The study of angiogenesis in practical oncomorphology allowed getting information on the relapses, formation of metastasis, and course of the oncological disease depending on the degree of the development of vessels. For this purpose CD-31 prognostic factor, which does not depend on the other characteristic features of tumor, is determined in the histological preparation. Color dopplerographic imaging is considered to be a promising opportunity of ultrasonic examination in the differential diagnostics of the malignant and benign ovarian tumors. Dopplerography allows visualizing tumor blood vessels, including capillaries. High opportunities of the method allow visualizing and identifying even the tiniest blood vessels of the microcirculatory system, which cannot be detected when scanning in the regime B. Twisted, abnormally shaped vessels more characteristic for malignant tumors can be identified by dopplerography. The aim of the research was the determination of the correlation among quantitative indices (VI-vascular index, PI-pulsatility index, RI- resistive index, VFI-vascular flow indices) of dopplerometry with CD-31 in malignant ovarian tumors. ROC examination of quantitative indices of doplerometry was also performed in malignant ovarian tumors. Object and methods. Data of the examination of 123 patients diagnozed with malignant ovarian tumors and treated at the Oncological Clinic of the Azerbaijan Medical University during 2008-2015 years have been used in the presented research. The final diagnosis was verified at the laboratory of Patomorphology of Oncological Clinic of AMU. The researches were performed after cytological and histological verification, patients were systematized, the clinical picture of the disease was clarified, and the clinical phases of the process were determined after the summarization of the results of laboratory instrumental analyses of the patients. According to the research plan all the patients were subjected to ultrasound examination. The examination was carried out through transabdominal and transvaginal sensors at 3.5-5 MHz using the Ultrasound Scanner ALOKA SSD-4000. DAKO ((France) CD 31, Endothеlial Cell, clone JC 70A, isotype: Lg GI, kappa 0.2/1ml) reagents were used for histological examinations. Cryostat sections prepared from a material frozen in liquid nitrogen and fixed in acetone and paraffin blocks fixed in a 10% formalin solution were used for the immunohistochemical examination. The results were analyzed using modern statistic methods. Results and discussion. We have revealed that an increase in CD-31 concentration in epithelial ovarian tumors indicates the malignancy. Color doppler examination showed that, the systolic velocity of the blood circulation was higher in malignant tumors compared to the benign tumors and the resistance of the intratumor blood circulation was lower. Low peripheral vascular resistance in malignant tumors is associated with a sharp increase in the diameter of the arterial vessels. Malignant ovarian tumors are also synthesized by angiogenic factors, which cause the formation of new vessels and further progression of tumors. Histological structure and density of blood vessels are different in diseased and healthy ovary, and this influences on the type of tumor blood circulation. Using Spirmen’s correlation analysis we detected correlation relationship between doplerometric indices of intratumoral blood flow and CD-31. Thus, high expression of CD-31 corresponds to high values of FI. In this case correlation index r=0.463, and p<0.001. A strong correlation relationship was observed between VI and CD-31. Correlation coefficient ρ=0.658 (p<0.01).There is also a strong correlation relationship between VFI and CD-31. In this case ρ=0.463 (p<0.01). No relationship was found between PI index and CD 31: ρ=0.006 (p=0.938). ROC curves of dopplerometric indices in malignant epithelial ovarian tumors indicate that dopplerography is of great importance in diagnosis of this disease. Thus, we have established a positive correlation relationship between dopplerometric indices of blood flow and CD-31. It has been found that increases in dopplerometric indices occur in accordance with CD-31 depending on the degree of malignancy. Thus, high dopplerometric indices of blood flow determine the malignancy of the tumor mass. Because of the positive correlation between CD-31 and dopplerographic indices, it is possible to determine the characteristics of tumor vasculization using non-invasive method. Thus, the characteristics of tumor can be determined prior to surgery. This is particularly important for the correct selection of treatment tactics and surgery volume. Conclusion. Positive correlation between Doppler blood flow and CD-31. On the basis of Doppler examination of malignant ovarian tumors and Doppler blood parameters, the need for prescribing antiangiogenic drugs to patients can be clarified.
Doppler USD, CD-31, ovarian tumors, ROC.
«Bulletin of problems biology and medicine» Issue 4 Part 2 (154), 2019 year, 226-230 pages, index UDK 616-006.04-092, 618.11
