Clinical efficacy and mechanism for focused ultrasound (FUS) in the management of cervical intraepithelial neoplasia 1 (CIN1)

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.