de Castro Cynthia Aparecida, Lombardi Welington, Stringasci Mirian Denise, Bagnato Vanderlei Salvador, Inada Natalia Mayumi
Sao Carlos Institute of Physics, University of Sao Paulo, Brazil; Department of Morphology and Pathology, Federal University of Sao Carlos, Brazil.
Woman Health Ambulatory, UNIARA, Brazil.
Photodiagnosis Photodyn Ther. 2020 Sep;31:101937. doi: 10.1016/j.pdpdt.2020.101937. Epub 2020 Jul 30.
High-grade cervical intraepithelial neoplasia (CIN) is the precursor to cervical cancer. HPV (human papillomavirus) infection is strongly related with this disease. The CIN treatment is generally excision of the transformation zone (ETZ). Photodynamic therapy (PDT) has also shown to be a promising treatment. We are reporting a case of a 33-years-old patient with high-grade CIN 3 treated with topical MAL (methyl aminolevulinate) PDT. Was applied 2.5 g of 20 % (w/w) MAL cream overnight and the cervix was illuminated twice, with three weeks apart, using a probe with LEDs simultaneously with a cylindrical laser fiber emitting both at 630 nm, with a fluency of 150 J/cm. CIN 3 and the presence of high-risk HPV virus was eliminated 120 days after the second procedure. There was no recurrence at 6 months follow-up. This case report using MAL-PDT and a different light arrangement with LEDs and laser fiber associated both cured the patient with CIN 3 and eliminated low and high-risk HPV in just two PDT sessions.
高级别宫颈上皮内瘤变（CIN）是宫颈癌的前驱病变。人乳头瘤病毒（HPV）感染与该疾病密切相关。CIN的治疗通常是切除转化区（ETZ）。光动力疗法（PDT）也已显示出是一种有前景的治疗方法。我们报告一例33岁高级别CIN 3患者，采用局部应用甲基氨基乙酰丙酸（MAL）光动力疗法进行治疗。将2.5 g 20%（w/w）的MAL乳膏过夜涂抹，使用带有发光二极管（LED）的探头和一根同时发射630 nm光的圆柱形激光光纤，相隔三周对宫颈进行两次照射，通量为150 J/cm²。第二次治疗后120天，CIN 3及高危HPV病毒均被清除。6个月随访时无复发。本病例报告采用MAL光动力疗法以及一种使用LED和激光光纤的不同光照配置，仅通过两次光动力治疗就治愈了CIN 3患者，并清除了低危和高危HPV。
