5-Aminolevulinic acid-mediated photodynamic therapy (5-ALA-PDT) is a possible minimally-invasive treatment for high-grade cervical intraepithelial neoplasia (HSIL). The present study was carried out to assess the effect of 5-ALA-PDT and loop electrosurgical excision procedure (LEEP) in cervical squamous intraepithelial neoplasia (CIN2) combined with high-risk human papillomavirus (HR-HPV) infection. In this study, 190 patients with CIN2 and HR-HPV infection were finally included. They were divided into the LEEP Group (n=116) and PDT Group (n=74) according to gynecologist's recommendation and patient's willingness. All patients were followed up at 4-6 months and 12 months after treatment, including HPV testing, cytology, and colposcopy examination. (1) 4-6 months after treatment, the pathological regression rate was 97.30% (72/74) in the PDT group and 98.28% (114/116) in the LEEP group (P = 0.952). The HPV clearance rate was 81.08% (60/74) in the PDT group and 80.17% (93/116)in the LEEP group (P = 0.877). (2) 12 months after treatment, the pathological regression rate was 93.24% (69/74) in the PDT group and 96.55% (112/116) in the LEEP group (P= 0.486). The recurrence rate of CIN2 was 4.05% (3/74) in the the PDT group and 1.72% (2/116) in the LEEP group (P=0.608). The HPV clearance rate was 90.54% (67/74) in the PDT group and 89.66% (104/116)in the LEEP group (P = 0.843). The reinfection rate of HR-HPV was 5.41% (4/74) in the PDT group and 1.72% (2/116) in the LEEP group (P=0.322). (3) The adverse reactions in the PDT Group were slightly lower than that in the LEEP Group (P = 0.4956), but the incidence of vaginal bleeding in the PDT group was lower than that in the LEEP group during follow-up. The effectiveness of 5-ALA-PDT is similar to LEEP for CIN2 with less side effects. Therefore, 5-ALA-PDT, a non-invasive treatment, may be an effective method for CIN2 patients of childbearing age.

Female vulvar lichen sclerosus (VLS) is a chronic inflammatory skin disease of the vulva and its etiology is unknown. The main clinical symptoms are itching, burning and dyspareunia, and there is a lack of effective treatment. Clinical and follow-up data of women with VLS who underwent 5-Aminolevulinic acid photodynamic therapy (ALA-PDT) from January 2023 to December 2023 in the department of obstetrics and gynecology, Qilu Hospital of Shandong University, were retrospectively analyzed. According to the inclusion and exclusion criteria, 36 patients with VLS who received ineffective conventional treatment (intractable VLS) were enrolled. Objective signs and subjective symptoms of vulvar lesions were recorded before treatment and 6 months after the end of treatment according to corresponding scoring criteria. Quality of life was evaluated using the Dermatology Life Quality Index (DLQI). All patients received six sessions of ALA-PDT treatment and follow-up visits. After ALA-PDT treatment, 24 of 36 (66.67%) patients' itching symptoms completely disappeared, 10 of 36 (27.78%) patients' itching symptoms were relieved from severe to mild, and only 2 of 36 (5.56%) patients' symptoms were not significantly relieved. 16 of 36 (44.4%) patients' itching symptoms completely disappeared, 9 of 36 (25%) patients' itching symptoms were relieved from severe to mild, and only 2 of 36 (5.56%) patients still had severe pain. Compared to 22 patients with dyspareunia before treatment, only 9 patients still had dyspareunia with varying degrees of dyspareunia relief after treatment. Clinical signs improved significantly in the patients after ALA-PDT treatment. The total scores of clinical signs were (5.31±1.67 vs 3.67±1.71) before and after treatment. All patients showed improvement in DLQI after treatment. The main side effects of ALA-PDT were pain, erythema and swelling which were transient and tolerable. All patients were "satisfied" or "very satisfied" with the results of the treatment. ALA-PDT is a safe and effective treatment for women with intractable vulva lichen sclerosus.

Background: Tumor microenvironment is widely considered as a critical factor influencing prognosis of ovarian cancer patients. To further improve the unsatisfied clinical outcome of ovarian cancer patients, it is desperately needed to explore biomarkers with potential clinical value of ovarian cancer. Asporin (ASPN), as a member of the proteoglycan family in tumor microenvironment, has been proved to play a vital role in cancer progression by binding with CD44 receptor. However, there is still no report about the research of Asporin in ovarian cancer. The purpose of the present study was to explore the expression and prognostic significance of Asporin in high grade serous ovarian cancinoma(HGSOC). Methods: The expression level of Asporin and CD44 in 85 formalin fixed paraffin embedded (FFPE) samples of 85 HGSOC patients was detected by immunohistochemistry. The association between the expression of the two biomarkers and the clinicopathologic factors of HGSOC was assessed by χ² test. The survival analyses were performed by Kaplan-Meier.Results: Asporin was mainly expressed in CAFs of 85 HGSOC patients, while CD44 was mainly expressed on membrane of tumor cells. The positive rates of Asporin, CD44, and Asporin /CD44 co-expression were 43.53% (37/85), 34.12% (29/85) and 28.23% (24/85) in 85 HGSOC tissues, respectively. There were close associations between Asporin, CD44, Asporin/CD44 expression and CA125 level of blood, tumor differentiation, FIGO staging, chemoresistance of HGSOC patients. Further, univariate survival analysis showed that positive expression of Asporin and positive Asporin/CD44 co-expression of HGSOC indicated poor clinical outcomes, and multivariate survival analysis suggested that positive expression of Asporin and positive Asporin/CD44 co-expression were independent prognostic factors for disease–free survival (DFS) and overall survival (OS) of HGSOC patients, respectively.Conclusion: Asporin was mainly expressed in CAFs of HGSOC patients. High expression of Asporin may identify a subgroup of HGSOC patients with more chemoresistance clinicopathological features and may be a potential prognostic predictor and therapeutic target for HGSOC patients.