Comparative investigation of 5-aminolevulinic acid and hexyl aminolevulinate-mediated photodynamic diagnostics and therapy of cervical dysplasia and vulvar leukoplakia

This study aims to conduct a comparative analysis of aminolevulinic acid and its hexyl aminolevulinate (HAL) for photodynamic diagnostics and therapy of cervical dysplasia and vulvar leukoplakia in continuous and pulsed laser irradiation mode. The fluorescence intensity of protoporphyrin IX (PpIX) in the cervix epithelium was five times higher after the application of HAL compared with the application of aminolevulinic acid. Increased intensity of fluorescence of PpIX in vulvar tissues complicated by leukoplakia was not observed with 5-aminolevulinic acid and its HAL. Intraepithelial changes in patients with cervical dysplasia were absent after photodynamic therapy (PDT) in continuous irradiation mode. Repeated PDT was prescribed to several patients with vulvar leukoplakia after pulsed light irradiation. Pulse irradiation made it possible to avoid the use of various types of anesthesia in patients. In the regime of continuous irradiation, pain sensations of varying degrees from a burning sensation to sharp pains were observed in patients in the zone of photodynamic exposure. The results presented in this paper will help to optimize the PDT process of cervical dysplasia and leukoplakia using 5-aminolevulinic acid or HAL.

Automated summary

HAL showed better diagnostic and therapeutic effects for cervical dysplasia compared to ALA. Continuous PDT did not induce intraepithelial changes in cervical dysplasia patients, while repeated PDT was needed for vulvar leukoplakia patients after pulsed light irradiation.