A comparative study of treatment of persistent cervical low-grade squamous intraepithelial lesions with HPV16/18 infection.

OBJECTIVE: Current treatment options for persistent cervical low-grade squamous intraepithelial lesion (LSIL) with HPV16/18 infection have certain limitations. This study aims to evaluate the efficacy of 5-aminolevulinic acid photodynamic therapy (ALA-PDT) in these patients. METHODS: A retrospective analysis was conducted on 304 outpatients with persistent cervical LSIL with HPV16/18 infection in our hospital from January 2023 to December 2024. Based on the treatment received, patients were divided into three groups: ALA-PDT group, loop electrosurgical excision procedure (LEEP) group, and observation group. After diagnosis and corresponding treatment, patients were followed up for one year. The LSIL regression rates, HPV16/18 clearance rates, and adverse effects were compared among the three groups. RESULTS: The ALA-PDT, LEEP, and observation groups respectively enrolled 90, 42, and 172 patients. The cervical LSIL regression rates in the ALA-PDT, LEEP, and observation groups were 85.56%, 90.48%, and 56.98%, respectively. The difference between the ALA-PDT and LEEP groups was not statistically significant, but both were significantly superior to the observation group. The HPV clearance rates in the ALA-PDT, LEEP, and observation groups were 84.44%, 78.57%, and 44.19%, respectively. Similarly, the difference between the ALA-PDT and LEEP groups was not statistically significant, but both were significantly higher than the observation group. Adverse effects in the ALA-PDT group were mild. The incidence of postoperative cervical stenosis or adhesion in the LEEP group was 21.43%. CONCLUSION: ALA-PDT appears to be an effective and safe treatment option for patients with persistent cervical LSIL with HPV16/18 infection, and is particularly significant for young women who wish to preserve fertility.