A digital study of blood supply balance in early stage cervical cancer lesions

ZHOU Jing; DUAN Hui; CHEN Chun-lin; LIU Ping; LI Peng-fei; ZHAO Chun-mei; WANG Xue-qin; LIAO Ke-dan; GONG Shi-peng

Abstract：Objective To investigate the correlation between the type of tumor blood supply balance and postop -erative pathological factors in early stage cervical cancer through in vivo three-dimensional reconstruction of the uterine artery network.Methods A total of 87 cases of FIGO stages Ⅰb1 andⅡa1 cervical cancer, with preoperative scan of computed tomography angiography ( CTA) , were enrolled in the study .The uterine artery network model of each case was reconstructed from the preoperative CTA data using the software Mimics .Space partitioning was performed before calcula-tion of the volume of tumor arterial network on either side of the lesion .A definition was made for the types of tumor blood supply balance:balanced type , in which the ratio of the volume of arteries of one side to that of both sides of the cervical cancer was between 40%and 60%;unbalanced , in which the ratio of the volume of arteries of one side to that of both sides was less than 40%or higher than 60%.The correlation between the type of blood supply and various postoperative pathological indices , including pathological type , maximal tumor diameter , degree of differentiation , depth of invasion in cervix, lymph-vascular space invasion , parametrial infiltration, endometrial invasion , vaginal invasion and pelvic lymph node metastasis were analyzed .Results Out of the 87 cases enrolled, 29 were of the balanced type and 58 were of the un-balanced type .Cases with vaginal invasion had higher proportion of balanced type ( P=0.003 ) .No statistically signifi-cant difference was found between the blood supply balance type and other pathological indices (P>0.05).Conclusions The majority of early stage cervical cancer cases are of the unbalanced type , which suggests that tumor growth deflects towards one side of the cervix .Vaginal invasion enhances blood supply to the cancer lesion from the contralateral uterine artery.