Abstract
Currently, there is no relevant literature specifically discussing the human papillomavirus (HPV) negative conversion rate following Hiporfin photodynamic therapy (PDT) in HPV-associated high-grade squamous intraepithelial lesion (HSIL) of the female lower reproductive tract. Our study aims to fill this gap. Prospective study of 91 patients aged 37.4 ± 13.2 years old with HSIL in the female lower reproductive tract (cervical HSIL: 55, vaginal HSIL: 25, cervical HSIL combined with vaginal HSIL: 8, cervical HSIL combined with vulvar HSIL: 1, vaginal HSIL combined with vulvar HSIL: 2). Hiporfin(®) (2 mg/kg) was administered intravenously, and 48-72 h later, 630-nm laser irradiation was applied to the lesions. The median follow-up period was 36 months. Before treatment, all patients (91/91, 100%) tested positive for HPV, and only 6 patients (6/91, 6.6%) had been previously vaccinated against HPV. The HPV negative conversion rates were 74.5% (41/55), 89.1% (49/55), 89.8% (44/49) and 95.8% (23/24) at 3-6 months, 12 months, 24 months and 36 months respectively after PDT in treating cervical HSIL. For vaginal HSIL, the negative conversion rates were 28.0% (7/25) at 3-6 months, 52.0% (13/25) at 12 months, 60.9% (14/23) at 24 months, and 64.7% (11/17) at 36 months. In cases of multiple sites of female lower genital tract HSIL, the negative conversion rates were 18.2% (2/11), 45.5% (5/11), 60.0% (6/10), and 62.5% (5/8) at 3-6, 12, 24, and 36 months, respectively. Hiporfin-PDT was most effective in achieving HPV negative conversion for treating cervical HSIL, followed by vaginal HSIL, and finally for multisite female lower genital tract HSIL.