Topical 5-aminolevulinic acid photodynamic therapy for cervical high-grade squamous intraepithelial lesions.

Abstract

OBJECTIVE:

To evaluate the efficacy of 5-aminolevulinic acid photodynamic therapy (ALA-PDT) in the treatment of high-grade squamous intraepithelial lesions of the cervix (HSIL).

METHODS:

This retrospective study included 22 female patients with histologically confirmed HSIL and high-risk human papillomavirus (HR-HPV) infections. Patients were treated with ALA-PDT once a week for a total of 6 times. All patients had a follow-up period of 3 months and 6 months. The assessment of effectiveness of ALA-PDT was performed by ThinPrep cytology test (TCT), HPV DNA assay, HPV E6/E7 mRNA examination, colposcopy, biopsy, and immunohistochemistry detection.

RESULTS:

Three months after 5-ALA PDT, the histologic disappearance rate was 81.82% (18/22), while the HPV clearance rate was 54.55% (12/22). At the 6 months checkpoint, the HSIL disappearance rate was 90.91% (20/22) and the HPV clearance rate was 86.36% (19/22). Before PDT, 68.18% of patients (15/22) were confirmed with TCT abnormalities, while only one patient (1/22, 4.55%) was abnormal in the TCT test at 6 months checkpoint. All participants were found HPV E6/E7 mRNA positive initially, while the HPV E6/E7 mRNA negative rate was 90.91% (20/22) at 6 months checkpoint. Additionally, we found a significant difference of the expression of CD4+ and CD8+ T cells and HPV E6 and E7 proteins before ALA-PDT and at 3 months follow-up (P < 0.01). No severe side effects were seen.

CONCLUSIONS:

Topical 5-ALA PDT is an effective treatment for cervical HSIL with HR-HPV infection.

• Authors: Yan Hu, Yu Li, Yanli Xu, Yincheng Teng, Jing Chen, Li Ma
• Journal: Photodiagnosis and photodynamic therapy (Photodiagnosis Photodyn Ther) Vol. 39 Pg. 103037 (Sep 2022) ISSN: 1873-1597 [Electronic] Netherlands
• PMID: 35905829 (Publication Type: Journal Article)
• Copyright: Copyright © 2022 The Author(s). Published by Elsevier B.V. All rights reserved.

Chemical References

• RNA, Messenger
• Aminolevulinic Acid

Topics

• Aminolevulinic Acid (therapeutic use)
• Female
• Humans
• Papillomaviridae (genetics)
• Papillomavirus Infections (diagnosis, drug therapy)
• Photochemotherapy (methods)
• RNA, Messenger (metabolism)
• Retrospective Studies
• Squamous Intraepithelial Lesions
• Uterine Cervical Neoplasms (diagnosis)
• Uterine Cervical Dysplasia (drug therapy)