Treatment of HPV Infection-Associated Low Grade Cervical Intraepithelial Neoplasia with 5-Aminolevulinic Acid-Mediated Photodynamic Therapy

Objective: To investigate the efficacy of 5-aminoketovalic acid (5-ALA) photodynamic therapy (PDT) in the treatment of patients with low cervical intraepithelial neoplasia (CINI) combined with high-risk human papillomavirus ((HR-HPV), and the factors affecting the efficacy. Methods: 80 patients with CINI and HR-HPV infection were selected for the study. They received once weekly 5-ALA-PDT for either three or six treatments. To evaluate the clinical efficacy of 5-ALA-PDT treatment, follow-up evaluations were conducted at 3, 6 and 12 months, utilizing thinPrep cytology test(TCT)and colposcopic histopathological biopsy for the detection of HPVDNA. Results: Following PDT, HR-HPV remission rates at 3, 6 and 12 months were 75.32%, 80.52%, and 81.82%, respectively. Complete remission rate of CINI was 94.81% (73/77 patients). There was no statistically significant difference in the remission rate of HR-HPV between 3 and 6 treatments with PDT (P > 0.05). Likewise, there was no difference in the remission rate comparing patients <= 40 years old and those >40 years old (P > 0.05). However, the remission rate was statistically greater in patients with normal vaginal microecology compared to patients with vaginal microecologic imbalance (P = 0.004). Conclusions: Not only can 5-ALA-PDT effectively clear CINI, but it also can clear HR-HPV. Vaginal microecological imbalance can reduce the effect of PDT on HR-HPV, whereas differences in age or frequency of PDT do not affect the remission rate of PDT on HR-HPV.