ArticleFrontiers in medicine2026
Efficacy of 5-aminolevulinic acid photodynamic therapy for the treatment of female lower reproductive tract intraepithelial lesions and its predictive biomarker: DNA methylation.
Article in Frontiers in medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- Case Report: Possible spatially-distinctFrontiers in medicine · 2026Article
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3 authors.
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Abstract
Objective: This prospective study aimed to evaluate the efficacy of 5-aminolevulinic acid-mediated photodynamic therapy (ALA-PDT) for cervical/vaginal intraepithelial neoplasia (CIN/VaIN) and explore the predictive value of pretreatment PAX1/JAM3 methylation status in exfoliated cells for treatment outcomes. Methods: A total of 516 patients with histologically confirmed high-grade squamous intraepithelial lesion (HSIL: CIN2/3, VaIN2/3) who received ALA-PDT between September 2024 and February 2026 were enrolled. Pretreatment exfoliated cells were collected for HR-HPV detection, ThinPrep cytology test (TCT), and PAX1/JAM3 methylation analysis via multiplex real-time quantitative PCR. All patients received two courses of ALA-PDT consisting of six treatment sessions in total at 7-14-day intervals. Each session was performed with 20% ALA topical application for 3 h followed by irradiation at 80 mW/cm Results: The overall disease remission rates were 92.21% (CIN2), 88.68% (CIN3), 78.57% (VaIN2), and 66.67% (VaIN3). The HR-HPV clearance rates at 6 months were 60.79% for CIN2, 61.90% for CIN3, 52.38% for VaIN2, and 50.00% for VaIN3; the corresponding 12-month clearance rates were 71.72, 74.36, 58.54, and 50.00%, respectively. Univariate analysis identified prior cervical surgery, HPV16/18 positivity, TCT ≥ LSIL, and multiple lesions as adverse factors for CIN2. TCT ≥ LSIL, and multiple lesions were associated with poorer outcomes in VaIN2/3. PAX1/JAM3 hypomethylation was significantly associated with higher remission rates ( Conclusion: ALA-PDT is effective for HSIL with favorable HPV clearance. Pretreatment PAX1/JAM3 methylation status serves as a reliable non-invasive biomarker for predicting PDT efficacy, supporting individualized clinical decision-making.
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