Clinical Preliminary Study On Focused Ultrasound Therapy For Cervical Intraepithelial Neoplasia

Objective:To investigate the healing rates and complications of focused ultrasound and electrocoagulation therapy for the cervical intraepithelial neoplasia gradeⅠ(CINⅠ) associated with high risk human papilloma virus (HR-HPV) infection, comparing with the control group. To explore the efficacy and safety of focused ultrasound therapy on CINⅠassociated with HR-HPV infection.Method:140 patients with CINⅠassociated with HR-HPV infection who visited out-patient clinic from June 2008 to October 2009 were enrolled in the study.38 patients were assigned to focused ultrasound group,57 patients to electrocoagulation group and 45 patients to control group. In focused ultrasound group, the patient were treated by the ultrasound therapeutic device (Seapostar○R), which was developed by the Chongqing Haifu(HIFU) Technology,Co.Ltd, China.In electrocoagulation group, the patients were treated by the Loop electrosurgical therapeutic device (Quantum 2000) with ball electrode, which was developed by the WALLACH Company. At 6 months and 12 months'follow-up visit, the healing rates of CINⅠand HPV infection were studied in three groups. Average operation time, pain intensity index, vaginal discharge, vaginal bleeding and cervical recuperation were compared in two therapy groups.Result:At 6 months'follow-up visit, the healing rate of CINⅠin ultrasound group was 81.58%,compared with 84.21% in electrocoagulation group, 37.78% in control group,respectively. At 12 months'follow-up visit, the healing rate of CINⅠwas 86.21% in focused ultrasound group ,electrocoagulation group was 86.48% , however control group was 46.88%.There was highly significant difference in three groups(P﹤0.01), the healing rates of two therapy groups were significantly higher than that of control group, however it was not statistical significant difference between the focused ultrasound group and electrocoagulation group (P> 0.05).At 6 months'follow-up visit, the negative rate of HR-HPV was 78.96% in focused ultrasound group, compared with 73.69% in electrocoagulation group and 33.33% in control group,respectively. At 12 months'follow-up visit, the healing rate of HR-HPV was 82.76% in focused ultrasound group,hower electrocoagulation group was 81.11%, control group was 50.00%.There was highly significant statistical difference in the three groups(P﹤0.01)not only in the 6months but also 12months;the healing rates of two therapy groups were obviously higher than control group, however it was insignificant difference between the focused ultrasound group and electrocoagulation group (P> 0.05).Compared with two therapy groups during operation, the average operation time of focused ultrasound group was 3.78±1.45 minutes, electrocoagulation group was 5.23±1.91 minutes, the former is obviously shorter than the latter(P﹤0.01); pain intensity index of two group were 4.01±1.58 and 4.99±1.35, the focused ultrasound group was lower than the other group(P﹤0.01). After treatment, vaginal discharge in focused ultrasound group patients was 47.36%, the other group was 73.68%, and vaginal bleeding in two therapy groups were 21.05% and 42.11%.The rates of vaginal discharge and bleeding in focused ultrasound group were significantly lower than those of electrocoagulation group (P<0.05), however the cervical recuperation of two groups were not significant difference in 2 months later. (P﹥0.05).Conclusion:The healing rates of focused ultrasound group on CIN I and HR-HPV infection were similar to those of electrocoagulation group, but focused ultrasound therapy was less side reaction and complications than electrocoagulation treatment. It is an effective and safe way in the treatment of patient with CIN I associated with HR-HPV infection.