL-17expression in carcinoma lymph node metastasis in patients with significantly higher, IL-17May participate in the occurrence of endometrial carcinoma,17high expression and contrast-enhanced ultrasound combined with IL-Gao Zengjiang mode and speed up the downhill "type curve of early stage endometrial carcinoma diagnosed with higher value.