Analysis on clinical effect of photodynamic therapy combined with CO2 laser in treatment of vaginal intraepithelial neoplasia
Objective To analyze the clinical efficacy and safety of photodynamic therapy(PDT)com-bined with CO2 laser in treating vaginal intraepithelial neoplasia(VaIN)to provide reference for the treatment scheme of the patients with VaIN.Methods A total of 80 patients with definitely diagnosed VaIN by colpo-scopic biopsy in Henan University People's Hospital from June 2022 to February 2023 were selected and di-vided into the PDT combined CO2 laser group and CO2 laser group by the random number table method,40 cases in each group.The follow up lasted for 6 months.The cure rate,negative conversion rate of human papillomavir-us(HPV),adverse reactions,recurrence and progression were compared between the two groups.Results After 3,6 months of treatment,the cure rates of VaIN in the PDT combined CO2 laser group were 77.50％and 82.50％,respectively,which in the CO2 laser group were 75.00％and 70.00％respectively,and the differ-ences between the two groups were not statistically significant(P＞0.05).There was no statistically signifi-cant difference in the cure rates of low-grade squamous intraepithelial lesion(LSIL)and high-grade squamous intraepithelial lesion(HSIL)after 3,6 months of treatment between the two groups(P＞0.05).There was no statistically significant difference in the negative conversion rate of HPV after 3 months of treatment be-tween the PDT combined with CO2 laser group and CO2 laser group(71.79％vs.56.41％,P＞0.05).How-ever,after 6 months of treatment,the negative conversion rate of HPV in the PDT combined CO2 laser group was significantly higher than that in the CO2 laser group(82.05％vs.58.97％,P＜0.05).In the CO2 laser group,one case experienced vaginal bleeding during treatment process,two cases appeared mild vaginal wall adhesion.No obvious adverse reaction was observed in the PDT combined with CO2 laser group.After 6 months of treatment,there was no case with progression of lesion in both groups;there were one case(3.23％)of relapse in the PDT combined CO2 laser group and three cases(10.00％)of relapse in the CO2 laser group,and the difference was not statistically significant(P＞0.05).Conclusion PDT combined with CO2 laser for treating VaIN has a high cure rate and HPV clearance rate,which is a safe and effective method for treating VaIN.
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