Comparison of 5-ALA-PDT and LEEP for cervical squamous intraepithelial neoplasia: A systematic review and meta-analysis

IF 2.1 4区医学 Q2 OBSTETRICS & GYNECOLOGY

European journal of obstetrics, gynecology, and reproductive biology Pub Date : 2025-05-08 DOI:10.1016/j.ejogrb.2025.114026

Junjie Li , Shan Su , Ning Guo , Zhe Zhang

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引用次数: 0

Abstract

Objectives

The objective of the study was to assess the function of 5-aminolevulinic acid photodynamic therapy (5-ALA-PDT) versus loop electrosurgical excision procedure (LEEP) in the treatment of cervical squamous intraepithelial neoplasia (CIN).

Methods

Following the PICO guidelines, a comprehensive literature review was carried out according to data from PubMed, Embase, and other related databases. Notably, only the randomized controlled trials (RCT) and retrospective clinical trials were included in this study and then analyzed. And the primary results were composed of the pathological regression rate, residual lesion rate, and HPV clearance rate at 3–6 months.

Results

The detailed review and meta-analysis in this study were composed of 7 relevant studies. A total of 851 patients were assigned in this study: 316 for the ALA-PDT group and 535 for the LEEP group. In the comparison of ALA-PDT and LEEP for the treatment of CIN, it showed no significant difference within the pathological regression and residual lesion. However, the HPV clearance of the ALA-PDT group was superior to the LEEP group.

Conclusions

Both of the two groups in this study showed substantial clinical effectiveness in the management of CIN. Additionally, ALA-PDT showed a superior HPV clearance rate within patients with CIN. However, the meta-analysis, which included only one RCT, requires cautious interpretation of the results, and more RCT are needed to confirm these findings.

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5-ALA-PDT和LEEP治疗宫颈鳞状上皮内瘤变的比较：系统回顾和荟萃分析

目的：本研究的目的是评估5-氨基乙酰丙酸光动力疗法（5-ALA-PDT）与环形电切手术（LEEP）在治疗宫颈鳞状上皮内瘤变（CIN）中的作用。方法按照PICO指南，根据PubMed、Embase和其他相关数据库的数据进行全面的文献综述。值得注意的是，本研究仅纳入随机对照试验（RCT）和回顾性临床试验进行分析。3-6个月的初步结果包括病理消退率、残留病变率和HPV清除率。结果本研究的详细综述和荟萃分析由7项相关研究组成。本研究共纳入851例患者：ALA-PDT组316例，LEEP组535例。在ALA-PDT和LEEP治疗CIN的比较中，在病理消退和残余病变范围内没有明显差异。然而，ALA-PDT组的HPV清除率优于LEEP组。结论两组治疗CIN均有较好的临床疗效。此外，ALA-PDT在CIN患者中显示出更高的HPV清除率。然而，该荟萃分析仅包括一项RCT，需要对结果进行谨慎的解释，需要更多的RCT来证实这些发现。

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

European journal of obstetrics, gynecology, and reproductive biology 医学-妇产科学

CiteScore

4.60

自引率

3.80%

发文量

898

审稿时长

8.3 weeks

期刊介绍： The European Journal of Obstetrics & Gynecology and Reproductive Biology is the leading general clinical journal covering the continent. It publishes peer reviewed original research articles, as well as a wide range of news, book reviews, biographical, historical and educational articles and a lively correspondence section. Fields covered include obstetrics, prenatal diagnosis, maternal-fetal medicine, perinatology, general gynecology, gynecologic oncology, uro-gynecology, reproductive medicine, infertility, reproductive endocrinology, sexual medicine and reproductive ethics. The European Journal of Obstetrics & Gynecology and Reproductive Biology provides a forum for scientific and clinical professional communication in obstetrics and gynecology throughout Europe and the world.