CLINICAL-SIGNIFICANCE OF INTRATUMORAL BLOOD-FLOW IN CERVICAL-CARCINOMA ASSESSED BY COLOR DOPPLER ULTRASOUND

Background. Much evidence has suggested that vascular density reflects the clinical behavior of cancer. In this study, the intratumoral bloo d flow in cervical carcinomas was assessed by transvaginal color Doppl er ultrasound, and its clinical significance was evaluated. Methods. S ixty-five patients with Stage Ib-IIb cervical carcinoma exhibiting vis ible cervical tumor by transvaginal ultrasound were enrolled. All pati ents were scheduled for radical hysterectomy and pelvic lymph node dis section. Transvaginal color Doppler ultrasound was performed before su rgery to search for blood flow signals from the tumor and the main ute rine artery. The corresponding arterial resistance index (RI) was calc ulated. Clinical and pathologic data were recorded. A cytokinetic stud y was performed by propidium iodide staining and flow cytometry. The h uman papillomavirus (HPV) status was assessed by polymerase chain reac tion. Results. Intratumoral blood flow was detected by color Doppler u ltrasound in 46.2% (30/65) of the tumors. Patients with detectable int ratumoral blood flow exhibited significantly more pelvic lymph node me tastasis (10/30 vs. 2/35, P = 0.005), a higher percentage of cancer ce lls in the S- + G(2)M-phase (30.02 +/- 18.54% vs. 19.35 +/- 11.21%, P < 0.005), and a higher prevalence of HPV infection (30/30 vs. 25/35, P = 0.001) when compared with those without intratumoral blood flow. No significant difference was observed concerning the patient's age, tum or size, clinical staging, histologic type, and DNA ploidy status betw een these two groups. Regression analysis of the intratumoral RI value on the S- + G,M-phase fraction showed linear regression (n = 30, r(2) = 0.501, P < 0.01). The RI values of the main uterine artery showed n o significant difference between these two groups. Conclusion. The int ratumoral blood flow by transvaginal color Doppler ultrasound correlat ed well with a higher proliferation index, higher incidence of HPV inf ection, and pelvic lymph node metastasis in cervical carcinoma.