中华超声影像学杂志
中華超聲影像學雜誌
중화초성영상학잡지
CHINESE JOURNAL OF ULTRASONOGRAPHY
2013年
1期
51-54
,共4页
张薇%程德敏%周艳秋%刘莹%张长淮%张建新%吴瑞芳
張薇%程德敏%週豔鞦%劉瑩%張長淮%張建新%吳瑞芳
장미%정덕민%주염추%류형%장장회%장건신%오서방
超声,高强聚焦%宫颈上皮内瘤样病变%预后
超聲,高彊聚焦%宮頸上皮內瘤樣病變%預後
초성,고강취초%궁경상피내류양병변%예후
Ultrasound,high intersity focused%Cervical intraepithelial neoplasia%Prognosis
目的 通过比较高强聚焦超声(HIFU)治疗和未予任何干预措施的轻度宫颈上皮内瘤样病变(CIN I)的转归情况,探讨HIFU对CIN I的疗效.方法 治疗组155例CIN Ⅰ患者应用HIFU进行治疗,自实施治疗后开始随访;对照组548例CIN患者自阴道镜下宫颈活检病理确诊开始随访.随访时间为6个月、12个月、24个月、36个月,随访方法为每次随访时行宫颈液基细胞学检查(LCT)和宫颈脱落细胞中高危型人乳头瘤病毒病毒(HR-HPV)检测,LCT检测结果为意义不明的不典型鳞状上皮细胞伴HR-HPV阳性,或LCT≥低度鳞状上皮内瘤样病变的妇女,行阴道镜下宫颈活检病理诊断,根据LCT、HR-HPV及病理结果确定病变转归.结果 ①治疗组与对照组随访至36个月时累积失访率分别为18.66%和10.22%.②治疗组在随访6个月、12个月、24个月及36个月时的累积逆转率分别为77.51、80.38%、86.12%和88.28%,逆转病例数随治疗后时间延长呈逐步上升趋势;累积持续率分别为33.01%、22.97%、9.33%和1.44%,呈逐步下降趋势.③治疗组与对照组的逆转率均随观察时间延长而增加,随访至6个月、12个月、24个月及36个月时两组比较差异均有统计学意义(P均<0.05);病变持续率在治疗组与对照组随观察时间延长均呈下降趋势,其中6个月、12个月及24个月时两组间差异有统计学意义(P<0.05),而36个月时两组间差异无统计学意义;治疗组与对照组进展率比较差异有统计学意义(P<0.05).结论 对于有干预指征的CINI,HIFU具有使宫颈局部无坚硬瘢痕的优点,而且可促进病变的逆转,减少病变持续率,并阻断其进一步发展为癌前病变.
目的 通過比較高彊聚焦超聲(HIFU)治療和未予任何榦預措施的輕度宮頸上皮內瘤樣病變(CIN I)的轉歸情況,探討HIFU對CIN I的療效.方法 治療組155例CIN Ⅰ患者應用HIFU進行治療,自實施治療後開始隨訪;對照組548例CIN患者自陰道鏡下宮頸活檢病理確診開始隨訪.隨訪時間為6箇月、12箇月、24箇月、36箇月,隨訪方法為每次隨訪時行宮頸液基細胞學檢查(LCT)和宮頸脫落細胞中高危型人乳頭瘤病毒病毒(HR-HPV)檢測,LCT檢測結果為意義不明的不典型鱗狀上皮細胞伴HR-HPV暘性,或LCT≥低度鱗狀上皮內瘤樣病變的婦女,行陰道鏡下宮頸活檢病理診斷,根據LCT、HR-HPV及病理結果確定病變轉歸.結果 ①治療組與對照組隨訪至36箇月時纍積失訪率分彆為18.66%和10.22%.②治療組在隨訪6箇月、12箇月、24箇月及36箇月時的纍積逆轉率分彆為77.51、80.38%、86.12%和88.28%,逆轉病例數隨治療後時間延長呈逐步上升趨勢;纍積持續率分彆為33.01%、22.97%、9.33%和1.44%,呈逐步下降趨勢.③治療組與對照組的逆轉率均隨觀察時間延長而增加,隨訪至6箇月、12箇月、24箇月及36箇月時兩組比較差異均有統計學意義(P均<0.05);病變持續率在治療組與對照組隨觀察時間延長均呈下降趨勢,其中6箇月、12箇月及24箇月時兩組間差異有統計學意義(P<0.05),而36箇月時兩組間差異無統計學意義;治療組與對照組進展率比較差異有統計學意義(P<0.05).結論 對于有榦預指徵的CINI,HIFU具有使宮頸跼部無堅硬瘢痕的優點,而且可促進病變的逆轉,減少病變持續率,併阻斷其進一步髮展為癌前病變.
목적 통과비교고강취초초성(HIFU)치료화미여임하간예조시적경도궁경상피내류양병변(CIN I)적전귀정황,탐토HIFU대CIN I적료효.방법 치료조155례CIN Ⅰ환자응용HIFU진행치료,자실시치료후개시수방;대조조548례CIN환자자음도경하궁경활검병리학진개시수방.수방시간위6개월、12개월、24개월、36개월,수방방법위매차수방시행궁경액기세포학검사(LCT)화궁경탈락세포중고위형인유두류병독병독(HR-HPV)검측,LCT검측결과위의의불명적불전형린상상피세포반HR-HPV양성,혹LCT≥저도린상상피내류양병변적부녀,행음도경하궁경활검병리진단,근거LCT、HR-HPV급병리결과학정병변전귀.결과 ①치료조여대조조수방지36개월시루적실방솔분별위18.66%화10.22%.②치료조재수방6개월、12개월、24개월급36개월시적루적역전솔분별위77.51、80.38%、86.12%화88.28%,역전병례수수치료후시간연장정축보상승추세;루적지속솔분별위33.01%、22.97%、9.33%화1.44%,정축보하강추세.③치료조여대조조적역전솔균수관찰시간연장이증가,수방지6개월、12개월、24개월급36개월시량조비교차이균유통계학의의(P균<0.05);병변지속솔재치료조여대조조수관찰시간연장균정하강추세,기중6개월、12개월급24개월시량조간차이유통계학의의(P<0.05),이36개월시량조간차이무통계학의의;치료조여대조조진전솔비교차이유통계학의의(P<0.05).결론 대우유간예지정적CINI,HIFU구유사궁경국부무견경반흔적우점,이차가촉진병변적역전,감소병변지속솔,병조단기진일보발전위암전병변.
Objective To evaluate the effectiveness of cervical intraepitheliar neoplasia grade Ⅰ (CIN Ⅰ) after treated by high intensity focused ultrasound (HIFU) Ⅰ.Methods 155 CIN Ⅰ cases in treatment group started following after HIFU method,548 cases in control group started following after cervical biopsy under the colposcope.The following intermissions were 6 months,12 months,24 months,36 months,Liquid based cytological test (LCT) and hybrid captured-Ⅱ for high rate-humanpapilomavirus (HR-HPV)test were used in every following test,and if the LCT result was atypical squamous cells (ASC-US) and HR-HPV positive,or the LCT result was greater than or equal,cervical biopsy was undergone by the colposcope to make sure the CIN Ⅰ diagnosis.Results (1) The lost rates of treatment group and control group in 36 months were 18.66% and 10.22%.(2) The inversion rates in 6 months,12 months,24 months and 36 months were 77.51 %,80.38 %,86.12 % and 88.28 %,inversion cases were rose up by the treatment gradually,succession rates were 33.01 %,22.97%,9.33% and 1.44%,and descended down gradually.(3)The inversion rates in treatment group and control group increased with observation time,there were significant differences during the 6 months,12 months,24 months and 36 months (P < 0.05) ; the succession rates in treatment group and control group descended with observation time,there were significant differences during the 6 months,12 months and 24 months (P < 0.05),and there were not significant differences in the 36 months,but significant differences between treatment group's and control group s progressive rate.Conclusions No solid scar,improving lesions inversion,reducing succession rate,guarding against the canceration were the advantages of HIFU in treatment for CIN I.