Li Junjie, Su Shan, Guo Ning, Zhang Zhe
Department of Anesthesiology, Zibo Central Hospital, No. 54 Gongqingtuan West Road, Zibo, Shandong 255036, China.
Department of Gynecology, Zibo Central Hospital, No. 54 Gongqingtuan West Road, Zibo, Shandong 255036, China.
Eur J Obstet Gynecol Reprod Biol. 2025 Jul;311:114026. doi: 10.1016/j.ejogrb.2025.114026. Epub 2025 May 8.
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).
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.
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.
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.
本研究的目的是评估5-氨基酮戊酸光动力疗法（5-ALA-PDT）与环形电切术（LEEP）在治疗宫颈鳞状上皮内瘤变（CIN）中的作用。
按照PICO指南，根据来自PubMed、Embase和其他相关数据库的数据进行了全面的文献综述。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，然后进行分析。主要结果包括3至6个月时的病理消退率、残留病变率和HPV清除率。
本研究中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。在比较ALA-PDT和LEEP治疗CIN时，病理消退和残留病变方面无显著差异。然而，ALA-PDT组的HPV清除率优于LEEP组。
本研究中的两组在CIN管理方面均显示出显著的临床疗效。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，需要谨慎解释结果，并且需要更多RCT来证实这些发现。
