光动力疗法对阴道上皮内瘤变1~2级患者预后的影响

Influence of photodynamic therapy on prognosisof patients with grade 1 or 2 of vaginal intraepithelial neoplasia

  • 摘要:
      目的  探讨光动力疗法治疗阴道上皮内瘤变(VAIN)1~2级患者的疗效。
      方法  选择18例VAIN患者,均采取光动力治疗。治疗结束后,所有患者均进行定期随访3个月~1年。记录患者妇科检查情况、液基薄层细胞检测(TCT)、人乳头瘤病毒(HPV)感染情况、阴道镜结果、疗效和预后情况。
      结果  治疗后,患者阴道镜结果好转。18例患者均完成定期随访,其中13例患者的随访都超过6个月,并且没有复发, 1年内妇科检查和HPV检查均转为正常。术后6个月复查, 13例患者的HPV均转为阴性, TCT显示正常; 5例HPV处于阳性的患者中, 3例TCT显示正常, 2例TCT显示阴道其他部位有局灶性VAIN1级(活检病理)。术后1年再次复查, 3例HPV阳性的患者都显示阴性, TCT都显示正常, 1例术后仍显示VAIN 1级的患者的局部病灶消失。18例患者术后阴道镜检查均转为正常。
      结论  光动力治疗VAIN有很明显的临床疗效,VAIN与HPV感染、宫颈上皮内瘤变感染及TCT异常相关。

     

    Abstract:
      Objective  To investigate the efficacy of photodynamic therapy in treating patients with grade 1 or 2 of vaginal intraepithelial neoplasia (VAIN).
      Methods  Eighteen patients with VAIN were treated with photodynamic therapy. After the treatment, all patients were followed up regularly for 3 months to 1 year. Gynecological examination results, liquid-based thin layer cell detection (TCT), human papillomavirus (HPV) infection, colposcopy results, efficacy and prognosis were recorded.
      Results  After treatment, the patients′colposcopy results improved. Eighteen patients completed regular follow-up, of which 13 patients were followed up for more than 6 months without recurrence. Within one year, gynecological examination and HPV examination became normal. Six months after operation, 13 patients had negative HPV and normal TCT results. Among 5 patients with positive HPV, 3 patients had normal TCT and 2 patients had focal grade 1 of VAIN in other parts of vagina (biopsy pathology). One year after operation, 3 HPV-positive patients had negative results, TCT results turned to normal, and 1 patient with grade 1 of VAIN showed local lesions disappeared. Postoperative colposcopy in 18 patients turned to normal.
      Conclusion  Photodynamic therapy is effective in treating patients with VAIN, and VAIN is associated with HPV infection, cervical intraepithelial neoplasia infection and abnormal TCT.

     

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