title: Preoperative assessment of vascularity by color Doppler ultrasonography in human rectal carcinoma.
abstract: OBJECTIVE
  Although angiogenesis assessed by immunostaining endothelial cells (microvessel density) is a well-known prognostic factor in a wide variety of human solid tumors, preoperative determination of microvessel density seems to be difficult in rectal carcinoma. Thus, we performed transanal color Doppler ultrasonography in 46 patients with rectal carcinoma to assess preoperative angiogenic status and compare it with microvessel density in surgical specimens.
  
  
  METHODS
  Time-averaged maximal velocity, peak systolic velocity, number of vascular points, and vascular point index were conducted by color Doppler ultrasonography in 46 patients with rectal carcinoma. Number of vascular points was defined as the number of vessels with pulsation in the section of tumor. Vascular point index was defined as the average number of vascular points divided by the area assessed by color Doppler ultrasonography in the section of tumor. The profiles of number of vascular points were similar to those assessed by microangiography in five rectal carcinomas.
  
  
  RESULTS
  Vascular point index significantly correlated with microvessel density (P < 0.0001). No significant correlation was found between microvessel density and time-averaged maximal velocity or peak systolic velocity. Vascular point index was also a better indicator of lymph node metastasis and venous invasion than microvessel density. In addition, 11 of 46 cases with postoperative hematogenous metastasis (23.9 percent) were observed prospectively. Vascular point index may be a best predictor for hematogenous metastasis from rectal carcinoma compared with peak systolic velocity, time-averaged maximal velocity, and microvessel density by receiver operating characteristic analysis.
  
  
  CONCLUSIONS
  These results suggest that preoperative quantification of angiogenesis using color Doppler ultrasonography will provide quick and useful information in the management of rectal carcinoma.
authors.affiliation: Ogura Memorial Hospital, Kagoshima, Japan.
authors.forename: O
authors.initials: O
authors.lastname: Ogura
authors.forename: Y
authors.initials: Y
authors.lastname: Takebayashi
authors.forename: T
authors.initials: T
authors.lastname: Sameshima
authors.forename: S
authors.initials: S
authors.lastname: Maeda
authors.forename: K
authors.initials: K
authors.lastname: Yamada
authors.forename: K
authors.initials: K
authors.lastname: Hata
authors.forename: S
authors.initials: S
authors.lastname: Akiba
authors.forename: T
authors.initials: T
authors.lastname: Aikou
mesh_terms: D001783:Blood Flow Velocity; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008833:Microcirculation; D009362:Neoplasm Metastasis; D009389:Neovascularization, Pathologic / Q000000981:diagnostic imaging* / Q000473:pathology; D012004:Rectal Neoplasms / Q000098:blood supply* / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology; D018615:Ultrasonography, Doppler, Color; D014841:von Willebrand Factor / Q000378:metabolism
chemical_list: D014841:von Willebrand Factor