Comparison of Topical 5-Aminolevulinic Acid Photodynamic Therapy With the Loop Electrosurgical Excision Procedure for Patients With Cervical High-Grade Squamous Intraepithelial Neoplasia: A Prospective and Propensity-Matched Analysis

IF 2.2 3区医学 Q2 DERMATOLOGY

Lasers in Surgery and Medicine Pub Date : 2025-03-03 DOI:10.1002/lsm.70004

Yao Yang, Bingying Sun, Dan Cao, Ying Xu, Yi Chen, Dan Wu

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Abstract

Objective

To evaluate the efficacy of 5-aminolevulinic acid photodynamic therapy (PDT) for high-grade squamous intraepithelial lesions of the cervix associated with high-risk human papillomavirus (HPV) infection.

Methods

In this study, 120 patients who received treatment for high-grade squamous intraepithelial lesions of the cervix from March 2023 to March 2024 were followed up prospectively, which were categorized into the PDT and loop electrosurgical excision procedure (LEEP) groups and matched 1:1 using a propensity score. The regression rate of the lesions and the HPV clearance rate were compared between the groups at 6 and 12 months. Factors affecting the clearance rate were analyzed.

Results

At the 6- and 12-month follow-ups, no significant difference was observed in the rate of lesion regression between the PDT (86.7%, 91.7%) and LEEP groups (85.0%, 93.3%) (p > 0.05), nor the HPV clearance rate (55.0%, 76.7% vs. 65.0%, 78.3%) (p > 0.05). Neither group had any lesions that progressed to Grade 3 or invasive cervical carcinoma at follow-up. According to regression analysis, thinprep cytology test (TCT) results influenced lesion regression in the PDT group.

Conclusion

Compared to the LEEP, 5-aminolevulinic acid PDT had a similar rate of lesion regression and HPV clearance for the treatment of high-grade squamous intraepithelial lesions of the cervix; thus, PDT offers an alternative and effective minimally invasive approach.

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局部5-氨基乙酰丙酸光动力疗法与环形电切术治疗宫颈高级别鳞状上皮内瘤变的比较：前瞻性和倾向匹配分析。

目的：评价5-氨基乙酰丙酸光动力疗法（PDT）治疗高危人乳头瘤病毒（HPV）感染相关宫颈高级别鳞状上皮内病变的疗效。方法：本研究对2023年3月至2024年3月接受宫颈高级别鳞状上皮内病变治疗的120例患者进行前瞻性随访，分为PDT组和环形电切术组（LEEP），采用倾向评分1:1匹配。比较6个月和12个月时两组间病变消退率和HPV清除率。分析了影响清除率的因素。结果：在6个月和12个月的随访中，PDT组（86.7%,91.7%）和LEEP组（85.0%,93.3%）的病变消退率和HPV清除率（55.0%,76.7% vs. 65.0%, 78.3%）无显著差异（p > 0.05）。随访时，两组均未见病变进展为3级或浸润性宫颈癌。根据回归分析，薄层细胞学检查（TCT）结果影响PDT组病变的消退。结论：与LEEP相比，5-氨基乙酰丙酸PDT治疗宫颈高级别鳞状上皮内病变的病变消退率和HPV清除率相似；因此，PDT提供了另一种有效的微创方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Lasers in Surgery and Medicine 医学-外科

CiteScore

5.40

自引率

12.50%

发文量

119

审稿时长

1 months

期刊介绍： Lasers in Surgery and Medicine publishes the highest quality research and clinical manuscripts in areas relating to the use of lasers in medicine and biology. The journal publishes basic and clinical studies on the therapeutic and diagnostic use of lasers in all the surgical and medical specialties. Contributions regarding clinical trials, new therapeutic techniques or instrumentation, laser biophysics and bioengineering, photobiology and photochemistry, outcomes research, cost-effectiveness, and other aspects of biomedicine are welcome. Using a process of rigorous yet rapid review of submitted manuscripts, findings of high scientific and medical interest are published with a minimum delay.