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聚焦超声与冷冻治疗宫颈鳞状上皮内病变的回顾性研究。

A retrospective study of focused ultrasound versus cryotherapy in treatment of cervical squamous intraepithelial lesions.

机构信息

Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.

出版信息

Int J Hyperthermia. 2022;39(1):1294-1299. doi: 10.1080/02656736.2022.2129104.

Abstract

PURPOSE

To compare the efficacy and safety of focused ultrasound (FUS) therapy and cryotherapy for cervical squamous intraepithelial lesion (SIL).

METHODS

In this retrospective study, data pertaining to women treated for cervical SIL with FUS therapy or cryotherapy at the Second Affiliated Hospital of Chongqing Medical University between 21 April 2018 and 31 August 2020 were obtained. The patients were followed up after 3-6 and 6-12 months. The proportions of women with no evidence of disease, recurrent disease, clearance of the human papillomavirus (HPV) and adverse effects or complications were determined.

RESULTS

Of the 250 women with complete data who were included in the study, 144 and 106 received FUS therapy and cryotherapy, respectively. Overall, FUS therapy was observed to be more effective than cryotherapy (91.7 vs. 79.2%,  = 0.005). Statistically significant differences were noted in the treatment efficacy for patients with low-grade SIL (LSIL) (92.3 vs. 80.2%,  = 0.011). However, there were no significant differences in the treatment efficacy for patients with high-grade SIL (HSIL) (88.9 vs. 75.0%,  = 0.390). The recurrence rates in patients with LSIL treated with FUS therapy or cryotherapy showed no significant differences at the 6-12-month follow-up (1.0 vs. 6.0%,  = 0.163). Furthermore, there was no recurrence in patients with HSIL, either in the FUS or cryotherapy group. FUS therapy and cryotherapy resulted in similar HPV clearance at the 3-6-month follow-up (77.1 vs. 64.8%,  = 0.057). No statistically significant differences were observed in the complication rates between the two groups (3.5 vs. 1.9%,  = 0.717).

CONCLUSION

The results of this study suggest that FUS therapy is superior to cryotherapy in the treatment of cervical LSIL.

摘要

目的

比较聚焦超声(FUS)治疗与冷冻疗法治疗宫颈鳞状上皮内病变(SIL)的疗效和安全性。

方法

本回顾性研究收集了 2018 年 4 月 21 日至 2020 年 8 月 31 日期间在重庆医科大学第二附属医院接受 FUS 治疗或冷冻疗法治疗宫颈 SIL 的女性患者的数据。患者在治疗后 3-6 个月和 6-12 个月进行随访。确定无疾病证据、疾病复发、人乳头瘤病毒(HPV)清除和不良反应或并发症的患者比例。

结果

在纳入本研究的 250 例完整数据的女性中,144 例接受 FUS 治疗,106 例接受冷冻疗法治疗。总体而言,FUS 治疗的疗效优于冷冻疗法(91.7%比 79.2%, = 0.005)。对于低级别 SIL(LSIL)患者,治疗效果存在统计学显著差异(92.3%比 80.2%, = 0.011)。然而,对于高级别 SIL(HSIL)患者,治疗效果无统计学差异(88.9%比 75.0%, = 0.390)。在 LSIL 患者中,接受 FUS 治疗或冷冻疗法治疗的患者在 6-12 个月的随访中复发率无显著差异(1.0%比 6.0%, = 0.163)。此外,FUS 或冷冻治疗组均未发现 HSIL 患者复发。在 3-6 个月的随访中,FUS 治疗和冷冻治疗的 HPV 清除率相似(77.1%比 64.8%, = 0.057)。两组之间的并发症发生率无统计学差异(3.5%比 1.9%, = 0.717)。

结论

本研究结果表明,FUS 治疗在治疗宫颈 LSIL 方面优于冷冻疗法。

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