聚焦超声治疗合并高危型HPV感染的宫颈疾病可行性研究  

Feasibility on Focused Ultrasound Treatment for Cervical Disease with High-risk Human Papillomavirus Infection

作　　者：杨君[1] 王彬[1] 刘玉明[1] 彭建华[1] 王敏[1] 钱丹[1] 周德平[1] 

机构地区：[1]重庆市妇幼保健院,重庆市400013

出　　处：《中国超声医学杂志》2013年第5期446-449,共4页Chinese Journal of Ultrasound in Medicine

基　　金："十二五"国家科技支撑计划(No.2011BAI14B01);重庆市卫生局医疗特色专科建设项目;重庆市卫生局科研项目(No.2010-2-318)

摘　　要：目的探讨聚焦超声(HIFU)治疗合并高危型人乳头瘤病毒(high risk human papillomavirus,HR-HPV)感染的宫颈疾病的可行性研究。方法对我院宫颈专科2006年5月至2008年10月确诊为宫颈HR HPV感染(HC-2检测法)患者共149例,其中单纯宫颈HR-HPV感染患者58例,宫颈上皮内瘤变(CIN)Ⅰ级患者66例,CINⅡ级患者25例,采用聚焦超声治疗;另外,以同期患者98例为对照组,其中单纯宫颈HR HPV感染患者31例,CINⅠ级患者57例,CINⅡ级患者10例,单纯随访。研究期间皆禁止性生活但可使用安全套避孕。随访并评价HIFU治疗效果和副反应。结果治疗后12个月复查评估,治疗组:总有效率97.32%(145/149),其中治愈121例(81.21%),好转24例(1 6.55%);无效4例(2.68%)。对照组:宫颈HPV感染病灶总体自然好转率64.29%(63/98),其中病灶完全消退伴HPV转阴35例(35.71%),病灶部分消退和/或HPV载量下降28例(28.57%),无效35例(35.71%)。两组间差异有统计学意义(P<0.01)。随访24个月,治疗组CINⅡ复发率为24.00%(6/25),对照组为30.00%(3/10),两组间差异无统计学意义(P>0.05)。结论聚焦超声治疗合并HR-HPV感染的低度宫颈上皮内病变是可行的,但对CINⅡ的治疗安全性尚需长期大样本量观察。Objective To discuss the feasibility of focused ultrasound treatment（FU） for cervical disease with HR- HPV infection. Methods 247 patients with cervical HR-HPV infection （HC-2 test）in Chongqing Obstetric and Gynecology Hospital from May 2006 to October 2008 were divided into 2 groups. The treatment group （149 patients： 58 patients with cervical HR-HPV infection merely, 66 patients with cervical intraepithelial neoplasia （CIN I and 25 patients with CIN II ）was treated by FU, while the control group（98 patients：31 patients with cervical HR-HPV infec- tion merely, 57 patients with CIN I and 10 patients with CIN lI ）did not receive any treatment. Sexual life were prohib ited or using condom in all of the patients during the study period. The HPV-DNA titer in two groups was compared after three months to one year,and the clinical efficacy and adverse effects were observed. Results Total effective rate of cervical disease with HR HPV infection is 97.32%（145/149） in the treatment group equal to 64.29% （63/98） in the control group（P%0.01）. The cure rate in treatment group was 81.21 %, which was significantly higher than that in the control group （35. 71%）（P%0. 01）. There were 6 cases 24. 00%（6/25）returned in the patients with CINII of the treatment group after two years equal to 30.00% （3/10） in the control group. There was no significant difference be- tween the two groups（P%0.05）. Conclusions It is feasible for focused ultrasound to treat cervical disease with HR- HPV infection, but its long-term safety of treating CIN 1I still need long term observation.

关 键 词：聚焦超声人乳头瘤病毒 宫颈宫颈上皮内瘤样病变 

分 类 号：R737.33[医药卫生—肿瘤]