背景:确定基于5-氨基乙酰丙酸的光动力疗法(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治疗宫颈转化区3型病变的适用性。
方法:我们纳入了青岛大学附属医院妇科诊断为N2CI的81例患者,收集了2019年1月至2021年1月ALA-PDT后的数据。此外,我们根据11例需要生育的患者的随访数据,分析了ALA-PDT在育龄妇女保留生育力方面的优越性.
结果:我们的研究结果证实了ALA-PDT对于CIN2治疗的长期疗效,在25-36个月的随访中,总有效率为95.83%(23/24)。此外,宫颈转化区3型改善和人乳头瘤病毒(HPV)阴性有效率分别为69.2%(18/26)和82.4%(14/17),分别。ALA-PDT推荐用于同意宫颈转化区3型的患者。此外,没有原发性不孕症的女性在ALA-PDT治疗CIN2后可能会经历自然怀孕和足月分娩的多个婴儿,满意率≈100%。
结论:ALA-PDT可用于治疗高度鳞状上皮内病变,尤其是有生育要求的患者。
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.