Efficacy and Safety of Focused Ultrasound Treatment for High-risk Human Papillomavirus Infection-related Cervical Intraepithelial Neoplasia Grade 2 in Nulligravidae Women: A Retrospective Study

Objective

This retrospective study aimed to investigate the efficacy and safety of focused ultrasound (FU) treatment for high-risk human papillomavirus (HR-HPV) infection-related cervical intraepithelial neoplasia grade 2 (CIN2) in nulligravidae under 35 y old, while also assessing pregnancy outcomes post-treatment.

Methods

Nulligravid patients aged 18–35 y with histologically confirmed CIN2 and HR-HPV infection were included in the study. We collected demographics, pertinent medical history, HPV genotypes and cervical length at baseline. Follow-up evaluations were conducted at 6- and 12-mo intervals post-treatment to assess histopathological response, HPV infection clearance and adverse events related to treatment.

Results

A total of 31 eligible patients were recruited and underwent FU treatment. At the 6-mo follow-up, complete pathologic response was observed in 22 out of 31 patients (70.96%), while partial response was seen in eight out of 31 patients (25.80%). The average duration from pathological diagnosis to achieving either a complete response or partial response after treatment was 214.36 ± 24.31 (186–270) d. The baseline remission rate for HPV was 35.48% at 6 mo, increasing to 71.49% at 12 mo. Moderate lower abdominal pain and increased vaginal discharge were the most frequent adverse events. Among the patients desiring pregnancy, the successful pregnancy rate was 57.14%, resulting in eight deliveries.

Conclusion

FU demonstrated a favorable safety profile and efficacy in nulliparous females under 35 y old with CIN2, and its benefits for fertility warrant further investigation.