光动力疗法对一级阴道上皮内瘤变的影响：一项回顾性队列研究。
Effect of photodynamic therapy on vaginal intraepithelial neoplasia grade one: A retrospective cohort study.
作者信息
Yang Yao, Cao Dan, Chen Yi, Xu Ying, Xiong Zhenhong, Zhang Zhengrong, Wu Dan
机构信息
Cervical Center of The International Peace Maternity & Child Health Hospital of China Welfare Institute, No. 910 Hengshan Road, Xuhui District, Shanghai 200030, China.
Cervical Center of The International Peace Maternity & Child Health Hospital of China Welfare Institute, No. 910 Hengshan Road, Xuhui District, Shanghai 200030, China.
出版信息
Photodiagnosis Photodyn Ther. 2025 Feb;51:104486. doi: 10.1016/j.pdpdt.2025.104486. Epub 2025 Jan 16.
OBJECTIVE
To evaluate the efficacy of photodynamic therapy (PDT) for vaginal intraepithelial neoplasia grade 1 (VaIN1) related to high-risk (Hr)-human papillomavirus (HPV).
METHODS
Participants aged 25-65 years treated for VaIN1 between March 2022 and September 2022 were retrospectively analyzed into three groups. The PDT and follow-up groups were matched 1:1 for gravidity, HPV type, and quadrants involved. The PDT and CO laser groups were compared without matching. Patients were followed up at 6, 12, and 24 months.
RESULTS
After matched, the lesion and Hr-HPV clearance rates of the PDT group (89.5%, 89.5%, 92.1%, and 81.6%, 84.2%, 89.5%) were significantly higher than those of the follow-up group (31.6%, 50.0%, 63.2%, and 21.1%, 26.3%, 31.6%, P < 0.05) at 6, 12, and 24 months. But the lesion clearance rates did not differ significantly between the PDT (68.9%, 82.2%, and 91.1%) and CO laser groups (68.7%, 78.3%, and 85.5%, P > 0.05) at 6, 12, and 24 months, and so did Hr-HPV clearance rates (PDT as 62.2% and 77.8%, and CO laser 54.2% and 61.4%, respectively, P > 0.05) at 6 and 12 months. However, at 24 months, the Hr-HPV clearance rate was higher in the PDT group than in the CO laser group (86.7% vs 71.1%, P = 0.047). In the PDT group, none of the lesions progressed.
CONCLUSIONS
Compared with CO laser, PDT resulted in a higher Hr-HPV clearance, as well as a low risk of complications and disease progression. PDT is an effective and noninvasive treatment for VaIN1.
目的
评估光动力疗法（PDT）治疗与高危（Hr）-人乳头瘤病毒（HPV）相关的1级阴道上皮内瘤变（VaIN1）的疗效。
方法
回顾性分析2022年3月至2022年9月期间接受VaIN1治疗的25至65岁参与者，并将其分为三组。PDT组和随访组在妊娠情况、HPV类型和受累象限方面按1:1匹配。PDT组和CO激光组未进行匹配直接比较。在6、12和24个月时对患者进行随访。
结果
匹配后，PDT组在6、12和24个月时的病变清除率（89.5%、89.5%、92.1%）和Hr-HPV清除率（81.6%、84.2%、89.5%）显著高于随访组（31.6%、50.0%、63.2%和21.1%、26.3%、31.6%，P<0.05）。但在6、12和24个月时，PDT组（68.9%、82.2%、91.1%）和CO激光组（68.7%、78.3%、85.5%，P>0.05）的病变清除率无显著差异，6个月和12个月时的Hr-HPV清除率也无显著差异（PDT组分别为62.2%和77.8%，CO激光组分别为54.2%和61.4%，P>0.05）。然而，在24个月时，PDT组的Hr-HPV清除率高于CO激光组（86.7%对71.1%，P=0.047）。在PDT组中，无病变进展。
结论
与CO激光相比，PDT导致更高的Hr-HPV清除率，以及更低的并发症和疾病进展风险。PDT是治疗VaIN1的一种有效且无创的方法。
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