Efficacy and Safety of Focused Ultrasound for Cervical Ectopy: A Meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

 TANGXue-li ¹ , GAOZhan ² ,  LIYou-ping ¹ , YUJia-jie ¹ , LIXiang-lian ¹

1. Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu 610041, China;
2. 404 Hospital of Mianyang, Mianyang 621000, China;

Corresponding?author：

LIYou-ping, Email: yzmylab@hotmail.com

Keywords：

Cervical ectopy; Focused ultrasound; Microwave; Meta-analysis; Randomized controlled trial

DOI：

10.7507/1672-2531.20150072

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To assess the efficacy and safety of focused ultrasound (FU) and microwave therapy (MW) for cervical ectopy (CE). Methods We searched the following databases:PubMed, EMbase, The Cochrane Library, CBM, VIP, CNKI and WanFang Data from inception to 30th August 2014. Two reviewers (Tang XL and Gao Z) independently screened literatures according to the inclusion and exclusion criteria, extracted data and assessed the methodological quality of included studies. Then, meta-analysis was performed by using RevMan 5.2.0 software. Results A total of 33 randomized controlled trials (RCTs) involving 1 759 patients were included. All the included studies were considered to be at high risk of bias. The results of meta-analysis showed that:compared with MW, FU could significantly reduce the risk of vaginal bleeding (RR=0.09, 95%CI 0.05 to 0.17, P<0.000 01) and vaginal discharge (RR=0.10, 95%CI 0.04 to 0.24, P<0.000 01), increase cure rate (RR=1.10, 95%CI 1.05 to 1.15, P<0.000 1) and total effective rate (RR=1.04, 95%CI 1.02 to 1.06, P=0.000 5). However, there was no difference in decreasing recurrence rate (RR=0.13, 95%CI 0.02 to 1.00, P=0.05). Conclusion Current available evidence suggest that FU is safer and more effective than MW for treating CE. Due to the limitation of quality of included studies, more high quality RCTs are needed to verify the above conclusion.

Citation： TANGXue-li, GAOZhan, LIYou-ping, YUJia-jie, LIXiang-lian. Efficacy and Safety of Focused Ultrasound for Cervical Ectopy: A Meta-analysis. Chinese Journal of Evidence-Based Medicine, 2015, 15(4): 425-438. doi: 10.7507/1672-2531.20150072 Copy

1.	World Health Organization (WHO). Global strategy for the prevention and control of sexually transmitted infections:2006-2015:breaking the chain of transmission. 2007. Available at:http://www.who.int/publications/list/9789241563475/zh/.
2.	Ministry of Foreign Affairs of the People's Republic of China United Nations System in China. China's Progress Towards The Millennium Development Goals 2013 Report. 2013. Available at:http://www.cn.undp.org/content/china/zh/home/library/mdg/mdgs-report-2013/.
3.	中華人民共和國國家衛生和計劃生育委員會. 2013中國衛生統計年鑒. 2014. Available at:http://www.nhfpc.gov.cn/htmlfiles/zwgkzt/ptjnj/year2013/index2013.html.
4.	WHO. Comprehensive cervical cancer control:a guide to essential practice. 2006. Available at:http://apps.who.int/iris/handle/10665/43469.
5.	Lee V, Tobin JM, Foley E. Relationship of cervical ectopy to chlamydia infection in young women. J Fam Plann Reprod Health Care, 2006; 32(2):104-106.
6.	Clemetson DB, Moss GB, Willerford DM, et al. Detection of HIV DNA in Cervical and Vaginal Secretions:Prevalence and Correlates Among Women in Nairobi, Kenya. J Am Med Assoc, 1993, 269(22):2860-2864.
7.	Plourde PJ, Pepin J, Agoki E, et al. Human immunodeficiency virus type1 seroconversion in women with genital ulcers. J Infect Dis, 1994, 170(2):313-317.
8.	Tanton C, Weiss HA, Le Goff J, et al. Correlates of HIV-1 genital shedding in Tanzanian women. PLoS ONE, 2011, 6(3):e17480.
9.	Rocha-Zavaleta L, Yescas G, Cruz RM, et al. Human papillomavirus infection and cervical ectopy. Int J Gynaecol Obstet, 2004, 85(3):259-266.
10.	Monroy OL, Aguilar C, Lizano M, et al. Prevalence of human papillomavirus genotypes, and mucosal IgA anti-viral responses in women with cervical ectopy. J Clin Virol, 2010, 47(1):43-48.
11.	Li CD, Wu MH, Wang JD, et al. A population-based study on the risks of cervical lesion and human papillomavirus infection among women in Beijing, People's Republic of China. Cancer Epidemiol Biomarkers Prev, 2010, 19(10):2655-2664.
12.	Dowe G, Smikle M, King SD, et al. High prevalence of genital Chlamydia trachomatis infection in women presenting in different clinical settings in Jamaica:implications for control strategies. Sex Transm Infect, 1999, 75(6):412-416.
13.	李曉艷, 李學軍, 胡義芹, 等. 聚焦超聲治療宮頸炎的臨床分析. 現代中西醫結合雜志, 2009, 18(35):4365-4366.
14.	Yang K, Li J, Liu Y, et al. Microwave therapy for cervical ectropion(Review). Cochrane Database Syst Rev, 2007, 17(4):CD006227.
15.	饒赟, 胡櫻, 陳雪花. 聚焦超聲在治療慢性子宮頸炎中的價值. 臨床超聲醫學雜志, 2008, 10(6):391-394.
16.	Higgins JPT, Green S. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0.[updated March 2011]. Available at:http://www.handbook.cochrane.org/.
17.	何佳, 李海燕. 聚焦超聲治療慢性宮頸炎500例臨床分析. 中華婦幼臨床醫學雜志, 2005, 1(2):113-114.
18.	毛靜月, 劉蕊, 余秀華, 等. 高頻聚焦超聲與微波治療宮頸糜爛的臨床研究. 中國基層醫藥, 2006, 13(7):1125-1126.
19.	張愛香. 聚焦超聲與微波治療宮頸糜爛療效的比較. 解放軍護理雜志, 2007, 24(8A):21-22.
20.	穆玉梅, 阿孜古麗. 聚焦超聲治療慢性宮頸炎的臨床研究. 中國社區醫師, 2007, 9(17):74.
21.	藍雪琴, 胡肖玲, 黃巧萍. 聚焦超聲治療慢性宮頸炎866例臨床分析. 微創醫學, 2007, 2(5):467-468.
22.	林庭佳. 聚焦超聲治療慢性宮頸炎的臨床分析. 現代醫院, 2008, 8(6):39-40.
23.	龔世雄, 李力, 許秀萍, 等. 微波與高強度聚焦超聲治療宮頸糜爛的對照研究. 臨床超聲醫學雜志, 2009, 11(1):62-63.
24.	張軍蓮, 杜玉琴. 超聲聚焦治療慢性宮頸炎1128例的臨床體會. 中國當代醫藥, 2009, 16(15):87-88.
25.	李虹, 聶敦利, 隆玉華. 聚焦超聲治療慢性宮頸糜爛550例臨床分析. 中國婦幼保健, 2009, 24(17):2435-2436.
26.	趙璐. 聚焦超聲波治療慢性宮頸炎260例報告. 山東醫藥, 2009, 49(51):30.
27.	姬紅. 聚焦超聲與微波治療慢性子宮頸炎的對比研究. 中國煤炭工業醫學雜志, 2010, 13(7):983-984.
28.	易春輝. 超聲治療宮頸炎100例臨床分析. 中國現代藥物應用, 2010, 4(13):33-33.
29.	陳粉合. 聚焦超聲術與微波在宮頸糜爛治療中的效果對比. 醫藥論壇雜志, 2010, 31(12):107-108.
30.	雷曉鳳, 吳嵐慧. 聚焦超聲與微波治療宮頸糜爛的療效比較. 中國社區醫師, 2010, 12(22):115-115.
31.	李艷紅, 王云清. 聚焦超聲治療宮頸炎臨床分析. 中國誤診學雜志, 2010, 10(34):8357.
32.	陳漢君. 微波與超聲聚焦治療慢性宮頸炎的效果觀察. 中國康復, 2010, 25(4):261.
33.	胡錦霞. 聚焦超聲治療宮頸炎62例臨床觀察. 亞太傳統醫藥, 2010, 6(12):135-136.
34.	楊輔瓊. 超聲聚焦治療與微波治療宮頸糜爛療效比較分析. 中國民族民間醫藥, 2010, (8):81.
35.	陳潤玲. 聚焦超聲術與微波在宮頸糜爛治療中的效果比較. 中外醫療, 2011, 30(29):41.
36.	要靜. 聚焦超聲治療慢性宮頸炎302例療效觀察. 實用臨床醫學, 2011, 12(7):64-65.
37.	朱馳玉. 微波治療31例慢性宮頸炎臨床體會. 中國當代醫藥, 2011, 18(18):34-35.
38.	寧楊. 三種不同方法治療宮頸糜爛的臨床效果. 臨床醫學, 2011, 31(8):27-29.
39.	李蕾. 聚焦超聲治療慢性宮頸炎的臨床觀察. 中國實用醫刊, 2012, 39(17):46-49.
40.	徐紅霞. 微波治療慢性宮頸炎的療效觀察. 臨床合理用藥雜志, 2012, 5(2c):115-116.
41.	朱弘宇, 趙旻. 聚焦超聲治療慢性宮頸炎的臨床療效分析. 數理醫藥學雜志, 2013, 26(2):148-150.
42.	安芳, 齊素云, 張帥. 海扶刀治療宮頸糜爛療效觀察. 中國社區醫師, 2013, 15(9):128.
43.	陳霞. 聚焦超聲治療慢性宮頸炎的臨床療效研究. 中國醫藥指南, 2013, 11(21):202-203.
44.	馮麗. 聚焦超聲治療慢性宮頸炎的療效及臨床觀察. 維吾爾醫藥, 2013, (3):98.
45.	黃美晨. 聚焦超聲治療慢性宮頸炎的療效及臨床觀察. 中國保健營養, 2013, (8):2155-2156.
46.	劉丙蓮, 楊華英, 游社香, 等. 聚焦超聲治療慢性宮頸炎的療效. 實用臨床醫學 (江西), 2013, 14(7):78-79.
47.	陸儀. 聚焦超聲治療慢性宮頸炎86例臨床觀察. 大家健康, 2011, (8):141-142.
48.	賀國麗,王世閬. 關于"宮頸糜爛"的認識進展. 現代婦產科進展, 2011, 20(5):407-408.
49.	Myer L, Wright TC Jr, Denny L, et al. Nested Case-Control Study of Cervical Mucosal Lesions, Ectopy, and Incident HIV Infection Among Women in Cape Town, South Africa. Sex Transm Dis, 2006, 33(11):683-687.
50.	陳文直, 王智彪, 伍烽. 單純高強度聚焦超聲治療惡性實體腫瘤. 中華腫瘤雜志, 2002, 24(3):278-281.
51.	段潔, 李紅英, 熊俊, 陽艷, 吳緒峰, 肖冬會. 微波與聚焦超聲治療CINI的臨床療效對比分析. 公共衛生與預防醫學, 2010, 21(6):124-125.
52.	袁小芳, 張小芬. 聚焦超聲與微波治療尖銳濕疣的臨床體會. 實用臨床醫學, 2009, 10(3):79-79.
53.	張勝蓮, 蔣芝蓉. 聚焦超聲治療外陰上皮內非瘤變效果及臨床意義的探討. 中國計劃生育和婦產科, 2014, 6(2):50-52.
54.	李成志, 王智彪, 陳文直. 聚焦超聲治療外陰白色病變的研究. 中華婦產科雜志, 2004, 39(6):373-377.
55.	林川, 楊君, 李成志, 等. 聚焦超聲治療低級別宮頸上皮內瘤樣病變. 中國介入影像與治療學, 2012, 9(12):873-876.

1. World Health Organization (WHO). Global strategy for the prevention and control of sexually transmitted infections:2006-2015:breaking the chain of transmission. 2007. Available at:http://www.who.int/publications/list/9789241563475/zh/.
2. Ministry of Foreign Affairs of the People's Republic of China United Nations System in China. China's Progress Towards The Millennium Development Goals 2013 Report. 2013. Available at:http://www.cn.undp.org/content/china/zh/home/library/mdg/mdgs-report-2013/.
3. 中華人民共和國國家衛生和計劃生育委員會. 2013中國衛生統計年鑒. 2014. Available at:http://www.nhfpc.gov.cn/htmlfiles/zwgkzt/ptjnj/year2013/index2013.html.
4. WHO. Comprehensive cervical cancer control:a guide to essential practice. 2006. Available at:http://apps.who.int/iris/handle/10665/43469.
5. Lee V, Tobin JM, Foley E. Relationship of cervical ectopy to chlamydia infection in young women. J Fam Plann Reprod Health Care, 2006; 32(2):104-106.
6. Clemetson DB, Moss GB, Willerford DM, et al. Detection of HIV DNA in Cervical and Vaginal Secretions:Prevalence and Correlates Among Women in Nairobi, Kenya. J Am Med Assoc, 1993, 269(22):2860-2864.
7. Plourde PJ, Pepin J, Agoki E, et al. Human immunodeficiency virus type1 seroconversion in women with genital ulcers. J Infect Dis, 1994, 170(2):313-317.
8. Tanton C, Weiss HA, Le Goff J, et al. Correlates of HIV-1 genital shedding in Tanzanian women. PLoS ONE, 2011, 6(3):e17480.
9. Rocha-Zavaleta L, Yescas G, Cruz RM, et al. Human papillomavirus infection and cervical ectopy. Int J Gynaecol Obstet, 2004, 85(3):259-266.
10. Monroy OL, Aguilar C, Lizano M, et al. Prevalence of human papillomavirus genotypes, and mucosal IgA anti-viral responses in women with cervical ectopy. J Clin Virol, 2010, 47(1):43-48.
11. Li CD, Wu MH, Wang JD, et al. A population-based study on the risks of cervical lesion and human papillomavirus infection among women in Beijing, People's Republic of China. Cancer Epidemiol Biomarkers Prev, 2010, 19(10):2655-2664.
12. Dowe G, Smikle M, King SD, et al. High prevalence of genital Chlamydia trachomatis infection in women presenting in different clinical settings in Jamaica:implications for control strategies. Sex Transm Infect, 1999, 75(6):412-416.
13. 李曉艷, 李學軍, 胡義芹, 等. 聚焦超聲治療宮頸炎的臨床分析. 現代中西醫結合雜志, 2009, 18(35):4365-4366.
14. Yang K, Li J, Liu Y, et al. Microwave therapy for cervical ectropion(Review). Cochrane Database Syst Rev, 2007, 17(4):CD006227.
15. 饒赟, 胡櫻, 陳雪花. 聚焦超聲在治療慢性子宮頸炎中的價值. 臨床超聲醫學雜志, 2008, 10(6):391-394.
16. Higgins JPT, Green S. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0.[updated March 2011]. Available at:http://www.handbook.cochrane.org/.
17. 何佳, 李海燕. 聚焦超聲治療慢性宮頸炎500例臨床分析. 中華婦幼臨床醫學雜志, 2005, 1(2):113-114.
18. 毛靜月, 劉蕊, 余秀華, 等. 高頻聚焦超聲與微波治療宮頸糜爛的臨床研究. 中國基層醫藥, 2006, 13(7):1125-1126.
19. 張愛香. 聚焦超聲與微波治療宮頸糜爛療效的比較. 解放軍護理雜志, 2007, 24(8A):21-22.
20. 穆玉梅, 阿孜古麗. 聚焦超聲治療慢性宮頸炎的臨床研究. 中國社區醫師, 2007, 9(17):74.
21. 藍雪琴, 胡肖玲, 黃巧萍. 聚焦超聲治療慢性宮頸炎866例臨床分析. 微創醫學, 2007, 2(5):467-468.
22. 林庭佳. 聚焦超聲治療慢性宮頸炎的臨床分析. 現代醫院, 2008, 8(6):39-40.
23. 龔世雄, 李力, 許秀萍, 等. 微波與高強度聚焦超聲治療宮頸糜爛的對照研究. 臨床超聲醫學雜志, 2009, 11(1):62-63.
24. 張軍蓮, 杜玉琴. 超聲聚焦治療慢性宮頸炎1128例的臨床體會. 中國當代醫藥, 2009, 16(15):87-88.
25. 李虹, 聶敦利, 隆玉華. 聚焦超聲治療慢性宮頸糜爛550例臨床分析. 中國婦幼保健, 2009, 24(17):2435-2436.
26. 趙璐. 聚焦超聲波治療慢性宮頸炎260例報告. 山東醫藥, 2009, 49(51):30.
27. 姬紅. 聚焦超聲與微波治療慢性子宮頸炎的對比研究. 中國煤炭工業醫學雜志, 2010, 13(7):983-984.
28. 易春輝. 超聲治療宮頸炎100例臨床分析. 中國現代藥物應用, 2010, 4(13):33-33.
29. 陳粉合. 聚焦超聲術與微波在宮頸糜爛治療中的效果對比. 醫藥論壇雜志, 2010, 31(12):107-108.
30. 雷曉鳳, 吳嵐慧. 聚焦超聲與微波治療宮頸糜爛的療效比較. 中國社區醫師, 2010, 12(22):115-115.
31. 李艷紅, 王云清. 聚焦超聲治療宮頸炎臨床分析. 中國誤診學雜志, 2010, 10(34):8357.
32. 陳漢君. 微波與超聲聚焦治療慢性宮頸炎的效果觀察. 中國康復, 2010, 25(4):261.
33. 胡錦霞. 聚焦超聲治療宮頸炎62例臨床觀察. 亞太傳統醫藥, 2010, 6(12):135-136.
34. 楊輔瓊. 超聲聚焦治療與微波治療宮頸糜爛療效比較分析. 中國民族民間醫藥, 2010, (8):81.
35. 陳潤玲. 聚焦超聲術與微波在宮頸糜爛治療中的效果比較. 中外醫療, 2011, 30(29):41.
36. 要靜. 聚焦超聲治療慢性宮頸炎302例療效觀察. 實用臨床醫學, 2011, 12(7):64-65.
37. 朱馳玉. 微波治療31例慢性宮頸炎臨床體會. 中國當代醫藥, 2011, 18(18):34-35.
38. 寧楊. 三種不同方法治療宮頸糜爛的臨床效果. 臨床醫學, 2011, 31(8):27-29.
39. 李蕾. 聚焦超聲治療慢性宮頸炎的臨床觀察. 中國實用醫刊, 2012, 39(17):46-49.
40. 徐紅霞. 微波治療慢性宮頸炎的療效觀察. 臨床合理用藥雜志, 2012, 5(2c):115-116.
41. 朱弘宇, 趙旻. 聚焦超聲治療慢性宮頸炎的臨床療效分析. 數理醫藥學雜志, 2013, 26(2):148-150.
42. 安芳, 齊素云, 張帥. 海扶刀治療宮頸糜爛療效觀察. 中國社區醫師, 2013, 15(9):128.
43. 陳霞. 聚焦超聲治療慢性宮頸炎的臨床療效研究. 中國醫藥指南, 2013, 11(21):202-203.
44. 馮麗. 聚焦超聲治療慢性宮頸炎的療效及臨床觀察. 維吾爾醫藥, 2013, (3):98.
45. 黃美晨. 聚焦超聲治療慢性宮頸炎的療效及臨床觀察. 中國保健營養, 2013, (8):2155-2156.
46. 劉丙蓮, 楊華英, 游社香, 等. 聚焦超聲治療慢性宮頸炎的療效. 實用臨床醫學 (江西), 2013, 14(7):78-79.
47. 陸儀. 聚焦超聲治療慢性宮頸炎86例臨床觀察. 大家健康, 2011, (8):141-142.
48. 賀國麗,王世閬. 關于"宮頸糜爛"的認識進展. 現代婦產科進展, 2011, 20(5):407-408.
49. Myer L, Wright TC Jr, Denny L, et al. Nested Case-Control Study of Cervical Mucosal Lesions, Ectopy, and Incident HIV Infection Among Women in Cape Town, South Africa. Sex Transm Dis, 2006, 33(11):683-687.
50. 陳文直, 王智彪, 伍烽. 單純高強度聚焦超聲治療惡性實體腫瘤. 中華腫瘤雜志, 2002, 24(3):278-281.
51. 段潔, 李紅英, 熊俊, 陽艷, 吳緒峰, 肖冬會. 微波與聚焦超聲治療CINI的臨床療效對比分析. 公共衛生與預防醫學, 2010, 21(6):124-125.
52. 袁小芳, 張小芬. 聚焦超聲與微波治療尖銳濕疣的臨床體會. 實用臨床醫學, 2009, 10(3):79-79.
53. 張勝蓮, 蔣芝蓉. 聚焦超聲治療外陰上皮內非瘤變效果及臨床意義的探討. 中國計劃生育和婦產科, 2014, 6(2):50-52.
54. 李成志, 王智彪, 陳文直. 聚焦超聲治療外陰白色病變的研究. 中華婦產科雜志, 2004, 39(6):373-377.
55. 林川, 楊君, 李成志, 等. 聚焦超聲治療低級別宮頸上皮內瘤樣病變. 中國介入影像與治療學, 2012, 9(12):873-876.

Chinese Journal of Evidence-Based Medicine

Efficacy and Safety of Focused Ultrasound for Cervical Ectopy: A Meta-analysis

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content