[Color Doppler blood flow measurements and microvessel density assessment in ovarian tumors]

Abstract

Objective: The aim of our study was to compare ultrasound vascular blood flow indices with the expression of CD-34 in women with benign and malignant adnexal tumors.

Materials and methods: Transvaginal color and pulsed Doppler sonography was performed before surgical procedure in 105 women with adnexal tumors. Blood flow indices: pulsatility index (PI) and resistive index (RI) in blood vessels with the highest flow velocity were measured within each tumor. Immunohistochemical analysis of microvessel density (MVD) was performed on representative highly vascular tumor specimens fixed in 10% formalin and paraffin embedded. The primary monoclonal mouse anti-human CD-34 antibody (1:25, DAKO, Denmark) was used. Statistical calculations included group comparison with Kruskal-Wallis ANOVA on ranks and correlation analysis (Statistica for Windows 6.0, Statsoft Poland).

Results: Mean age of the studied women was 55.6 +/- 11.5 yrs. Of 104 tumors, 35 (33.6%) were benign and 69 (66.4%) were malignant. The latter included 14 FIGO stage I cases. Low resistance or pulsatility indices (RI < 0.5 or PI < 0.8) were found in 58 of 69 (84%) malignant masses and in 21 of 35 (60%) benign tumors. Substantial overlap in measured indices was found between both studied groups. Median number of microvessels per high power field in the benign and malignant tumors were 37 (range: 14-156) and 68 (range: 25-177), respectively. These differences were statistically significant (p = 0.007, Mann-Whitney U test). Also, a significant correlation was found between MVD and low resistance to blood flow as measured by the PI or RI (r = 0.43, p < 0.05). However, no statistically significant differences in MVD were found between FIGO stage I and other stages of ovarian cancer.

Conclusion: Low resistance to blood flow as measured by the resistive or pulsatlity indices used in color Doppler sonography may by positively correlated with the microvessel density in the malignant ovarian tumors.