Rational of topical photodynamic therapy (PDT) with 5-aminolevulinic acid (5-ALA) for treatment of endocervical canal low-grade squamous intraepithelial lesion with high-risk human papillomavirus infection

IF 2.2 3区医学 Q2 DERMATOLOGY

Lasers in Surgery and Medicine Pub Date : 2023-09-26 DOI:10.1002/lsm.23727

Lin-Jing Yuan MD, Ke He MD, Cai-Xia Zhu MD, Tie-Feng Cao MD, Mian He MD

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Abstract

Background

The detection and continuous monitoring of low-grade squamous intraepithelial lesions (LSIL) within the endocervical canal pose considerable challenges, and the effectiveness of ablation treatment is also constrained. In this context, the potential efficacy of 5-aminolevulinic acid photodynamic therapy (5-ALA PDT) in targeting these concealed lesions merits exploration. The present study undertakes a comprehensive analysis of the clinical effectiveness and safety aspects associated with the utilization of 5-ALA PDT.

Methods

A retrospective analysis was conducted on a cohort of 13 patients who were diagnosed with LSIL within the endocervical canal, concomitant with high-risk human papillomavirus (hrHPV) infection. These patients were subjected to treatment with 5-ALA PDT and subsequently monitored over a period of 3−6 months following the intervention.

Results

The study cohort comprised 13 patients, among whom 4 presented with isolated lesions within the endocervical canal, 5 exhibited LSIL involving both the endocervical canal and the cervix vaginal portion, 3 displayed LSIL within the endocervical canal in conjunction with vaginal involvement, and 1 patient demonstrated lesions across all three of these anatomical sites. All identified lesions underwent therapeutic intervention via 5-ALA PDT. Before treatment initiation, 9 patients returned positive results in the liquid-based cytologic test (LBC), 4 displayed concurrent multiple hrHPV infections, and 5 manifested infections specifically with HPV 16/18. Subsequent to the application of 5-ALA PDT, regression was observed in the LBC results of all patients, with only 3 individuals retaining a singular type of hrHPV infection. Adverse reactions following treatment encompassed mild aberrant vaginal secretions and mild to moderately pronounced distending abdominal discomfort, all of which were remitted within a span of 7 days.

Conclusions

Within the context of LSIL within the endocervical canal in association with hrHPV infection, the findings affirm the efficacy and safety of 5-ALA PDT as a viable therapeutic modality.

查看原文本刊更多论文

5-氨基乙酰丙酸（5-ALA）局部光动力疗法（PDT）治疗宫颈管低级别鳞状上皮内病变伴高危人乳头瘤病毒感染的合理性。

背景：宫颈管内低度鳞状上皮内病变（LSIL）的检测和持续监测带来了相当大的挑战，消融治疗的有效性也受到限制。在这种情况下，5-氨基乙酰丙酸光动力疗法（5-ALA PDT）针对这些隐蔽性病变的潜在疗效值得探索。本研究对5-ALA PDT的临床有效性和安全性进行了全面分析。方法：对13名被诊断为宫颈管内LSIL并伴有高危型人乳头瘤病毒（hrHPV）感染的患者进行回顾性分析。这些患者接受5-ALA PDT治疗，随后在干预后3-6个月内进行监测。结果：研究队列包括13名患者，其中4名患者出现宫颈管内孤立性病变，5名患者同时出现宫颈管和宫颈阴道部分的LSIL，3名患者在宫颈管内出现LSIL并伴有阴道受累，1名患者在所有三个解剖部位都出现病变。所有确定的病变均通过5-ALA PDT进行治疗干预。在开始治疗之前，9名患者的液体细胞学检查（LBC）结果呈阳性，4名患者同时表现为多发性hrHPV感染，5名患者表现为HPV 16/18特异性感染。应用5-ALA PDT后，在所有患者的LBC结果中观察到回归，只有3人保留了单一类型的hrHPV感染。治疗后的不良反应包括轻度异常阴道分泌物和轻度至中度明显的腹胀不适，所有这些都在7天内缓解。结论：在宫颈管内LSIL与hrHPV感染相关的背景下，研究结果证实了5-ALA PDT作为一种可行的治疗方式的有效性和安全性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Lasers in Surgery and Medicine 医学-外科

CiteScore

5.40

自引率

12.50%

发文量

119

审稿时长

1 months

期刊介绍： Lasers in Surgery and Medicine publishes the highest quality research and clinical manuscripts in areas relating to the use of lasers in medicine and biology. The journal publishes basic and clinical studies on the therapeutic and diagnostic use of lasers in all the surgical and medical specialties. Contributions regarding clinical trials, new therapeutic techniques or instrumentation, laser biophysics and bioengineering, photobiology and photochemistry, outcomes research, cost-effectiveness, and other aspects of biomedicine are welcome. Using a process of rigorous yet rapid review of submitted manuscripts, findings of high scientific and medical interest are published with a minimum delay.

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