光动力疗法和锥切术治疗宫颈高级别鳞状上皮内病变的比较分析：一项系统综述和荟萃分析。

IF 3.1 3区医学 Q2 ONCOLOGY

Photodiagnosis and Photodynamic Therapy Pub Date : 2025-03-07 DOI:10.1016/j.pdpdt.2025.104544

Yu Liu , Ruizhen Li , Changzhong Li , Ruifang Wu

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引用次数: 0

摘要

目的：本综述旨在比较光动力疗法（PDT）与锥形切除术（包括环电切术（LEEP）和冷刀锥形切除术（CKC））治疗宫颈高级别鳞状上皮内病变（HSIL）的有效性。方法：检索PubMed、Cochrane Library、b谷歌Scholar、Embase、中国知网（CNKI）、万方数据库。评估的结果包括完全缓解（CR）率、人乳头瘤病毒（HPV）根除率、复发率和不良事件（ae）。结果：纳入9项研究。共有312例患者接受了PDT， 380例患者接受了锥化（LEEP/CKC）。PDT与锥切术在3-6个月CR率上无显著差异(OR: 1.64 [0.97, 2.76]；P = 0.06)，12个月CR (OR: 0.49 [0.13, 1.90]；P = 0.30)，3-6个月HPV根除率(OR: 1.40 [0.95, 2.07]；P = 0.09)，12个月HPV根除率(OR: 0.92[0.47, 1.82]；P = 0.81)，或12个月复发率(or: 2.97 [0.62, 14.25]； = 0.17页)。然而，ae的发生率，包括阴道出血(OR: 0.10 [0.03, 0.33]；P = 0.0002)，宫颈管粘连(OR: 0.16 [0.03, 0.90]；P = 0.04)，宫颈瘢痕形成(OR: 0.04 [0.01, 0.30]；P=0.002)， PDT组明显低于锥切组。异质性程度不高。结论：基于我们的系统综述和荟萃分析，可以得出结论，与锥切（LEEP/CKC）相比，PDT可能是一种实用的宫颈HSIL回归方法。然而，需要进一步的高质量对照试验来证实这些发现。

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Comparative analysis of photodynamic therapy and conization for cervical high-grade squamous intraepithelial lesion: A systematic review and meta-analysis

Objectives

This review aims to compare the effectiveness of photodynamic therapy (PDT) with conization, including loop electrosurgical excision procedure (LEEP) and cold-knife conization (CKC), in treating cervical high-grade squamous intraepithelial lesions (HSIL).

Methods

PubMed, Cochrane Library, Google Scholar, Embase, China National Knowledge Infrastructure (CNKI), and Wanfang Data were searched. The outcomes assessed were complete response (CR) rate, human papillomavirus (HPV) eradication rate, recurrence rate, and adverse events (AEs).

Results

9 studies were included. A total of 312 patients received PDT, while 380 underwent conization (LEEP/CKC). There was no significant difference between PDT and conization in the CR rate at 3–6 months (OR: 1.64 [0.97, 2.76]; P = 0.06), 12-month CR (OR: 0.49 [0.13, 1.90]; P = 0.30), HPV eradication rate at 3–6 months (OR: 1.40 [0.95, 2.07]; P = 0.09), HPV eradication rate at 12 months (OR: 0.92[0.47, 1.82]; P = 0.81), or 12-month recurrence rate (OR: 2.97 [0.62, 14.25]; P = 0.17). However, the rate of AEs, including vaginal bleeding (OR: 0.10 [0.03, 0.33]; P = 0.0002), cervical canal adhesion (OR: 0.16 [0.03, 0.90]; P = 0.04), and cervical scar formation (OR: 0.04 [0.01, 0.30]; P = 0.002), was significantly lower with PDT than with conization. The degree of heterogeneity was not high.

Conclusion

Based on our systematic review and meta-analysis, it could be concluded that PDT may be a practical approach for cervical HSIL regression compared to conization (LEEP/CKC). However, further high-quality, controlled trials are needed to confirm these findings.

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来源期刊

Photodiagnosis and Photodynamic Therapy ONCOLOGY-

CiteScore

5.80

自引率

24.20%

发文量

509

审稿时长

50 days

期刊介绍： Photodiagnosis and Photodynamic Therapy is an international journal for the dissemination of scientific knowledge and clinical developments of Photodiagnosis and Photodynamic Therapy in all medical specialties. The journal publishes original articles, review articles, case presentations, "how-to-do-it" articles, Letters to the Editor, short communications and relevant images with short descriptions. All submitted material is subject to a strict peer-review process.