用甲基氨基乙酰丙酸和六氨基乙酰丙酸对宫颈上皮内瘤变1 - 3级及人乳头瘤病毒（HMV）感染进行光动力治疗——一项双盲剂量探索性研究。
Photodynamic therapy of cervical intraepithelial neoplasia 1-3 and human papilloma virus (HMV) infection with methylaminolevulinate and hexaminolevulinate--a double-blind, dose-finding study.
作者信息
Soergel Philipp, Dahl Gunn Fallås, Onsrud Mathias, Hillemanns Peter
机构信息
Department of Obstetrics and Gynaecology, Hannover Medical School, Hannover, Germany.
出版信息
Lasers Surg Med. 2012 Aug;44(6):468-74. doi: 10.1002/lsm.22041. Epub 2012 Jun 12.
INTRODUCTION
Cervical intraepithelial neoplasia (CIN) 1-3 is the precursor of invasive cervical cancer and associated with human papillomavirus infection. Standard treatment is surgical and may be associated with subsequent pregnancy complications. Photodynamic therapy (PDT) of CIN may be an interesting alternative.
MATERIAL AND METHODS
Patients were treated by PDT using hexaminolevulinate (HAL) and methylaminolevulinate in six dose and light groups and two incubation periods in a double-blind setting. Follow-up examinations were performed after 3, 6, and 12 months with histology, cytology, and HPV testing.
RESULTS
We included eight patients with CIN1, 23 with CIN2, and 36 with CIN3. Treatment was well tolerated. HAL 40 mM with 3-hour application turned out to be the most-effective group with 67% (10/15) complete response rate. The combined complete and partial response for patients with CIN2 was 83% (20/24).
CONCLUSION
PDT with CIN may be a safe and effective procedure for CIN treatment.
引言
宫颈上皮内瘤变（CIN）1 - 3级是浸润性宫颈癌的前驱病变，与人乳头瘤病毒感染相关。标准治疗方法是手术治疗，且可能会引发后续妊娠并发症。CIN的光动力疗法（PDT）可能是一种值得关注的替代疗法。
材料与方法
在双盲环境下，患者采用六氨基乙酰丙酸（HAL）和甲基氨基乙酰丙酸进行光动力治疗，分为六个剂量组、光组以及两个孵育期。在3个月、6个月和12个月后进行随访检查，包括组织学、细胞学和人乳头瘤病毒检测。
结果
我们纳入了8例CIN1级患者、23例CIN2级患者和36例CIN3级患者。治疗耐受性良好。应用3小时的40 mM HAL组疗效最佳，完全缓解率为67%（10/15）。CIN2级患者的完全缓解和部分缓解合并率为83%（20/24）。
结论
光动力疗法治疗CIN可能是一种安全有效的治疗方法。
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