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宫颈上皮内瘤变 2 级(CIN2)的光动力疗法的长期随访。

Long-term follow-up of photodynamic therapy of cervical intraepithelial neoplasia grade 2 (CIN2).

机构信息

Department of Gynecology, the Affiliated Hospital of Qingdao University, Qingdao, 266003, China.

College of Resource Environment and Tourism, Hubei University of Arts and Science, Xiangyang, 441053, China.

出版信息

Photodiagnosis Photodyn Ther. 2024 Jun;47:104219. doi: 10.1016/j.pdpdt.2024.104219. Epub 2024 May 18.

DOI:10.1016/j.pdpdt.2024.104219
PMID:38768844
Abstract

BACKGROUND

To determine the long-term efficacy and safety of 5-aminolevulinic acid-based photodynamic therapy (ALA-PDT) for treating cervical intraepithelial neoplasia grade 2 (CIN2) as well as the suitability of ALA-PDT in treating of cervical lesions divided into cervical transformation zone type 3.

METHODS

We included 81 patients diagnosed with CIN2 at the Department of Gynecology of the Affiliated Hospital of Qingdao University with data collected between January 2019 and January 2021 following ALA-PDT. Furthermore, we analyzed the superiority of ALA-PDT in fertility preservation among women of childbearing age based on follow-up data from 11 patients with fertility requirements.

RESULTS

Our findings confirmed the long-term efficacy of ALA-PDT for CIN2 treatment, with an overall efficacy of 95.83 % (23/24) at follow-up of 25-36 months. Moreover, the cervical transformation zone type 3 improvement and human papillomavirus (HPV)-negative efficacy were 69.2 % (18/26) and 82.4 % (14/17), respectively. ALA-PDT is recommended for consenting patients with cervical transformation zone type 3. Additionally, women without primary infertility could experience natural pregnancy and full-term birth of more than one baby following ALA-PDT for CIN2 treatment, with a satisfaction rate of ≈100 %.

CONCLUSIONS

ALA-PDT is recommendable for treating high-grade squamous intraepithelial lesions, especially in patients with fertility requirements.

摘要

背景

为了确定 5-氨基酮戊酸光动力疗法(ALA-PDT)治疗宫颈上皮内瘤变 2 级(CIN2)的长期疗效和安全性,以及 ALA-PDT 治疗宫颈病变的适宜性,我们将病变分为宫颈转化区 3 型。

方法

我们纳入了 2019 年 1 月至 2021 年 1 月在青岛大学附属医院妇科接受 ALA-PDT 治疗的 81 例 CIN2 患者,对这些患者进行了回顾性分析。此外,我们对 11 例有生育要求的患者进行了随访,分析了 ALA-PDT 在生育保护方面的优势。

结果

我们的研究结果证实了 ALA-PDT 治疗 CIN2 的长期疗效,在随访 25-36 个月时,总有效率为 95.83%(23/24)。此外,宫颈转化区 3 型改善和 HPV 转阴的有效率分别为 69.2%(18/26)和 82.4%(14/17)。建议对宫颈转化区 3 型的患者使用 ALA-PDT。此外,无原发不孕的患者在接受 ALA-PDT 治疗 CIN2 后,可以自然妊娠并足月分娩一个以上的婴儿,其满意度约为 100%。

结论

ALA-PDT 是治疗高级别鳞状上皮内病变的推荐方法,尤其是在有生育要求的患者中。

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