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J Obstet Gynaecol Res. 2014 Feb;40(2):554-60. doi: 10.1111/jog.12196. Epub 2013 Oct 11.
2
Cervical conization and the risk of preterm delivery.宫颈锥切术与早产风险。
Am J Obstet Gynecol. 2011 Jul;205(1):19-27. doi: 10.1016/j.ajog.2011.01.003. Epub 2011 Feb 23.
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Perinatal mortality and other severe adverse pregnancy outcomes associated with treatment of cervical intraepithelial neoplasia: meta-analysis.围产期死亡率及与宫颈上皮内瘤变治疗相关的其他严重不良妊娠结局:荟萃分析
BMJ. 2008 Sep 18;337:a1284. doi: 10.1136/bmj.a1284.
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Natural history of cervical neoplasia and risk of invasive cancer in women with cervical intraepithelial neoplasia 3: a retrospective cohort study.宫颈上皮内瘤变3级女性的宫颈肿瘤自然史及浸润癌风险:一项回顾性队列研究
Lancet Oncol. 2008 May;9(5):425-34. doi: 10.1016/S1470-2045(08)70103-7. Epub 2008 Apr 11.
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Long term risk of invasive cancer after treatment for cervical intraepithelial neoplasia grade 3: population based cohort study.宫颈上皮内瘤变3级治疗后发生浸润性癌症的长期风险:基于人群的队列研究
BMJ. 2007 Nov 24;335(7629):1077. doi: 10.1136/bmj.39363.471806.BE. Epub 2007 Oct 24.
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Incomplete excision of cervical intraepithelial neoplasia and risk of treatment failure: a meta-analysis.宫颈上皮内瘤变不完全切除与治疗失败风险:一项荟萃分析
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Long-term follow-up after large-loop excision of the transformation zone: evaluation of 22 years treatment of high-grade cervical intraepithelial neoplasia.转化区大环形切除术的长期随访:对高级别宫颈上皮内瘤变22年治疗情况的评估
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Long-term risk of invasive cervical cancer after treatment of squamous cervical intraepithelial neoplasia.宫颈鳞状上皮内瘤变治疗后发生浸润性宫颈癌的长期风险。
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Diagnostic and therapeutic laser conization for cervical intraepithelial neoplasia.宫颈上皮内瘤变的诊断性和治疗性激光锥切术
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使用交变磁场产生热量的热疗设备治疗宫颈上皮内瘤变的安全性和有效性的临床研究。

Clinical investigation of the safety and efficacy of a cervical intraepithelial neoplasia treatment using a hyperthermia device that uses heat induced by alternating magnetic fields.

作者信息

Koizumi Koji, Fujioka Toru, Yasuoka Toshiaki, Inoue Aya, Uchikura Yuka, Tanaka Hiroki, Takagi Katsuko, Mori Miki, Koizumi Masae, Hashimoto Hisashi, Matsumoto Takashi, Matsubara Yuko, Matsubara Keiichi, Nawa Akihiro

机构信息

Bara-no-izumi Women's Clinic, Matsuyama, Ehime 790-0941, Japan.

Department of Obstetrics and Gynecology, Ehime University, Graduate School of Medicine, Toon, Ehime 791-0295, Japan.

出版信息

Mol Clin Oncol. 2016 Aug;5(2):310-316. doi: 10.3892/mco.2016.929. Epub 2016 Jun 13.

DOI:10.3892/mco.2016.929
PMID:27446569
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4950731/
Abstract

Multiple techniques have been used for the conservative treatment of high-grade cervical intraepithelial neoplasia (HG-CIN) in women of fertile age. Conization has been associated with stenosis of the cervix and a decrease in cervical mucus secretion, in addition to the increase in the risk of cervical canal shortening and problems during the perinatal period, including premature birth and premature rupture of membranes. Although the laser transpiration technique does not cause shortening of the cervical canal, it is associated with the recurrent risk of deep residual disease. The present study aimed to investigate the therapeutic safety and efficacy of the therapy performed using the transaction magnetic field induction heating device, AMTC400, in fertile patients with HG-CIN (excluding carcinoma ). Four premenopausal patients with CIN3 and high-risk human papilloma virus (HPV)-positive were treated using an AMTC400. Chronological colposcopic findings, high-risk HPV, final histological findings with conization and follow-up data were evaluated. All the treatments were successfully performed on the in-patients without anesthesia. Intra- and postoperative complications included minor pain and bleeding in all cases. Two of the cases (50%) were high-risk HPV-negative following the treatments. All cases exhibited a change in the observed color (to white), and subsequent epithelization following treatment. Although cytological analysis at 5 weeks following the treatment confirmed the cases were negative for intraepithelial lesions and malignancies, a definitive histology with conization 6 weeks following the treatment confirmed CIN1 and koilocytosis in all cases. The assessment of treatment effectiveness was determined as a moderate improvement in all cases. In conclusion, thermotherapy applied using AMTC400 represented a safe and effective treatment for HG-CIN in women of fertile age. However, additional improvements associated with the site of puncture needles are required. Further studies are required to confirm the long-term efficacy and reproductive outcomes.

摘要

多种技术已被用于育龄期女性高级别宫颈上皮内瘤变(HG-CIN)的保守治疗。除了增加宫颈管缩短的风险以及围产期问题(包括早产和胎膜早破)外,锥切术还与宫颈狭窄和宫颈黏液分泌减少有关。尽管激光汽化技术不会导致宫颈管缩短,但它与深部残留疾病的复发风险有关。本研究旨在探讨使用交变磁场感应加热装置AMTC400对患有HG-CIN(不包括癌)的育龄患者进行治疗的安全性和有效性。4例绝经前CIN3且高危人乳头瘤病毒(HPV)阳性的患者接受了AMTC400治疗。评估了按时间顺序排列的阴道镜检查结果、高危HPV、锥切术后的最终组织学结果以及随访数据。所有治疗均在住院患者未麻醉的情况下成功进行。术中及术后并发症包括所有病例均有轻微疼痛和出血。治疗后2例(50%)病例高危HPV呈阴性。所有病例治疗后观察到颜色改变(变为白色),随后上皮化。尽管治疗后5周的细胞学分析证实病例上皮内病变和恶性肿瘤均为阴性,但治疗后6周的锥切最终组织学检查证实所有病例均为CIN1和挖空细胞。所有病例治疗效果评估为中度改善。总之,使用AMTC400进行的热疗对育龄期女性HG-CIN是一种安全有效的治疗方法。然而,穿刺针部位还需要进一步改进。需要进一步研究来证实长期疗效和生殖结局。