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