A study on the therapeutic efficacy of focused ultrasound and loop electrosurgical excision procedure for cervix high grade squamous intraepithelial lesions

YANG Yu-lu; YAO Yu-qin; ZHANG Miao; LIU Yu-juan; WANG Wen-ping; LIAO Ping; QU Da-cheng; ZHOU Hong-gui

doi:10.19538/j.fk2023120119

Abstract：Objective The study aims to compare the outcomes of focused ultrasound with those of loop electrosurgical excision procedure(LEEP)in the treatment of cervical high-grade squamous intraepithelial lesions(HSIL)and the clearance of high-risk human papillomavirus(HR-HPV).We also aim to investigate the safety and efficacy of focused ultrasound therapy for HSIL.Methods A total of 140 patients diagnosed with HR-HPV infection and HSIL through pathological biopsy between January 2020 and June 2022 at the Affiliated Hospital of North Sichuan Medical College were included in this study.They were divided into two groups:the focused ultrasound group(n=70)and the loop electrosurgical excision procedure group(n=70).We observed the cervical lesion outcomes and HR-HPV clearance rates at 6 and 12 months after treatment.Results A total of 67 cases in the focused ultrasound group met the inclusion criteria,of which 61 cases completed follow-up;A total of 58 cases met the inclusion criteria in the LEEP group,of which 53 cases completed follow-up.The cumulative HR-HPV clearance rates in the focused ultrasound group at 6 and 12 months after treatment were 49.2％and 72.1％,respectively.The cure rates of cervical lesion were 72.7％and 77.0％at these respective time points.In the loop electrosurgical excision procedure group,the cumulative HR-HPV clearance rates at 6 and 12 months after treatment were 50.9％and 71.7％,respectively,and the cure rates of cervical lesion were 75.7％and 77.4％.There were no statistically significant differences in HR-HPV clearance rates or cure rates of cervical lesion between the two groups(P＞0.05).The incidence of cervical adhesion,local tissue hyperplasia,and scarring after treatment in the focused ultrasound group was 0 case,2 cases,and 0 case,respectively,while in the loop electrosurgical excision procedure group,it was 6 cases,5 cases,and 1 case,respectively,and the differences between the two groups were statistically significant(Z=-2.513,P＜0.05).Conclusion Focused ultrasound and loop electrosurgical excision procedure achieve similar therapeutic efficacy in the treatment of HSIL.Focused ultrasound therapy has a lower incidence of complications.Therefore,under appropriate patient selection criteria,focused ultrasound can be considered as one of the treatment options for HSIL.