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Ovarian interstitial blood flow changes assessed by transvaginal colour Doppler sonography: predicting ovarian endometrioid cyst-induced injury to ovarian interstitial vessels

  • General Gynecology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

To evaluate the blood flow changes and their relationships to microvessel density (MVD) and thrombospondin-1 (TSP-1) by transvaginal colour Doppler sonography (TV-CDS) in the ovarian interstitium to predict ovarian interstitial microvascular injury in the pathological process of ovarian endometrial cysts (OEC).

Methods

TV-CDS was preoperatively performed to detect blood flow changes in 60 patients with 76 ovarian endometrioid cysts, and flow classification and resistance indices (RI) values were recorded for analysis. Ovarian interstitial specimens with blood flow signals were collected for postoperative pathologic examination. TSP-1 protein was evaluated by immunohistochemistry and Western blot, TSP-1 mRNA by reverse transcriptase polymerase chain reaction, microvessels by CD34 antibody, and MVD by image analysis. Thirty age-matched patients with benign ovarian tumours served as controls.

Results

Blood flow, most of star-shaped, within ovarian interstitial arteries in the OEC group was diminished; however, arterial spectra exhibited a high-resistance flow manifesting a significantly higher RI compared with that of the control group (P < 0.01). In ovarian interstitial specimens, there were significantly (P < 0.01) lower CD34-MVD and higher TSP-1 protein and mRNA in the OEC group than in the controls. CD34-MVD and TSP-1 showed remarkably negative correlation (rs = −0.76, P < 0.01). RI values correlated negatively with MVD values (rs = −0.91, P < 0.01), but positively with TSP-1 (rs = 0.81, P < 0.01), while flow classification correlated positively with MVD values (rs = 0.66, P < 0.01), but negatively with TSP-1 (rs = −0.54, P < 0.01).

Conclusions

Changes in CD34-MVD and TSP-1 reflected ovarian interstitial microvascular injury of OEC, pathologically supported the findings of blood flow changes within ovarian interstitial arteries, and prospectively predicted OEC-induced ovarian interstitial vessel injury. This has important clinical value: early treatment, instead of allowing the cyst to become bigger, is of great importance for OEC patients, because a greater number of functional tissue blood vessels would be destroyed as the disease progresses.

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Abbreviations

EDTA:

Ethylene diamine tetraacetic acid

TGF-β1:

Transforming growth factor-β1

TSP-1:

Thrombospondin-1

MVD:

Microvessel density

OEC:

Ovarian endometrial cysts

RI:

Resistance indices

SDS:

Sodium dodecyl sulphate

TV-CDS:

Transvaginal colour Doppler sonography

PAGE:

Polyacrylamide gel electrophoresis

PBS:

Phosphoric acid buffer solution

PMSF:

Phenylmethyl sulphonylfluoride

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Conflict of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

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Authors and Affiliations

  1. Department of Obstetrics and Gynaecology, The Second Affiliated Hospital of Nantong University, Nantong, 226001, Jiangsu Province, China

    Jun-jun Qiu, Ying-lei Liu, Man-hua Liu, Li-ping Chen & Da-wei Xu

  2. Department of Ultrasound, The Second Affiliated Hospital of Nantong University, Nantong, 226001, Jiangsu Province, China

    Zhong-xin Zhang

  3. Department of Pathology, The Second Affiliated Hospital of Nantong University, Nantong, 226001, Jiangsu Province, China

    Qi-chang Yang & Hong-bing Liu

Authors
  1. Jun-jun Qiu
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  2. Ying-lei Liu
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Correspondence to Man-hua Liu.

Additional information

J. Qiu and Y. Liu are co-first authors and they equally contributed to this work.

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Qiu, Jj., Liu, Yl., Liu, Mh. et al. Ovarian interstitial blood flow changes assessed by transvaginal colour Doppler sonography: predicting ovarian endometrioid cyst-induced injury to ovarian interstitial vessels. Arch Gynecol Obstet 285, 427–433 (2012). https://doi.org/10.1007/s00404-011-1971-1

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  • DOI: https://doi.org/10.1007/s00404-011-1971-1

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