光动力治疗宫颈上皮内瘤变3级的疗效：一项回顾性研究

IF 2.6 3区医学 Q2 ONCOLOGY

Photodiagnosis and Photodynamic Therapy Pub Date : 2025-08-21 DOI:10.1016/j.pdpdt.2025.104773

Huihui Cai , Yu Liu , Yanci Che , Yanhui Lou , Huaqin Sun , Tingting Ma , Yankui Wang

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引用次数: 0

摘要

本研究旨在评估5-氨基乙酰丙酸光动力疗法（ALA-PDT）治疗后高级别鳞状上皮内病变（HSIL），也称为宫颈上皮内瘤变3 （CIN 3）的组织学反应率。方法回顾性分析2022年3月至2024年12月49例经ALA-PDT治疗的CIN 3型患者。患者接受ALA-PDT单独或联合环电手术切除程序（LEEP）或CO2激光治疗。临床结果，包括人乳头瘤病毒（HPV）状态、细胞学和组织学，在12个月的随访期间进行评估。结果44例完全随访患者中，ALA-PDT单药总有效率为85.19%(23/27)，联合治疗总有效率为88.24%(15/17)，总有效率为86.36%（38/44）。双阴性率（HPV和组织病理学均阴性）为100%。当按年龄组分层时，病理阴性结果（被认为是有效治疗反应）在20岁以下的患者中观察到100%，21-30岁的患者中观察到80%，31-40岁的患者中观察到93.7%，40岁以上的患者中观察到100%。不同颈椎转化区（TZ）总有效率TZ1为75% (18/24)，TZ2为100% (12/12)，TZ3为100%（8/8）。hpv16 /18阳性组HPV阴性转换率为82.35%(28/34)，非hpv16 /18组为80%(8/10)，多发高危HPV组为73.33%（11/15）。结论ala - pdt在HSIL/CIN 3患者中表现出良好的疗效和稳定性，为临床医生治疗这些宫颈病变提供了额外的选择。

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Efficacy of photodynamic therapy for cervical intraepithelial neoplasia grade 3: a retrospective study

Background

This study aimed to evaluate the histologic response rate of high-grade squamous intraepithelial lesion (HSIL), also referred to as cervical intraepithelial neoplasia 3 (CIN 3), following treatment with 5-aminolevulinic acid photodynamic therapy (ALA-PDT).

Method

A retrospective analysis was conducted on 49 patients diagnosed with CIN 3 and treated with ALA-PDT between March 2022 and December 2024. Patients received either ALA-PDT alone or in combination with the Loop Electrosurgical Excision Procedure (LEEP) or CO₂ laser therapy. Clinical outcomes, including human papillomavirus (HPV) status, cytology, and histology, were assessed over a 12-month follow-up period.

Results

Among the 44 patients with complete follow-up, the total response rate was 85.19% (23/27) for ALA-PDT alone and 88.24% (15/17) for combination therapy, yielding an overall response rate of 86.36% (38/44). The double-negative rate (negative for both HPV and histopathology) was 100%. When stratified by age group, pathology-negative outcomes—considered effective treatment responses—were observed in 100% of patients younger than 20, 80% of those aged 21–30, 93.7% in the 31–40 age group, and 100% in patients over 40. The total effective rates across different cervical transformation zones (TZ) were 75% (18/24) for TZ1, 100% (12/12) for TZ2, and 100% (8/8) for TZ3. Negative HPV conversion rates were 82.35% (28/34) in the HPV16/18-positive group, 80% (8/10) in the non-HPV16/18 group, and 73.33% (11/15) in the multiple high-risk HPV group.

Conclusion

ALA-PDT demonstrates favorable efficacy and stability in patients with HSIL/CIN 3, offering clinicians an additional option for managing these cervical lesions.

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来源期刊

Photodiagnosis and Photodynamic Therapy ONCOLOGY-

CiteScore

5.80

自引率

24.20%

发文量

509

审稿时长

50 days

期刊介绍： Photodiagnosis and Photodynamic Therapy is an international journal for the dissemination of scientific knowledge and clinical developments of Photodiagnosis and Photodynamic Therapy in all medical specialties. The journal publishes original articles, review articles, case presentations, "how-to-do-it" articles, Letters to the Editor, short communications and relevant images with short descriptions. All submitted material is subject to a strict peer-review process.