Value of laser therapy,photodynamic therapy,and follow-up observation in the management of cervical low-grade squamous intraepithelial lesions:a prospective cohort study
Objective To explore the value of CO2 laser therapy,photodynamic therapy,and follow-up observation in the management of cervical low-grade squamous intraepithelial lesion(LSIL).Methods Women diagnosed with cervical LSIL and high risk human papillomavirus(HR-HPV)infection through colposcopy-guided biopsy from January 1,2021 to December 31,2023 were collected.According to a 1:1 ratio,107 cases were included in each of the laser treatment,photodynamic therapy,and follow-up groups.The complete remission rate and HR-HPV clearance rate were compared during the 6-12 months follow-up period.Results(1)Comparison of clinical data among the three groups before treatment:the median age of the 321 patients was(34.9±8.1)years.Before treatment,cytological abnormalities were present in 51.7％(166/321)of patients,and 35.2％(113/321)had human papillomavirus(HPV)16/18 infections.The accuracy rate of colposcopic diagnosis was 69.2％(222/321).Age,cytology results,HPV 16/18 infection,and colposcopy diagnosis in the laser group,photodynamic group,and follow-up group were compared,and there were not statistically significant differences(all P＞0.05).(2)During the 6-12 months follow-up period,the complete remission rate was 89.7％(96/107)in the laser group,slightly higher than the 86.9％(93/107)in the photodynamic group,with no statistical difference between the two groups(x2=0.41,P=0.523).However,both were significantly higher than the 64.5％(69/107)in the follow-up group(x2=19.30,P＜0.001;x2=14.63,P＜0.001).The HR-HPV clearance rates in the laser and photodynamic groups were 73.8％(79/107)and 68.2％(73/107),respectively,both significantly higher than the 32.7％(35/107)in the follow-up group(x2=36.34,P＜0.001;x2=26.99,P＜0.001),but with no statistical difference between the laser and photodynamic groups(x2=0.82,P=0.366).Conclusions CO2 laser therapy and photodynamic therapy are effective treatments for cervical LSIL,significantly superior to follow-up observation in terms of lesion remission and HR-HPV clearance rates.Individualized treatment plans could be developed based on the patient's age,duration of HR-HPV infection,colposcopic impression,and economic conditions.
Squamous intraepithelial lesions of the cervixPapillomavirus infectionsLaser therapyPhotochemotherapyFollow-up studiesCohort studies
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