Department of Dermatology and Venereology, Shanghai Skin Diseases Hospital, Shanghai, China.
Photochem Photobiol. 2012 May-Jun;88(3):565-9. doi: 10.1111/j.1751-1097.2011.01060.x. Epub 2012 Jan 10.
The aim of this study was to investigate the efficacy of 5-aminolaevulinic acid (ALA)-mediated photodynamic therapy (PDT) in treatment of human papillomavirus (HPV)-associated cervical condylomata. A total of 56 patients with cervical and external condylomata lesions were recruited for this open-label study. HPV genotyping of exfoliated cells collected from the cervix and external lesions was performed. Cervical lesions were treated with PDT by applying ALA gel (10%) to the surface of the cervix for 4 h followed by irradiating with a 635 nm laser at 100 J cm(-2). PDT was repeated at 2-week intervals if lesion and HPV infection remained. Patients were followed up for 6-24 months. Genotyping analysis revealed four HPV subtypes (HPV6, 11, 16 and 18). The overall complete remission rate of 1-4 sessions of treatments was 98.2% and the corresponding HPV clearance rate was 83.9%. Ten cases showed complete removal of cervical lesions and HPV infection after a single treatment. Recurrence rate was 3.6%. Adverse effects were minimal and no structural complications were reported. In conclusion, topical ALA PDT is safe and effective for eradicating cervical HPV infection and eliminating condylomata lesion. Its definitive role in treating cervical condylomata deserves further investigation.
本研究旨在探讨 5-氨基酮戊酸(ALA)介导的光动力疗法(PDT)治疗人乳头瘤病毒(HPV)相关宫颈尖锐湿疣的疗效。共招募了 56 例宫颈和外阴尖锐湿疣患者进行这项开放性研究。对从宫颈和外阴病变处采集的脱落细胞进行 HPV 基因分型。将 ALA 凝胶(10%)涂于宫颈表面 4 小时,然后用 635nm 激光以 100J/cm²的剂量照射,对宫颈病变进行 PDT 治疗。如果病变和 HPV 感染仍然存在,则每 2 周重复进行 PDT 治疗。对患者进行 6-24 个月的随访。基因分型分析显示有四种 HPV 亚型(HPV6、11、16 和 18)。1-4 次治疗的总完全缓解率为 98.2%,相应的 HPV 清除率为 83.9%。10 例患者单次治疗后宫颈病变和 HPV 感染完全消除。复发率为 3.6%。不良反应轻微,无结构并发症报告。总之,局部 ALA-PDT 安全有效,可根除宫颈 HPV 感染,消除尖锐湿疣病变。其在治疗宫颈尖锐湿疣中的明确作用值得进一步研究。