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目的采用在体子宫动脉血管网数字化三维重建方法,探讨早期宫颈癌灶血供均衡性与术后病理学指标之间的相关性。方法收集术前行盆腔CTA扫描的FIGO分期Ⅰb1期、Ⅱa1期宫颈癌手术患者87例。将CTA数据集导入Mimics软件行子宫动脉血管网数字化三维重建,并立体分割计算双侧宫颈癌灶血管网体积。根据宫颈癌灶血供一侧占双侧的比例分为均衡型(40%~60%)和非均衡型(<40%或>60%)2种血供类型。分析2种血供类型与术后病理学指标包括病理学类型、肿瘤最大径、组织分化程度、宫颈浸润深度、脉管间隙浸润、宫旁浸润、宫体浸润、阴道浸润、盆腔淋巴结转移的相关性。结果 87例患者中宫颈癌灶血供均衡型29例,非均衡型58例。有阴道浸润的血供均衡型比例更高(P=0.003)。其他病理学指标与血供均衡性无相关性(P>0.05)。结论早期宫颈癌灶以血供非均衡型为主,呈偏向性生长;阴道浸润可增强对侧子宫动脉对宫颈癌灶供血。
OBJECTIVE: To study the correlation between the blood supply balance and the postoperative pathological parameters of early cervical foci by using 3D reconstruction method of in-vivo uterine artery network. Methods Preoperative pelvic CTA scan of FIGO stage Ⅰ b1, Ⅱ a1 87 cases of cervical cancer surgery. The CTA dataset was imported into the Mimics software to perform the digital three-dimensional reconstruction of the uterine artery network and the three-dimensional segmentation was used to calculate the volume of the bilateral cervix. Cervical cancer based on the proportion of bilateral blood supply side is divided into balanced type (40% ~ 60%) and unbalanced (<40% or> 60%) two types of blood supply. The relationship between the two types of blood supply and postoperative pathology including pathological type, maximal diameter of tumor, degree of tissue differentiation, depth of cervical invasion, vascular interstitial infiltration, parametrial invasion, uterine invasion, vaginal invasion and pelvic lymph node metastasis were analyzed Sex. Results Among 87 patients, 29 cases of cervical foci had balanced blood supply and 58 cases of unbalanced type. The proportion of patients with vaginal infiltrates was higher (P = 0.003). There was no correlation between other pathological indexes and blood supply (P> 0.05). Conclusions The early cervical foci are predominantly unbalanced with blood supply and tend to grow in opposite directions. Vaginal infiltration can enhance the supply of blood to cervical foci in the contralateral uterine artery.