Comparison of photodynamic therapy and LEEP in women of reproductive age with cervical squamous intraepithelial neoplasia 2 (CIN2): A prospective observational study in China
Background: Non-invasive treatments, such as 5-Aminolevulinic acid photodynamic therapy (5-ALA-PDT), has gained increasing attention among women with cervical intraepithelial neoplasia grade 2 (CIN2) who have fertility requirements. To compare the effectiveness of 5-ALA-PDT and loop electrosurgical...
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Elsevier
2025-04-01
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| Series: | Photodiagnosis and Photodynamic Therapy |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1572100025000262 |
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| author | Cheng Li Xuanhui Wang Qiulin Cui Mian He Ming Chen |
| author_facet | Cheng Li Xuanhui Wang Qiulin Cui Mian He Ming Chen |
| author_sort | Cheng Li |
| collection | DOAJ |
| description | Background: Non-invasive treatments, such as 5-Aminolevulinic acid photodynamic therapy (5-ALA-PDT), has gained increasing attention among women with cervical intraepithelial neoplasia grade 2 (CIN2) who have fertility requirements. To compare the effectiveness of 5-ALA-PDT and loop electrosurgical excision procedure (LEEP) in patients with CIN2, we conducted this prospective cohort study in Chinese patients with CIN2. Methods: 229 patients with CIN2 were enrolled. They were divided into the PDT Group (n=94) and LEEP Group (n=135) according to the patient's willingness. Patients were evaluated at the 3-, 6-, 12- and 18-month follow-up periods, using cytology, HPV testing, and colposcopy examination. Results: At the 3-month follow-up, the rates of disease regression to normal or CIN1 in the PDT group were 76.6% (72/94) and 13.8% (13/94), respectively, whereas in the LEEP group, they were 80.7% (109/135) and 11.1% (15/135), respectively. Logistic regression analysis revealed that the transformation zone type 3 was the only risk factor for both the PDT (OR=3.68; 95% CI, 2.43-5.26; P=0.008) and LEEP groups (OR=2.34; 95% CI, 1.84-4.53; P=0.02). The treatment efficacy in the PDT group increased gradually and peaked at the 18-month follow-up point with disease disappearance and regression rates of 90.4% and 8.5%, respectively. The disease disappearance and regression rates in the LEEP group were highest at the first half year posttreatment, with disease disappearance and regression rates of 87.4% and 12.6%, respectively. The hrHPV-negative rates in the PDT group and LEEP group were the highest at the 18-month follow-up (78.7% and 74.8%). There was no significant difference in the disappearance or regression rates between the two groups at the follow-up points (P > 0.05). Conclusions: Our study revealed that both 5-ALA PDT therapy and LEEP were highly effective at treating CIN2. 5-ALA-PDT, as a non-invasive treatment, could be an effective option for CIN2 patients with fertility preservation needs. |
| format | Article |
| id | doaj-art-c3fd1e4a7908426d802e38e7b0acf2f2 |
| institution | Kabale University |
| issn | 1572-1000 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Photodiagnosis and Photodynamic Therapy |
| spelling | doaj-art-c3fd1e4a7908426d802e38e7b0acf2f22025-02-05T04:31:22ZengElsevierPhotodiagnosis and Photodynamic Therapy1572-10002025-04-0152104496Comparison of photodynamic therapy and LEEP in women of reproductive age with cervical squamous intraepithelial neoplasia 2 (CIN2): A prospective observational study in ChinaCheng Li0Xuanhui Wang1Qiulin Cui2Mian He3Ming Chen4Department of Gynaecology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, ChinaDepartment of Gynaecology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, ChinaDepartment of Gynaecology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, ChinaDepartment of Gynaecology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, ChinaCorrespondence author: Ming Chen Department of Gynecology, the First Affiliated Hospital, Sun Yat-sen University, Zhongshan 2nd Road, Guangzhou 510080, Guangdong, China; Department of Gynaecology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, ChinaBackground: Non-invasive treatments, such as 5-Aminolevulinic acid photodynamic therapy (5-ALA-PDT), has gained increasing attention among women with cervical intraepithelial neoplasia grade 2 (CIN2) who have fertility requirements. To compare the effectiveness of 5-ALA-PDT and loop electrosurgical excision procedure (LEEP) in patients with CIN2, we conducted this prospective cohort study in Chinese patients with CIN2. Methods: 229 patients with CIN2 were enrolled. They were divided into the PDT Group (n=94) and LEEP Group (n=135) according to the patient's willingness. Patients were evaluated at the 3-, 6-, 12- and 18-month follow-up periods, using cytology, HPV testing, and colposcopy examination. Results: At the 3-month follow-up, the rates of disease regression to normal or CIN1 in the PDT group were 76.6% (72/94) and 13.8% (13/94), respectively, whereas in the LEEP group, they were 80.7% (109/135) and 11.1% (15/135), respectively. Logistic regression analysis revealed that the transformation zone type 3 was the only risk factor for both the PDT (OR=3.68; 95% CI, 2.43-5.26; P=0.008) and LEEP groups (OR=2.34; 95% CI, 1.84-4.53; P=0.02). The treatment efficacy in the PDT group increased gradually and peaked at the 18-month follow-up point with disease disappearance and regression rates of 90.4% and 8.5%, respectively. The disease disappearance and regression rates in the LEEP group were highest at the first half year posttreatment, with disease disappearance and regression rates of 87.4% and 12.6%, respectively. The hrHPV-negative rates in the PDT group and LEEP group were the highest at the 18-month follow-up (78.7% and 74.8%). There was no significant difference in the disappearance or regression rates between the two groups at the follow-up points (P > 0.05). Conclusions: Our study revealed that both 5-ALA PDT therapy and LEEP were highly effective at treating CIN2. 5-ALA-PDT, as a non-invasive treatment, could be an effective option for CIN2 patients with fertility preservation needs.http://www.sciencedirect.com/science/article/pii/S1572100025000262high-grade squamous intraepithelial lesion (HSIL)Cervical intraepithelial neoplasia grade 2 (CIN2)5-aminolevulinic acid photodynamic therapy (5-ALA PDT)loop electrosurgical excision procedure (LEEP)human papilloma virus (HPV) |
| spellingShingle | Cheng Li Xuanhui Wang Qiulin Cui Mian He Ming Chen Comparison of photodynamic therapy and LEEP in women of reproductive age with cervical squamous intraepithelial neoplasia 2 (CIN2): A prospective observational study in China Photodiagnosis and Photodynamic Therapy high-grade squamous intraepithelial lesion (HSIL) Cervical intraepithelial neoplasia grade 2 (CIN2) 5-aminolevulinic acid photodynamic therapy (5-ALA PDT) loop electrosurgical excision procedure (LEEP) human papilloma virus (HPV) |
| title | Comparison of photodynamic therapy and LEEP in women of reproductive age with cervical squamous intraepithelial neoplasia 2 (CIN2): A prospective observational study in China |
| title_full | Comparison of photodynamic therapy and LEEP in women of reproductive age with cervical squamous intraepithelial neoplasia 2 (CIN2): A prospective observational study in China |
| title_fullStr | Comparison of photodynamic therapy and LEEP in women of reproductive age with cervical squamous intraepithelial neoplasia 2 (CIN2): A prospective observational study in China |
| title_full_unstemmed | Comparison of photodynamic therapy and LEEP in women of reproductive age with cervical squamous intraepithelial neoplasia 2 (CIN2): A prospective observational study in China |
| title_short | Comparison of photodynamic therapy and LEEP in women of reproductive age with cervical squamous intraepithelial neoplasia 2 (CIN2): A prospective observational study in China |
| title_sort | comparison of photodynamic therapy and leep in women of reproductive age with cervical squamous intraepithelial neoplasia 2 cin2 a prospective observational study in china |
| topic | high-grade squamous intraepithelial lesion (HSIL) Cervical intraepithelial neoplasia grade 2 (CIN2) 5-aminolevulinic acid photodynamic therapy (5-ALA PDT) loop electrosurgical excision procedure (LEEP) human papilloma virus (HPV) |
| url | http://www.sciencedirect.com/science/article/pii/S1572100025000262 |
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