Value-based medicine analysis on loop electrosurgical excision procedure and CO2 laser vaporization for the treatment of cervical intraepithelial neoplasia 2
单位:[1]Chinese Acad Med Sci, Peking Union Med College, Peking Union Med Coll Hosp, Dept Obstet & Gynecol, Beijing 100730, Peoples R China[2]Peking Univ, China Japan Friendship Hosp, Dept Obstet & Gynecol, Beijing 100871, Peoples R China[3]Peking Univ, Peoples Hosp, Dept Obstet & Gynecol, Beijing 100871, Peoples R China
Aim: The best treatment option for cervical intraepithelial neoplasia 2 (CIN2) is controversial and there is a lack of studies in value-based medicine. This multicenter comparative study was undertaken to evaluate the effectiveness, cost-effectives and quality of life (QOL) of loop electrosurgical excision procedure (LEEP) and CO2 laser vaporization for the treatment of CIN2. Material and Methods: A database of LEEP and laser vaporizations performed at three research centers was created. Patients with colposcopic-histopathologically confirmed CIN2 were randomly submitted to LEEP and laser vaporization. Cytology, human papilloma virus (HPV) DNA test and histology were performed, and a questionnaire on QOL was filled out during follow-up. Effectiveness, cost-effectives and QOL were analyzed. Results: Three hundred and thirty-eight women with CIN2 were included in the study. Frequencies of remission, and persistent and recurrent CIN were 89.2%, 7.2%, and 3.6% for LEEP, and 86.7%, 12.6%, 0.70% for laser, respectively. There was no significant difference in remission and persistence of CIN. There was a significant difference in the number of operations, recovery time and costs. Women treated with two methods showed relatively identical QOL. Conclusion: Both LEEP and CO2 laser vaporization are effective and reliable treatments for CIN2, whereas cervical tissue can be obtained for histology by LEEP. Preoperative evaluation and postoperative follow-up are important. Gynecologists should pay attention to QOL of patients with CIN.
基金:
Technology Project Program of Beijing [D0906008040391]
第一作者单位:[1]Chinese Acad Med Sci, Peking Union Med College, Peking Union Med Coll Hosp, Dept Obstet & Gynecol, Beijing 100730, Peoples R China
通讯作者:
推荐引用方式(GB/T 7714):
Sun Lu-lu,Cao Dong-yan,Yang Jia-xin,et al.Value-based medicine analysis on loop electrosurgical excision procedure and CO2 laser vaporization for the treatment of cervical intraepithelial neoplasia 2[J].JOURNAL of OBSTETRICS and GYNAECOLOGY RESEARCH.2012,38(8):1064-1070.doi:10.1111/j.1447-0756.2011.01832.x.
APA:
Sun, Lu-lu,Cao, Dong-yan,Yang, Jia-xin,Bian, Mei-lu,Wei, Li-hui&Shen, Keng.(2012).Value-based medicine analysis on loop electrosurgical excision procedure and CO2 laser vaporization for the treatment of cervical intraepithelial neoplasia 2.JOURNAL of OBSTETRICS and GYNAECOLOGY RESEARCH,38,(8)
MLA:
Sun, Lu-lu,et al."Value-based medicine analysis on loop electrosurgical excision procedure and CO2 laser vaporization for the treatment of cervical intraepithelial neoplasia 2".JOURNAL of OBSTETRICS and GYNAECOLOGY RESEARCH 38..8(2012):1064-1070