ALA-PDT 与 CO2 激光治疗伴高危型 HPV 感染的低级别阴道上皮内瘤变的比较：一项非随机对照的初步研究。
Comparison of ALA-PDT and CO laser treatment of low-grade vaginal intraepithelial neoplasia with high-risk HPV infection: A non-randomized controlled pilot study.
机构信息
Department of Obstetrics and Gynecology, Qilu Hospital of Shandong University, Mailing address: No. 107 West Wenhua Road, Jinan, Shandong 250012, China.
Department of Obstetrics and Gynecology, Qilu Hospital of Shandong University, Mailing address: No. 107 West Wenhua Road, Jinan, Shandong 250012, China; Key Laboratory of Gynecologic Oncology of Shandong Province, China.
出版信息
Photodiagnosis Photodyn Ther. 2023 Sep;43:103695. doi: 10.1016/j.pdpdt.2023.103695. Epub 2023 Jul 6.
OBJECTIVE
To evaluate the efficacy and safety of 5-aminolevulinic acid-mediated photodynamic therapy (ALA-PDT) and CO laser therapy of low-grade vaginal intraepithelial neoplasia (VAIN1) combined with high-risk human papillomavirus (hr-HPV) infection.
METHODS
A total of 163 patients with VAIN1 and hr-HPV infection were divided into PDT Group (n = 83) and CO laser Group (n = 80). The PDT Group received six times of ALA-PDT treatments and the CO laser Group received once CO laser treatment. HPV types, cytology, colposcopy, and pathological examinations were carried out before and after treatment. The differences in HPV clearance rate, VAIN1 regression rate, and adverse reactions between the two groups were analyzed during 6-month follow-up.
RESULTS
The overall HPV clearance rate of the PDT Group was significantly higher than that of the CO laser Group (65.06% vs 38.75%, P = 0.0008) although similar result was obtained for 16/18-related HPV infection patients (54.55% vs 43.48%, P = 0.4578). The VAIN1 regression rate of the PDT Group was significantly higher than that of the CO laser Group (95.18% vs 83.75%, P = 0.0170). In patients ≥ 50 years old, ALA-PDT showed better HPV clearance rate and VAIN1 regression rate than CO laser therapy (P < 0.05). The adverse reactions in the PDT Group were significantly lower than that in the CO laser Group (P > 0.05).
CONCLUSIONS
The efficacy of ALA-PDT appears better than CO laser for VAIN1 patients. However, the long-term effect of ALA-PDT for VAIN1 still needs to be explored. As a non-invasive treatment, ALA-PDT is a highly effective therapeutic procedure for VAIN1 with hr-HPV infection.
目的
评估 5-氨基酮戊酸介导的光动力疗法（ALA-PDT）联合高危型人乳头瘤病毒（hr-HPV）感染治疗低级别阴道上皮内瘤变（VAIN1）的疗效和安全性。
方法
将 163 例 VAIN1 和 hr-HPV 感染患者分为 PDT 组（n=83）和 CO 激光组（n=80）。PDT 组接受 6 次 ALA-PDT 治疗，CO 激光组接受 1 次 CO 激光治疗。治疗前后进行 HPV 型别、细胞学、阴道镜和组织病理学检查。分析两组患者 6 个月随访期间 HPV 清除率、VAIN1 消退率及不良反应差异。
结果
PDT 组 HPV 总清除率明显高于 CO 激光组（65.06% vs. 38.75%，P=0.0008），16/18 相关 HPV 感染患者的清除率亦高于 CO 激光组（54.55% vs. 43.48%，P=0.4578）。PDT 组 VAIN1 消退率明显高于 CO 激光组（95.18% vs. 83.75%，P=0.0170）。≥50 岁患者中，ALA-PDT 清除 HPV 和消退 VAIN1 的效果优于 CO 激光治疗（P<0.05）。PDT 组不良反应发生率明显低于 CO 激光组（P>0.05）。
结论
ALA-PDT 治疗 VAIN1 患者的疗效优于 CO 激光，但 ALA-PDT 治疗 VAIN1 的长期效果仍需进一步探讨。ALA-PDT 作为一种非侵入性治疗方法，对 HR-HPV 感染的 VAIN1 是一种高效的治疗方法。
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