Changes Of Local P16, Ki67, Fas And Fasl Expression Of Cervical Intraepithelial Neoplasia Grade Ⅰafter Focused Ultrasound Treatment

Objective1.To investigate the mechanism of focused ultrasound on the reversion of cervical intraepithelial neoplasia,and to provide theoretical basis for the treatment of cervical intraepithelial neoplasia.2. To investigate the changes of local P16, Ki-67 and Fas expression in cervical intraepithelial neoplasia grade I(CINI) before and after focused ultrasound treatment.Methods1. 40 mice model of cervical intraepithelial neoplasia I(CINI) induced by dimethl benzene anthracene(DMBA) in situ. They were randomly divided into treatment group and control group. The treatment group was treated by focused ultrasound(10.20 MHz, 1.5W). The control group was treated with the same operation method as the treatment group, but no power output. The immunohistochemical method was used to detect the expression of P16, Ki67 gene and expression of Fasl and Fas in mousecervical tissues after two weeks.2. Thirty patients with histologically confirmed CINⅠ were treated with focused ultrasound and followed up. All patients were examined for histopathological examination of the local cervical tissue after treatment 3months. The SP immunohistochemical method was used to detect the expression of P16, Ki-67 and Fas of cervical tissue before and after the treatment.Results1. After 2-3 months of continuous observation, the cervical tissue pathology microscope observation showed that the experimental modeling of 60 mice,CINⅠ40 only, CINⅡ5 only, CINⅢ2,cervical inflammation 6only, and another seven died.2. After two weeks of observation the control group of mice hair dark,thin, was inactive, while the treatment group was better than that of the control group mice. In focused ultrasound treatment group ten mice were cured, five mice improved, four mice were persistent, one mouse died, and the effective rate was 75%, While in the control group, 11 had no change, 6developed into CIN II, 1 developed into CIN III, and 2 died. The strong positive expression rate of P16 and Ki67 in the treatment group was lower than that in the control group. The strong positive expression rate of Fas in the treatment group was higher than that in the control group, while the strong positive expression rate of Fasl was lower than that of the controlgroup(all P<0.05).3. After focused ultrasound treatment, 25 patients were cured completely, 2 cases were improved, 3 cases were persistent, and the total effective rate was 90.00%(27/30). The expression of P16, Ki-67 in local cervical tissue was significantly lower than that before treatment, but the expression of Fas was up-regulated(all P<0.05).ConclusionThe focused ultrasound can be safe and effective in the treatment of CINⅠ by reduced the expression of P16, Ki67 and Fasl in cervical tissues and increased the expression of Fas to regulate the mechanism of cell proliferation and apoptosis, improve cervical local micro environment and to prevent it to the high grade.