Clinical efficacy of 5-aminolevulinic acid-based photodynamic therapy on cervical intraepithelial neoplasia grade Ⅱ
Objective To observe the efficacies of 5-aminolevulinic acid-based photodynamic therapy(5-ALA-PDT),ablation and surgical resection on cervical intraepithelial neoplasia grade Ⅱ(CINⅡ)and their safeties.Methods In 285 patients with CIN Ⅱ,86 patients received 5-ALA-PDT(photodynamic group),89 received cryotherapy,laser or electrocoagulation(ablation group),and 110 received cervical cold knife conization and cervical loop electrosurgical excision procedure(surgical resection group)in Henan Provincial People's Hospital from October 2021 to April 2023.The age,gravidity,parity,human papillomavirus(HPV)infection rate and HPV infection type were compared among three groups.The wound healing and occurrence of adverse reactions as bleeding,infection,cervical canal stenosis or adhesion and cervical hyperplasia 1 month after treatment were recorded.HPV,thin-prep cytologic test and colposcopy were performed to evaluate the efficacies 3 and 6 months after treatment.The cure rate,lesion persistence rate,recurrence rate,progression rate and HPV negative conversion rate were compared among three groups.Results There were no significant differences in the age,gravidity,parity,HPV infection rate and HPV infection type among three groups(P＞0.05).All patients had good wound healing 1 month after treatment.Eight patients in photodynamic group had slight pain or increased vaginal discharge after treatment,which were relieved without special treatment.In surgical resection group,there were 4 cases of wound bleeding,2 cases of infection,and 3 cases of cervical canal adhesion after treatment.In ablation group,there were 2 cases of wound bleeding,1 case of infection,and 1 case of cervical canal adhesion.There was no lesion progression in three groups 6 months after treatment.The cure rate was lower in ablation group(83.15％)than that in photodynamic group(90.70％)and surgical resection group(94.55％)(P＜0.05),and showed no significant difference between photodynamic group and surgical resection group(P＞0.05).There were no significant differences in the lesion persistence rate,lesion recurrence rate,and HPV negative conversion rate among three groups(P＞0.05).Conclusion 5-ALA-PDT achieves similar efficacy on CIN Ⅱ to surgical resection,with fewer adverse reactions and higher safety,and is a good choice for patients with cervical high-grade squamous intraepithelial lesions who have fertility needs.
cervical intraepithelial neoplasiagrade Ⅱ5-aminolevulinic acid-based photodynamic therapyablation therapycold knife conization of the cervixcervical loop electrosurgical excision
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