Abstract

Objective: This study was aimed at investigating the clinical efficacy and studying the possible mechanism of FUS applications to treat cervical intraepithelial neoplasia 1 (CIN1).

Methods: This was a prospective clinical study, in which 30 patients with CIN1 (28/30 of the patients were HPV positive) were enrolled and treated with FUS therapy by gynecologist. All patients were followed up for 3 months after FUS therapy. Telephone interviews, PAP smear, colposcopic examinations, cervical biopsies and HPVDNA tests were performed to assess the safety and effectiveness of FUS therapy for HPV-positive CIN1. The expression of p16, Ki-67 and Fas in the cervical tissues were examined in order to account for the possible mechanism of FUS therapy for CIN1 with HPV infection.

Results: FUS therapy was tolerated well, and no severe complications were observed in any patient. After FUS treatment, twenty-five patients were cured completely, and two cases were improved with the cervical smear results reversed to normal, and three cases remained the same status as before treatment. The total effectiveness rate was 90.00% (27/30). The expression of P16 and Ki-67 in the treated cervical tissues was significantly lower than that before treatment, and the expression of Fas was found up-regulated (all p < .05).

Conclusion: FUS therapy appears to be a feasible and effective treatment for patients with HPV positive CIN1. FUS therapy may help to reduce the expression of p16 and Ki-67 and enhance the expression of Fas in the treated cervical tissues to regulate cell proliferation and increase apoptosis, and thus prevent the disease from evolving into high grade lesions.

摘要

目的：本研究旨在研究FUS治疗宫颈上皮内瘤样变1（CIN1）的临床疗效并探讨其可能的机制。

方法：这是一项前瞻性临床研究，招募了30例CIN1患者（其中28/30例HPV阳性），并由妇科医生进行FUS治疗。FUS治疗后对所有患者进行了3个月的随访。进行电话采访，PAP涂片检查，阴道镜检查，宫颈活检和HPVDNA检测，以评估FUS治疗HPV阳性CIN1的安全性和有效性。检查了宫颈组织中p16，Ki-67和Fas的表达，以解释FUS治疗HPV感染的CIN1的可能机制。

结果： FUS治疗耐受良好，任何患者均未观察到严重并发症。经FUS治疗后，25例患者完全治愈，2例得到改善，宫颈涂片检查结果恢复正常，3例保持与治疗前相同的状态。总有效率为90.00％（27/30）。经治疗的宫颈组织中P16和Ki-67的表达明显低于治疗前，并且Fas的表达被上调（所有p  <.05）。

结论： FUS治疗对于HPV阳性CIN1患者似乎是一种可行而有效的治疗方法。FUS治疗可能有助于减少被治疗宫颈组织中p16和Ki-67的表达并增强Fas的表达，从而调节细胞增殖并增加细胞凋亡，从而防止疾病发展为高级别病变。