title: Prognostic significance of ultrasound derived intratumoral peak systolic velocity in epithelial ovarian cancer.
abstract: OBJECTIVE
  To evaluate the prognostic significance of ultrasound derived intratumoral peak systolic velocity in epithelial ovarian cancer.
  
  
  METHODS
  Color Doppler imaging and pulsed Doppler spectral analysis were used in the investigation of 49 patients with epithelial ovarian cancer (19 serous, 15 mucinous, eight endometrioid, four clear cell and three Brenner cell) immediately before laparotomy. Twenty-two were stage I, six were stage II, 17 were stage III and four were stage IV. Sections of malignant tumors were analyzed for the cellular expression of thymidine phosphorylase and the intratumoral density of microvessels by immunohistochemistry using antibodies to thymidine phosphorylase and factor VIII-related antigen, respectively. Moreover, the apoptotic index was evaluated by the terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end-labeling method. Intratumoral peak systolic velocity was tested for correlation with patients' age at diagnosis, stage of disease, presence of a residual tumor, histological subtype and grade, thymidine phosphorylase expression, apoptotic index, microvessel count and patient survival.
  
  
  RESULTS
  Histological grade (P = 0.025), thymidine phosphorylase expression (P = 0.044), apoptotic index (P = 0.039) and microvessel count (P = 0.014) were all significantly associated with peak systolic velocity. Stage of disease (P = 0.002), presence of residual disease (P = 0.0002) and peak systolic velocity (P = 0.041) were found by univariate Cox regression analysis to be significantly associated with a poor prognosis. Multivariate Cox regression analysis revealed that stage of disease (P = 0.006) and peak systolic velocity (P = 0.008) are independent prognostic factors.
  
  
  CONCLUSIONS
  Intratumoral peak systolic velocity could be a preoperatively pertinent prognostic predictor of survival in patients with epithelial ovarian cancer.
authors.affiliation: Department of Obstetrics and Gynecology, Shimane Medical University, Izumo, Japan. hata31@shimane-med.ac.jp
authors.forename: K
authors.initials: K
authors.lastname: Hata
authors.forename: M
authors.initials: M
authors.lastname: Yoshida
authors.forename: R
authors.initials: R
authors.lastname: Maruyama
authors.forename: R
authors.initials: R
authors.lastname: Fujiwaki
authors.forename: K
authors.initials: K
authors.lastname: Miyazaki
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017209:Apoptosis; D001783:Blood Flow Velocity; D005260:Female; D015870:Gene Expression; D006801:Humans; D020287:In Situ Nick-End Labeling; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000098:blood supply / Q000000981:diagnostic imaging* / Q000201:enzymology / Q000503:physiopathology*; D011379:Prognosis; D013939:Thymidine Phosphorylase / Q000378:metabolism; D018608:Ultrasonography, Doppler; D018615:Ultrasonography, Doppler, Color; D018617:Ultrasonography, Doppler, Pulsed
chemical_list: D013939:Thymidine Phosphorylase