Abstract:

Objective To evaluate the efficacy and incidence of adverse events of photodynamic therapy and loop electrosurgical excision procedure (LEEP) in the treatment of grade 2 cervical intraepithelial neoplasia (CIN2). Methods Forty CIN2 patients were divided into the photodynamic group (20 cases) and LEEP group (20 cases) according to different treatment options. Follow ups were conducted at 3, 6 and 12 months after treatment. High-risk HPV virus (HR-HPV), vaginal microbiota, colposcopy examination and cervical biopsy results were compared between the two groups. Adverse events were recorded. Results There was no significant difference in the composition of lesion reversal, residual lesions and progression after 3 months of treatment between the two groups of patients. After 6 months of treatment, one case relapsed in the photodynamic group, and 12 months after treatment one case relapsed in the LEEP group. Both cases of cervical biopsy pathology were CIN1 grade. There were no significant differences in the conversion rate of HR-HPV and the proportion of normal vaginal microbiota between the two groups of patients at 3, 6, and 12 months after treatment. The proportion of normal vaginal microbiota in the photodynamic group increased sequentially at 12 months after treatment compared to 3 and 6 months after treatment. During the photodynamic treatment, the pain was tolerable in the photodynamic group, while in the LEEP group, the pain was obviously accompanied by bleeding. After treatment, patients in both groups had increased vaginal discharge and lower abdominal pain, but in the LEEP group, local cervical scars formed and one case experienced vaginal bleeding. Conclusion Photodynamic therapy is effective on treating CIN2, with a high negative conversion rate of HR-HPV and almost no damage to the cervix, especially suitable for patients with fertility requirements.

Key words: cervical intraepithelial neoplasia, photodynamic therapy, cervical circular electrocautery