Volume 22 Issue 2
Feb.  2024
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Article Navigation >  Chinese Journal of General Practice  > 2024  >  22(2): 257-260
MA Xiaotuan, SHEN Qingwen, WANG Lingling. Analysis of clinical efficacy of photodynamic and carbon dioxide laser in the treatment of vaginal intraepithelial neoplasia[J]. Chinese Journal of General Practice, 2024, 22(2): 257-260. doi: 10.16766/j.cnki.issn.1674-4152.003378
Citation: MA Xiaotuan, SHEN Qingwen, WANG Lingling. Analysis of clinical efficacy of photodynamic and carbon dioxide laser in the treatment of vaginal intraepithelial neoplasia[J]. Chinese Journal of General Practice, 2024, 22(2): 257-260. doi: 10.16766/j.cnki.issn.1674-4152.003378
shu

Analysis of clinical efficacy of photodynamic and carbon dioxide laser in the treatment of vaginal intraepithelial neoplasia

doi: 10.16766/j.cnki.issn.1674-4152.003378

  • Department of Obstetrics and Gynecology, the First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui 233004, China

Funds:

 KJ2021A0754

  • Received Date: 2023-09-06
    Available Online: 2024-03-27
    Abstract
  •   Objective  To retrospectively analyze the clinical characteristics of vaginal intraepithelial neoplasia (VaIN), and to evaluate the clinical effect of 5-aminolevulinic acid-based photodynamic therapy (ALA-PDT) in the treatment of VaIN.  Methods  The clinical data of 136 patients diagnosed with VaIN by colposcopic biopsy who underwent ALA-PDT at the First Affiliated Hospital of Bengbu Medical College from January 2019 to April 2022 were selected, and the clinical data of 65 patients who underwent CO2 laser therapy were selected. HPV and TCT were regularly checked in all patients. At the same time, colposcopic biopsy was performed to retrospectively analyze the clinical characteristics of VaIN, explore the clinical efficacy of ALA-PDT treatment of VaIN, and compare with CO2 laser treatment.  Results  A 12-month follow-up was performed after the end of treatment. At the last follow-up, 85 cases (69.1%) in the ALA-PDT group and 32 cases (51.6%) in the CO2 laser group achieved complete HPV clearance. The HPV clearance rate was compared between the two groups, and the difference was statistically significant (P < 0.05). During the follow-up, 112 patients (82.4%) in the ALA-PDT group had complete clearance the lesions, 5 patients (3.7%) had persistent disease, 12 patients (8.8%) had partial remission, 3 patients (2.2%) had progression, and 4 patients (2.9%) had recurrence. In the CO2 laser group, 42 cases (64.6%) had complete remission, 3 cases (4.6%) persisted, 8 cases (12.3%)had partial remission, 2 cases (3.1%) progressed, and 10 cases (15.4%) recurred. The overall complete remission rate of lesions in ALA-PDT group was higher than that in the CO2 laser group, the difference was statistically significant (P < 0.05), and the recurrence rate in the ALA-PDT group was lower than that in the CO2 laser group, the difference was statistically significant (P < 0.05). There were 6 cases (4.4%) of adverse reactions in the ALA-PDT group and 9 cases (13.8%) in the CO2 laser group. The incidence of adverse reactions was lower in the ALA-PDT group than in the CO2 laser group, and the difference was statistically significant (P < 0.05).  Conclusion  ALA-PDT treatment of VaIN lesions has a higher complete remission rate, can effectively eradicate HPV infection, has fewer side effects, low recurrence rate, and merits further clinical promotion.

     

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    • References(21)
  • [1]
    DONG H, LI H Y, WANG L M, et al. Clinical analysis of 175 cases of vaginal intraepithelial neoplasia[J]. Eur J Obstet Gynecol Reprod Biol, 2023, 287: 232-236. doi: 10.1016/j.ejogrb.2023.06.020
    [2]
    王亚飞, 王立群, 叶国柳. 阴道上皮内瘤变的临床特征及治疗和预后分析[J]. 中华全科医学, 2023, 21(7): 1134-1137, 1237. doi: 10.16766/j.cnki.issn.1674-4152.003067

    WANG Y F, WANG L Q, YE G L. Clinical features, treatment and prognosis of vaginal intraepithelial neoplasia[J]. Chinese Journal of General Practice, 2023, 21(7): 1134-1137, 1237. doi: 10.16766/j.cnki.issn.1674-4152.003067
    [3]
    楼伟珍, 陈飞, 杨旎, 等. 光动力疗法在女性下生殖道疾病中的临床应用[J]. 中国实用妇科与产科杂志, 2018, 34(11): 1300-1304. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGSF201811031.htm

    LOU W Z, CHEN F, YANG N, et al. Photodynamic therapy in the female genital tract diseases under the clinical application[J]. Chinese Journal of Practical Gynecology and Obstetrics, 2018, 34(11): 1300-1304. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGSF201811031.htm
    [4]
    QU Z Y, WANG Z F, QIU S K, et al. Efficacy of photodynamic therapy with 5-aminolevulinic acid for the treatment of cervical high-grade squamous intraepithelial lesions with high-risk HPV infection: a retrospective study[J]. Photodiagnosis Photodyn Ther, 2022, 40: 103068. DOI: 10.1016/j.pdpdt.2022.103068.
    [5]
    IACOBONE A D, RADICE D, GUERRIERI M E, et al. Which Risk factors and colposcopic patterns are predictive for high-grade VAIN? A retrospective analysis[J]. Diagnostics(Basel), 2023, 13(2): 176.
    [6]
    ROUNTIS A, PERGIALIOTIS V, TSETSA P, et al. Management options for vaginal intraepithelial neoplasia[J]. Int J Clin Pract, 2020, 74(11): e13598. DOI: 10.1111/ijcp.13598.
    [7]
    YU D K, QU P P, LIU M H. Clinical presentation, treatment, and outcomes associated with vaginal intraepithelial neoplasia: a retrospective study of 118 patients[J]. J Obstet Gynaecol Res, 2021, 47(5): 1624-1630. doi: 10.1111/jog.14733
    [8]
    林艳华, 谢芳, 黄梅秀, 等. 阴道上皮内瘤变的回顾性分析[J]. 中国医药指南, 2021, 19(35): 46-48. https://www.cnki.com.cn/Article/CJFDTOTAL-YYXK202135017.htm

    LIN Y H, XIE F, HUANG M X, et al. Clinical analysis of vaginal intraepithelial neoplasia[J]. Guide of China Medicine, 2021, 19(35): 46-48. https://www.cnki.com.cn/Article/CJFDTOTAL-YYXK202135017.htm
    [9]
    AO M Y, ZHENG D X, WANG J W, et al. A retrospective study of cytology and HPV genotypes results of 3229 vaginal intraepithelial neoplasia patients[J]. J Med Virol, 2022, 94(10): 737-744.
    [10]
    ZHANG S, SAITO M, OKAYAMA K, et al. HPV Genotyping by molecular mapping of tissue samples in Vaginal Squamous Intraepithelial Neoplasia (VaIN) and Vaginal Squamous Cell Carcinoma (VaSCC)[J]. Cancers(Basel), 2021, 13(13): 3260.
    [11]
    GURUMURTHY M, LEESON S, TIDY J, et al. UK national survey of the management of vaginal intraepithelial neoplasia[N]. J Obstet Gynaecol, 2020, 40(5): 694-698. doi: 10.1080/01443615.2019.1652887
    [12]
    ZHANG Y Y, XIA R, CHEN D, et al. Analysis of related factors of cervical intraepithelial neoplasia complicated with vaginal intraepithelial neoplasia[J]. Clin Transl Oncol, 2022, 24(5): 902-908. doi: 10.1007/s12094-021-02739-x
    [13]
    徐晶, 屈清华, 刘宝, 等. 不同方法治疗阴道上皮内瘤变Ⅱ级合并高危HPV感染的临床疗效分析[J]. 中国病原生物学杂志, 2021, 16(12): 1470-1473. https://www.cnki.com.cn/Article/CJFDTOTAL-ZISC202112023.htm

    XU J, QU Q H, LIU B, et al. Analysis of the clinical effectiveness of different methods of treating gradeⅡvaginal intraepithelial neoplasia and a high-risk HPV infection[J]. Journal of Pathogen Biology, 2021, 16(12): 1470-1473. https://www.cnki.com.cn/Article/CJFDTOTAL-ZISC202112023.htm
    [14]
    蔡卉苒, 邢燕. 全子宫切除术后阴道残端上皮内瘤变临床诊治进展[J]. 临床误诊误治, 2022, 35(1): 112-116. https://www.cnki.com.cn/Article/CJFDTOTAL-LCWZ202201025.htm

    CAI H R, XING Y. Progress in the clinical diagnosis and treatment of intraepithelial neoplasia of vaginal stump after total hysterectomy[J]. Clinical Misdiagnosis & Mistherapy, 2022, 35(1): 112-116. https://www.cnki.com.cn/Article/CJFDTOTAL-LCWZ202201025.htm
    [15]
    孔东丽, 李双. 二氧化碳激光气化治疗下生殖道高级别鳞状上皮内病变的要点难点[J]. 实用妇产科杂志, 2021, 37(12): 892-894. https://www.cnki.com.cn/Article/CJFDTOTAL-SFCZ202112005.htm

    KONG D L, LI S. Key points and difficulties of carbon dioxide laser gasification in the treatment of high-grade squamous intraepithelial lesions of lower genital tract[J]. Journal of Practical Obstetrics and Gynecology, 2021, 37(12): 892-894. https://www.cnki.com.cn/Article/CJFDTOTAL-SFCZ202112005.htm
    [16]
    LIU T, MA X R, OUYANG T X, et al. Efficacy of 5-aminolevulinic acid-based photodynamic therapy against keloid compromised by downregulation of SIRT1-SIRT3-SOD2-mROS dependent autophagy pathway[J]. Redox Biol, 2019, 20: 195-203. doi: 10.1016/j.redox.2018.10.011
    [17]
    ZHANG Y C, SU Y H, TANG Y J, et al. Comparative study of topical 5-aminolevulinic acid photodynamic therapy (5-ALA-PDT) and surgery for the treatment of high-grade vaginal intraepithelial neoplasia[J]. Photodiagnosis Photodyn Ther, 2022, 39: 102958. DOI: 10.1016/j.pdpdt.2022.102958.
    [18]
    HE M Y, YU E L, HUI S K, et al. Clinical outcomes of laser vaporization for vaginal intraepithelial neoplasia: a 20-year retrospective review[J]. Eur J Obstet Gynecol Reprod Biol, 2022, 277: 101-109. doi: 10.1016/j.ejogrb.2022.08.017
    [19]
    YAO H X, ZHANG H Y, PU X W, et al. Photodynamic therapy combined with carbon dioxide laser for low-grade vaginal intraepithelial neoplasia: a retrospective analys[J]. Photodiagnosis Photodyn Ther, 2020, 30: 101731. DOI: 10.1016/j.pdpdt.2020.101731.
    [20]
    杨光, 吴寒舒, 朱颐, 等. 氨基酮戊酸光动力治疗阴道上皮内瘤变的价值初探[J]. 中国临床保健杂志, 2022, 25(5): 692-695. https://www.cnki.com.cn/Article/CJFDTOTAL-LZBJ202205026.htm

    YANG G, WU H S, ZHU Y, et al. Preliminary study on the value of aminolevulinic acid photodynamic therapy for vaginal intraepithelial neoplasia[J]. Chinese Journal of Clinical Healthcare, 2022, 25(5): 692-695. https://www.cnki.com.cn/Article/CJFDTOTAL-LZBJ202205026.htm
    [21]
    王阳阳, 张云凤, 牟婧祎, 等. 二氧化碳激光与光动力治疗阴道上皮内瘤变患者的临床疗效对比分析[J]. 实用妇产科杂志, 2022, 38(7): 520-524. https://www.cnki.com.cn/Article/CJFDTOTAL-SFCZ202207012.htm

    WANG Y Y, ZHANG Y F, MOU J Y, et al. Comparative analysis of efficacy of carbon dioxide laser and photodynamic therapy for vaginal intraepithelial neoplasia[J]. Journal of Practical Obstetrics and Gynecology, 2022, 38(7): 520-524. https://www.cnki.com.cn/Article/CJFDTOTAL-SFCZ202207012.htm
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