Department of Gynecology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China.
Department of Gynecology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Linping Campus, Hangzhou 311100, China.
Photodiagnosis Photodyn Ther. 2022 Jun;38:102807. doi: 10.1016/j.pdpdt.2022.102807. Epub 2022 Mar 11.
The treatment options for low-grade squamous intraepithelial neoplasia (LSIL) of the cervix with high-risk HPV infection have not been standardized. Studies show that photodynamic therapy (PDT) mediated by 5-aminolevulinic acid (ALA-PDT) might be effective. In this retrospective study, the clinical efficacy and safety of ALA-PDT in the treatment of LSIL were evaluated.
ALA-PDT was performed in 55 LSIL patients aged 21-45 years who also showed high-risk HPV infection and cervical ectropion. HPV test, cytology, colposcopy and pathology were examined before and after treatment. Meanwhile, PDT-related symptoms and adverse reactions were also reviewed.
At 6-month follow-up after PDT, except for 5 patients who showed the persistence of LSIL lesions, the pathological regression ratio of 90.1% (50/55) was achieved. No HPV-DNA was detected in exfoliated cervical cells in 81.8% (45/55) patients. Among them, the HPV clearance ratio of I Degree cervical ectropion was 96.2%, significantly higher than that of II Degree (70.8%) and III Degree (60%). Significant shrunk of cervical ectropion and reduction of vaginal secretions after PDT were seen in 78.0% patients.
ALA-PDT is a safe and effective therapeutic option for patients of reproductive age who suffer from LSIL with high-risk HPV infection and cervical ectropion.
高危型 HPV 感染所致低级别鳞状上皮内病变（LSIL）的治疗选择尚未标准化。研究表明，5-氨基酮戊酸（ALA）介导的光动力疗法（ALA-PDT）可能有效。在这项回顾性研究中，评估了 ALA-PDT 治疗 LSIL 的临床疗效和安全性。
对 55 例年龄在 21-45 岁之间、高危 HPV 感染和宫颈外翻的 LSIL 患者进行 ALA-PDT。治疗前后检查 HPV 检测、细胞学、阴道镜和病理学。同时，回顾 PDT 相关症状和不良反应。
在 PDT 后 6 个月随访时，除 5 例 LSIL 病变持续存在外，90.1%（50/55）的病理缓解率。55 例患者中有 81.8%（45/55）的宫颈脱落细胞中未检测到 HPV-DNA。其中，宫颈外翻 I 度的 HPV 清除率为 96.2%，明显高于 II 度（70.8%）和 III 度（60%）。78.0%的患者在 PDT 后宫颈外翻明显缩小，阴道分泌物减少。
ALA-PDT 是一种安全有效的治疗选择，适用于患有高危型 HPV 感染和宫颈外翻的育龄妇女 LSIL。
