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一项采用磨蚀术联合基于5-氨基酮戊酸的光动力疗法治疗鳞状细胞癌的临床试验。

A Clinical Trial Using Attrition Combined with 5-Aminolevulinic Acids Based Photodynamic Therapy in Treating Squamous Cell Carcinoma.

作者信息

Peng Jianzhong, Feng Weiguo, Luo Xianyan, Wang Tao, Xiang Wenzhong, Dai Yeqin, Zhu Jingyu, Zheng Junhui

机构信息

Department of Dermatology, Hangzhou Third People's Hospital, Hangzhou, Zhejiang, China (mainland).

Department of Urology, Hangzhou Third People's Hospital, Hangzhou, Zhejiang, China (mainland).

出版信息

Med Sci Monit. 2017 Mar 18;23:1347-1354. doi: 10.12659/msm.900420.

Abstract

BACKGROUND Squamous cell carcinoma (SCC) is the second most common type of skin cancer, for which non- or mini-invasive treatment is of critical importance. 5-aminolevulinic acids based photodynamic therapy (ALA-PDT) is a mini-invasive approach that causes focal tumor cell injury, apoptosis, and necrosis through light sensitivity. The efficacy of combining ALA-PDT and surgery in treating SCC, however, has not been demonstrated. MATERIAL AND METHODS A total of 60 SCC patients were randomly assigned into attrition plus ALA-PDT group (experimental group) and single ALA-PDT treatment group (control group). Clinical efficacy, recurrence rate, and adverse effects were analyzed in conjunction with H&E staining and immunohistochemistry (IHC) staining for p53 expression. RESULTS The overall effective rate of the experimental group was 73.3%, which was significantly higher than that of the control group (46.7%). The experimental group also had a lower recurrence rate (16.6% versus 30.0%, p<0.05). Similar rates of adverse effects existed between the two groups. After treatment, abnormal cells disappeared, while the p53 positive rate after treatment was elevated in the two groups (p<0.05 comparison of before and after treatment). The experimental group had a higher p53 positive rate compared to the control group (p<0.05). CONCLUSIONS Combined therapy of attrition with ALA-PDT significantly elevated the effective treatment rate and can decrease the recurrence rate with reliable safety in treating SCC, thus ALA-PDT can be used as an optimal plan for SCC treatment.

摘要

背景 鳞状细胞癌(SCC)是第二常见的皮肤癌类型,对于其治疗而言,非侵入性或微创治疗至关重要。基于5-氨基酮戊酸的光动力疗法(ALA-PDT)是一种微创方法,可通过光敏感性导致局部肿瘤细胞损伤、凋亡和坏死。然而,ALA-PDT与手术联合治疗SCC的疗效尚未得到证实。 材料与方法 总共60例SCC患者被随机分为磨削加ALA-PDT组(实验组)和单纯ALA-PDT治疗组(对照组)。结合苏木精-伊红(H&E)染色和p53表达的免疫组织化学(IHC)染色分析临床疗效、复发率和不良反应。 结果 实验组的总有效率为73.3%,显著高于对照组(46.7%)。实验组的复发率也较低(分别为16.6%和30.0%,p<0.05)。两组间不良反应发生率相似。治疗后,异常细胞消失,两组治疗后的p53阳性率均升高(治疗前后比较,p<0.05)。实验组的p53阳性率高于对照组(p<0.05)。 结论 磨削与ALA-PDT联合治疗可显著提高SCC的有效治疗率,并能降低复发率,治疗安全性可靠,因此ALA-PDT可作为SCC治疗的最佳方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/af48/5367852/2f7307c3a0b1/medscimonit-23-1347-g001.jpg

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