5-氨基酮戊酸光动力疗法对无宫颈病变女性 HPV 清除的效果。
Effectiveness of photodynamic therapy with 5-aminolevulinic acid on HPV clearance in women without cervical lesions.
机构信息
Department of Obstetrics and Gynecology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China; Shanghai Key Laboratory of Gynecologic Oncology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.
Department of Obstetrics and Gynecology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China; Shanghai Key Laboratory of Gynecologic Oncology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China; State Key Laboratory of Oncogenes and Related Genes, Shanghai Cancer Institute, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.
出版信息
Photodiagnosis Photodyn Ther. 2021 Jun;34:102293. doi: 10.1016/j.pdpdt.2021.102293. Epub 2021 Apr 20.
BACKGROUND
High-risk HPV (hrHPV) not only increases the risk of cervical precancerous lesions and cervical cancer, but also adds psychological burden to HPV-positive women. 5-aminolevulinic acid photodynamic therapy (ALA-PDT) is a non-invasive and highly tissue-selective therapy. We aim to investigate the clinical efficacy of ALA-PDT for elimination of cervical hrHPV infection in HPV-positive women without cervical lesions.
METHODS
A total of 57 hrHPV-positive women without pathologically proved cervical lesions received three treatments of ALA-PDT in total. HPV DNA testing and pap cytology were performed in all patients. Patients with positive HPV16/18 or abnormal TCT results received colposcopic biopsy during the follow-up.
RESULTS
hrHPV clearance rate was 56.1 % (32/57) at 3-month follow-up and 68.1 % at 6-month follow-up. 100 % of HPV 18 and 87.5 % of HPV16 infections were cleared while the clearance rate was 48.8 % among those positive for 12 other high-risk types. Multivariate analysis showed HPV16/18 infection was associated with significantly higher clearance rate. HPV clearance rate in patients with multiple-type HPV infection was significantly lower than that in patients with single-type HPV infections.
CONCLUSIONS
ALA-PDT is effective on treating hrHPV infection in patients with no cervical lesions. HPV16/18 positive cases can benefit most from ALA-PDT. Multitype-infected women need more sessions of 5- ALA-PDT to eradicate hrHPV infection.
背景
高危型人乳头瘤病毒（hrHPV）不仅增加了宫颈癌前病变和宫颈癌的风险，还增加了 HPV 阳性女性的心理负担。5-氨基酮戊酸光动力疗法（ALA-PDT）是一种非侵入性、高度组织选择性的治疗方法。我们旨在研究 ALA-PDT 对无宫颈病变的 HPV 阳性妇女消除宫颈 hrHPV 感染的临床疗效。
方法
共有 57 名无病理证实宫颈病变的 hrHPV 阳性妇女接受了总共 3 次 ALA-PDT 治疗。所有患者均行 HPV DNA 检测和巴氏细胞学检查。HPV16/18 阳性或 TCT 异常患者在随访中接受阴道镜活检。
结果
在 3 个月随访时，hrHPV 清除率为 56.1%（32/57），6 个月随访时为 68.1%。HPV18 感染的清除率为 100%，HPV16 感染的清除率为 87.5%，而其他 12 种高危型 HPV 阳性者的清除率为 48.8%。多因素分析显示，HPV16/18 感染与更高的清除率相关。多型 HPV 感染患者的 HPV 清除率明显低于单型 HPV 感染患者。
结论
ALA-PDT 对无宫颈病变的 hrHPV 感染患者有效。HPV16/18 阳性患者最受益于 ALA-PDT。多型感染的女性需要更多次的 5-ALA-PDT 来消除 hrHPV 感染。
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