About Prof. Ge Mingzhu
Prof. Ge Mingzhu is a cervical disease specialist at the Obstetrics & Gynecology Hospital of Fudan University (Red House Hospital), specialising in colposcopy, LEEP procedures, and HPV-related cervical lesion management. She is a key clinical expert in cervical cancer prevention and early intervention in China. Her innovations include an AI-assisted colposcopy image analysis platform (95% diagnostic accuracy, 50% reduction in diagnosis time), a layered LEEP resection technique that reduced cervical incompetence from 20% to 5%, and a photodynamic therapy (PDT) protocol enabling 60% of CIN2 patients to avoid surgery. She has contributed to the Chinese Cervical Cancer Diagnosis and Treatment Standards and leads integrated HPV vaccination and screening programmes that have reduced high-grade cervical lesion incidence by 35% in study populations.
Case Overview
Ms. Li (pseudonym), a 29-year-old woman planning her first pregnancy, was referred to Prof. Ge's clinic after a routine cervical screening returned a high-risk HPV 16 positive result with an abnormal ThinPrep cytology (HSIL). She had no symptoms. Colposcopy with NBI imaging identified a well-demarcated acetowhite lesion at the transformation zone; directed biopsy confirmed CIN2. Given her age, nulliparity, and explicit wish to preserve fertility, Ms. Li was strongly motivated to avoid surgery if possible. Prof. Ge discussed two options: LEEP with layered resection to minimise cervical tissue loss, or PDT as a non-surgical alternative with a 60% chance of complete CIN2 regression. After comprehensive counselling, Ms. Li elected PDT. Three sessions of photodynamic therapy were administered over twelve weeks using a topical photosensitiser activated by 635 nm laser light. At six-month follow-up, repeat colposcopy and biopsy confirmed complete histological regression to CIN1; HPV 16 load had decreased by 85% on quantitative PCR. At twelve months, ThinPrep cytology was NILM and HPV 16 was undetectable. Ms. Li reflected: "I was terrified when I got the result. I was planning to start a family and the idea of surgery on my cervix was frightening. Prof. Ge explained everything clearly — what the lesion was, what the options were, and what the risks of each were. The treatment worked. A year later everything is normal. I feel so relieved."
Diagnostic Workup
Cervical screening: HPV 16 positive (high-risk); ThinPrep cytology HSIL. Colposcopy with NBI imaging: acetowhite lesion at transformation zone, mosaic vascular pattern, sharp border — colposcopic impression CIN2–3; satisfactory colposcopy (entire transformation zone visible). AI-assisted colposcopy analysis: lesion boundary delineated automatically; predicted CIN2–3 probability 94%; biopsy sites recommended by AI platform. Directed biopsy ×2: CIN2 confirmed bilaterally; no CIN3 or invasive carcinoma. Endocervical curettage: negative. HPV 16 quantitative PCR: 4.2 × 10⁴ copies/mL. Fertility counselling: patient nulliparous, planning pregnancy within 2 years; cervical length 38 mm on ultrasound — adequate reserve for either LEEP or PDT. Multidisciplinary review confirmed CIN2 diagnosis, PDT eligibility (satisfactory colposcopy, no endocervical involvement, no suspicion of invasion), and structured follow-up plan.
Prof. Ge's assessment: CIN2 in a 29-year-old nulliparous woman planning pregnancy is a clinical situation that demands careful individualisation. CIN2 has a spontaneous regression rate of approximately 40–50% — but HPV 16 is the highest-risk genotype and this patient has HSIL cytology, which reduces the probability of spontaneous regression. PDT is appropriate here: satisfactory colposcopy, no endocervical involvement, no invasion. If PDT achieves complete regression, she avoids any cervical tissue loss. If it does not, LEEP remains available with no oncological compromise.
Treatment Strategy and Course
Diagnosis: CIN2, HPV 16 positive, HSIL cytology — nulliparous, fertility preservation priority; satisfactory colposcopy; no endocervical involvement; PDT eligible.
Treatment principle: photodynamic therapy as primary non-surgical treatment — selective destruction of HPV-infected dysplastic cells while preserving normal cervical architecture and fertility potential.
- PDT protocol: Topical 5-aminolevulinic acid (5-ALA) photosensitiser applied to transformation zone; 4-hour incubation; 635 nm laser activation (100 J/cm²); three sessions at 4-week intervals; well tolerated with mild local discomfort only
- Response monitoring: Colposcopy and HPV 16 quantitative PCR at 3 months: acetowhite lesion reduced; HPV 16 load decreased 85%; biopsy confirmed regression to CIN1
- 12-month follow-up: ThinPrep cytology NILM; HPV 16 undetectable on PCR; colposcopy normal; biopsy not required; complete histological and virological response confirmed
- Ongoing surveillance: Annual HPV testing and cytology; colposcopy if any abnormality detected; pregnancy planning cleared at 12-month review
Prof. Ge's clinical reflection: Complete histological regression and HPV 16 clearance at twelve months — no surgery, no cervical tissue loss, fertility fully preserved. PDT achieved what it was designed to achieve in this patient. The AI colposcopy platform identified the biopsy sites precisely; the PDT protocol addressed the HPV-infected dysplastic cells selectively. This patient can plan her pregnancy without any cervical compromise. That is the outcome individualised management is designed to produce.
Expert Commentary — Prof. Ge Mingzhu
1. AI-Assisted Colposcopy and Precision Lesion Delineation
Colposcopy is the cornerstone of cervical lesion diagnosis, but its accuracy is operator-dependent and its sensitivity for high-grade lesions varies between 60% and 85% in published series. Prof. Ge's AI-assisted colposcopy platform — trained on a deep learning model using annotated colposcopic images — automatically identifies acetowhite lesions, mosaic and punctation vascular patterns, and lesion boundaries, recommending optimal biopsy sites and predicting CIN grade. In clinical validation, the platform raised lesion detection accuracy from 70% to 95% and reduced diagnosis time from 30 to 10 minutes. NBI colposcopy further enhances vascular pattern visualisation, improving detection of microinvasive lesions by 30% compared with white-light colposcopy alone. Together, these technologies reduce the missed lesion rate and enable more precise biopsy targeting — the prerequisite for accurate histological diagnosis and appropriate treatment selection.
2. Layered LEEP Resection: Preserving Fertility Without Compromising Oncological Safety
LEEP (loop electrosurgical excision procedure) is the standard treatment for CIN2–3, but conventional cone excision removes a substantial volume of cervical stroma, increasing the risk of cervical incompetence and preterm birth in subsequent pregnancies — a significant concern in young nulliparous women. Prof. Ge's layered resection technique individualises excision depth by CIN grade: superficial excision for CIN1 (preserving maximum stroma), standard cone for CIN2 (3–5 mm additional depth), and extended cone for CIN3 (with endocervical margin assessment). This approach reduced cervical incompetence from 20% to 5% in her series while maintaining a one-time cure rate of 95% for high-grade CIN — demonstrating that oncological radicality and fertility preservation are not in conflict when excision is precisely calibrated to the lesion.
3. Photodynamic Therapy for CIN2: A Non-Surgical Option for Fertility Preservation
PDT exploits the preferential uptake of photosensitisers (5-ALA) by metabolically active dysplastic cells: laser activation generates reactive oxygen species that selectively destroy HPV-infected cells while sparing the underlying stroma and normal epithelium. For CIN2 patients with satisfactory colposcopy and no endocervical involvement — particularly young nulliparous women — PDT offers complete regression in approximately 60% of cases without any cervical tissue loss. Prof. Ge's multicentre clinical trial data confirm that PDT reduces CIN2 to CIN1 or normal in 60% of patients at six months, with HPV viral load reduction of 80–90% in responders. For non-responders, LEEP remains available with no oncological compromise — making PDT a low-risk first-line option in appropriately selected patients. The integrated prevention strategy combining HPV vaccination, structured screening, and PDT/LEEP has reduced high-risk HPV infection rates by 40% and high-grade cervical lesion incidence by 35% in Prof. Ge's study populations.
How CMCS Shanghai Coordinated This Case
CMCS Shanghai supported Ms. Li throughout her pathway at the Obstetrics & Gynecology Hospital of Fudan University, providing priority consultation coordination with Prof. Ge's cervical disease team, bilingual interpretation across all colposcopy, biopsy, and PDT consultations, bilingual explanation of the CIN2 diagnosis, HPV 16 risk profile, PDT protocol, and follow-up plan, coordination of colposcopy, AI-assisted biopsy, HPV PCR, and cytology with bilingual results communication, bilingual PDT consent, and annual surveillance scheduling.
For international patients and expatriates in China with abnormal cervical screening results, HPV infection, cervical dysplasia, or concerns about cervical cancer prevention — particularly those with fertility preservation priorities — Prof. Ge Mingzhu's team offers access to one of China's most advanced cervical disease programmes. CMCS ensures that expertise is accessible, in the patient's language, with every step coordinated clearly.
This case report is de-identified and published for educational purposes. All clinical details have been anonymized in accordance with patient privacy standards. CMCS Shanghai is a medical concierge service and does not provide direct medical care.
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