环形电外科切除术（LEEP）是宫颈上皮内瘤变（CIN）的常见治疗方法。由 5-氨基乙酰丙酸 (ALA) 介导的光动力疗法 (PDT) 是一种非侵入性疗法，已用于治疗癌前疾病和 HPV 感染。本对比研究评估了 ALA PDT 和 LEEP 治疗宫颈高级鳞状上皮内病变 (HSIL) 的疗效和安全性。审查患者记录，选择接受 PDT 或 LEEP 治疗的 HPV 感染的 HSIL 患者（24-51 岁）。根据治疗后 6 个月获得的 HPV-DNA、细胞学和阴道镜活检进行盲目分析疗效。还分析了与治疗相关的不适和副作用。 PDT 组和 LEEP 组的治愈率分别为 88.1% 和 70.0% (p < 0.05)。 PDT 组和 LEEP 组的 HPV 阴性转化率分别为 81.0% 和 62.0% (p < 0.05)。 PDT组的总体病灶缓解率比LEEP组高19%。 PDT 组的副作用发生率要低得多。这些结果表明ALA PDT是一种可行的非侵入性治疗宫颈HSIL的方法。

The loop electrosurgical excision procedure (LEEP) is a common treatment for cervical intraepithelial neoplasia (CIN). Photodynamic therapy (PDT) mediated by 5-aminolevulinic acid (ALA) is a non-invasive modality that has been used for treating precancerous diseases and HPV infections. This comparative study evaluated the efficacy and safety of ALA PDT and the LEEP in the treatment of cervical high-grade squamous intraepithelial lesions (HSILs). Patient records were reviewed and HSIL patients with HPV infections (24-51 years old) who underwent PDT or LEEP treatment were selected. Efficacy was analyzed blindly based on HPV-DNA, cytology, and colposcopy-directed biopsy obtained at 6 months after treatment. Treatment-related discomfort and side effects were also analyzed. Cure rates of 88.1% and 70.0% were achieved for the PDT group and LEEP group (p < 0.05), respectively. HPV-negative conversion rates of 81.0% and 62.0% were achieved for the PDT group and LEEP group (p < 0.05), respectively. The overall lesion remission rate of the PDT group was 19% higher than that of the LEEP group. The incidence of side effects was much lower in the PDT group. These results show that ALA PDT is a feasible non-invasive treatment for cervical HSIL.