聚焦超声治疗高危型人乳头瘤病毒感染相关低度宫颈病变：前瞻性队列研究。

Focused ultrasound for high-risk human papillomavirus infection-related low-grade cervical lesions: a prospective cohort study.

机构信息

Department of Gynecology, Affiliated Hospital of North Sichuan Medical College, Sichuan, China.

State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, China.

出版信息

Int J Hyperthermia. 2022;39(1):1327-1334. doi: 10.1080/02656736.2022.2130443.

DOI:10.1080/02656736.2022.2130443

PMID:36220185

Abstract

OBJECTIVES

To assess the efficacy and safety of focused ultrasound (FU) for high-risk human papillomavirus (HR-HPV) infection-related cervical low-grade squamous intraepithelial lesions (LSIL).

METHODS

Of 185 patients who met the inclusion criteria for this prospective study from October 2020 to November 2021, 95 received FU and 90 were followed up only. At the six-month follow-up, the HR-HPV clearance and LSIL regression rates of the groups were compared and factors affecting HR-HPV clearance were analyzed. The safety and side effects of FU were evaluated.

RESULTS

No significant difference was found in the baseline clinical data between the two groups ( > 0.05). At the six-month follow-up, the HR-HPV clearance rates were 75.6% in the FU group and 25.6% in the observation group ( = 0.000). The LSIL regression rates were 89.5% in the FU group and 56.4% in the observation group ( = 0.000). Multivariate logistic regression analysis showed that the HR-HPV clearance rate in the FU group was 9.03 times higher than that in the observation group (95% confidence interval [CI], 3.75-21.73, = 0.000), and the clearance rate of single-type HR-HPV infections was 5.28 times higher than that of multi-type infections (95% CI, 1.83-15.23, = 0.002). The mean intraoperative bleeding was 1.8 ± 0.6 (1-3) mL; the mean intraoperative pain score was 2.6 ± 1.0 (1-6).

CONCLUSIONS

For patients with HR-HPV infection-related histological LSIL, FU can eliminate HR-HPV infection and cause lesions to regress in a short time, with few adverse effects and good tolerance.

摘要

目的

评估聚焦超声（FU）治疗高危型人乳头瘤病毒（HR-HPV）感染相关宫颈低级别鳞状上皮内病变（LSIL）的疗效和安全性。

方法

本前瞻性研究于 2020 年 10 月至 2021 年 11 月期间纳入了 185 名符合纳入标准的患者，其中 95 名接受 FU 治疗，90 名仅接受随访。在 6 个月的随访中，比较了两组的 HR-HPV 清除率和 LSIL 消退率，并分析了影响 HR-HPV 清除的因素。评估了 FU 的安全性和副作用。

结果

两组的基线临床数据无显著差异（>0.05）。在 6 个月的随访中，FU 组的 HR-HPV 清除率为 75.6%，观察组为 25.6%（=0.000）。FU 组的 LSIL 消退率为 89.5%，观察组为 56.4%（=0.000）。多因素 logistic 回归分析显示，FU 组的 HR-HPV 清除率是观察组的 9.03 倍（95%置信区间[CI]，3.75-21.73，=0.000），单一型 HR-HPV 感染的清除率是多型感染的 5.28 倍（95%CI，1.83-15.23，=0.002）。术中平均出血量为 1.8±0.6（1-3）mL；术中平均疼痛评分为 2.6±1.0（1-6）。