热休克蛋白在尖锐湿疣组织中的检测及其与HPV感染相关性

目的　探讨热休克蛋白 70(HSP70)在尖锐湿疣(CA)组织中的检测及其与人乳头瘤病毒 (HPV)感染的关系。方法　采用免疫组化法检测了 24例CA、46例宫颈癌和 28例正常宫颈组织HSP70,用PCR技术对各组织标本的HPV-DNA进行检测和 6, 1 1, 1 6, 1 8分型。结果　HSP7 0在CA和宫颈癌组的阳性率显著高于正常宫颈对照组 (P<0. 01)。CA组HPV6, 11型DNA阳性者HSP70的检出率显著高于阴性者(P<0. 05),宫颈癌组HPV16, 18型DNA阳性者与阴性者HSP70的检出率差异无显著性(P>0. 05)。结论　HSP70的表达与尖锐湿疣的发病有关,HSP70在尖锐湿疣组织中的表达与HPV的感染明显相关。     

丁卡因表面麻醉在治疗男性尿道口尖锐湿疣中的应用

目的探索治疗男性尿道口尖锐湿疣适宜的麻醉方法。方法治疗组50例应用1%丁卡因注射液进行尿道口表面麻醉,对照组40例应用2%盐酸利多卡因注射液对尿道口内疣体进行基底部注射麻醉,两组均再以微波烧灼凝固疣体,并观察麻醉效果。治疗后1月,3月评价两组近期复发率。结果两组疼痛消失时间平均为5.4min,2.5min,未见不良反应发生。两组疼痛消失时间比较差异有显著性(t=12.40,P<0.05),而麻醉效果良好率比较差异无显著性(χ2=2.54,P>0.05)。对照组麻醉时患者均有不同程度的注射部位疼痛、表情痛苦、尿道口局部渗血和操作部位视野欠清晰。治疗后1月,3月随访,两组CA复发率比较差异有显著性(χ2分别为4.50,4.48,P<0.05)。结论丁卡因作为表面麻醉在治疗男性尿道口CA中显示麻醉效果好,手术视野清晰,病灶清除彻底。     

尖锐湿疣组织中微卫星DNA的改变与HPV感染的相关性

目的探讨特定位点的微卫星不稳定性(MSI)及杂合性丢失(LOH)在尖锐湿疣(CA)组织中的检出情况及其与人乳头瘤病毒(HPV)感染的关系。方法选取D3S1234,D3S1611,D9S171,D10S1687和D17S16785个微卫星位点,应用聚合酶链反应(PCR)和变性聚丙烯酰胺凝胶电泳-银染色技术对40例CA组织及11例CA癌变组织进行微卫星分析,并采用核酸分子快速导流杂交基因芯片技术检测HPV的基因分型。结果 CA及CA癌变组织中LOH的总检出率分别为22.50%(9/40)和63.64%(7/11),差异有统计学意义(P<0.05),两组中LOH发生频率最高的位点均为D9S171,其次为D17S1678位点。MSI的发生率较低,CA组中频率为10.00%(4/40),CA癌变组为18.18%(2/11)。CA组及CA癌变组标本,高危型HPV感染者LOH阳性率明显高于低危型HPV感染者,差异有统计学意义(P=0.019);两组中MSI阳性的6例样本均为高危型HPV感染。结论高频LOH位点D9S171和D17S1678连锁的抑癌基因p16,p53可能在CA癌变的发生过程中起着重要作用;另外,该结果也说明HPV感染,尤其高危基因型病毒是CA癌变的因素之一。微卫星DNA的改变与高危型HPV的感染有一定的相关性。     

Pigmented condyloma acuminatum

We herein report a case of pigmented condyloma acuminatum in the genital region. A histopathological examination revealed keratinocyte proliferation, papillomatosis and basal pigmentation. Cellular atypia was rarely observed. The patient also had ordinary skin‐colored nodules on the coronal sulcus. Polymerase chain reaction amplification with consensus primers for human papillomavirus (HPV) and subsequent sequencing confirmed an infection of HPV type 6. Pigmented condyloma acuminatum is not rare; however, making the differential diagnosis between bowenoid papulosis and seborrheic keratosis is sometimes difficult. The mechanism of pigmentation in such cases remains unknown and requires further investigation. HPV typing is a useful method for diagnosing the disease.     

光动力三阶段疗法治疗肛周尖锐湿疣的临床观察

目的:采用光动力三阶段疗法治疗肛周尖锐湿疣,观察疗效及复发率.方法:将我科门诊肛周尖锐湿疣患者随机分成治疗组(45例)、对照组(35例),分别采用冷冻、光动力疗法及局部免疫调节剂分三个阶段治疗和单纯采用冷冻治疗.比较两组患者的疗效和复发率.结果:治疗组治愈率97.78%,对照组治愈率65.72%;两组患者治疗结束后第4,8和12周时的复发率差异和治愈率均有统计学意义(P均<0.05).结论:肛周尖锐湿疣进行三阶段治疗,能明显降低复发率,疗效优于单一疗法.     

激光联合重组人干扰素α-2b凝胶治疗尖锐湿疣的临床研究

目的:研究激光联合重组人干扰素α-2b凝胶治疗尖锐湿疣(CA)的临床疗效;方法:选择2014年1月至2014年12月我院收治的尖锐湿疣患者96例,依据随机数字表法分为实验组与对照组各48例,两组性别、年龄、病程等基线资料比较无统计学差异(P0.05)。实验组以激光联合重组人干扰素α-2b凝胶治疗,对照组以5-氨基酮戊酸光动力(ALA-PDT)联合液氮冷冻治疗。观察两组临床疗效、复发及复发患者疣体个数与不良反应;结果:实验组治疗总有效率(89.58%)与对照组(83.33%)比较无统计学差异(P0.05)。跟踪回访6个月,实验组复发率(6.98%)与对照组(7.14%)比较无统计学差异(P0.05),两组复发患者疣体个数之间无统计学差异(P0.05)。实验组总不良反应发生率(10.42%)与对照组(6.25%)比较无统计学差异(P0.05);实验组治疗费用(1.45±0.53)千元显著低于对照组(6.05±0.74)千元,存在统计学意义(P0.05);结论:激光联合重组人干扰素α-2b凝胶治疗尖锐湿疣疗效均较为显著,且复发率低,在经济上更具有优势,值得应用与临床。     

尖锐湿疣复发机理与抗复发治疗进展

尖锐湿疣是全球范围内广泛流行的性传播疾病之一，本文主要对其发病和复发的危险因素，以及常用的抗复发治疗方法进行综述。     

Preoperative Immune Status Determines Anal Condyloma Recurrence After Surgical Excision

PURPOSE: Immunosuppression is an important risk factor for anal condyloma progression; however, its effects on postoperative outcomes remain unclear. In the present study, we investigated risk factors and recurrence rates in immunocompromised patients requiring surgery for medically intractable anal condyloma. METHODS: A retrospective review was performed on 63 consecutive patients who underwent surgical intervention for medically intractable anal condyloma at a single institution. Patient cohorts included immunosuppressed patients (e.g., HIV-seropositive, leukemia, idiopathic lymphopenic syndrome, or transplant patients; n = 45) and immunocompetent patients (n = 18). Recurrence rates and time to recurrence after surgery were determined for both groups. Preoperative CD4 count and viral load within the HIV subpopulation were also determined. The majority of the patients were male (90 percent), with a median age of 36 years. RESULTS: Anal condyloma recurred in 66 percent of the immunosuppressed patients compared with 27 percent of the immunocompetent group. Recurrence time expressed in months was shorter in immunosuppressed patients than in immunocompetent patients (6.8 ± 1.5 vs. 15 ± 5.7 months; P < 0.05). In the subpopulation of HIV-seropositive patients, no association was found between recurrence rates and viral loads; however, CD4 counts were significantly lower in those who had recurrence than in those who did not (226 ± 31.7 vs. 401 ± 51.2 cells/l; P < 0.05). CONCLUSIONS: After surgery, anal condyloma in immunosuppressed patients recurs significantly more often and within a shorter period of time than in patients with a competent immune system. Additionally, in HIV-seropositive patients, CD4 counts should be maximized to prevent early recurrence of anal condyloma.     

尖锐湿疣患者红细胞免疫功能与胸腺肽治疗的研究

目的 研究尖锐湿疣患者红细胞免疫及调节因子与胸腺肽治疗前后的变化及机理。方法 按照郭峰与刘景田等建立及改进方法检测红细胞C3b受体花环率、红细胞免疫复合物花环率和红细胞免疫调节因子,并用胸腺肽治疗。结果 尖锐湿疣治疗前红细胞C3b受体花环率明显降低,红细胞免疫复合物花环率降低,红细胞免疫促进因子明显降低,而红细胞免疫抑制因子明显升高。经胸腺肽治疗后以上指标趋于正常。治疗后3个月未复发者31例。结论 提示尖锐湿疣患者存在红细胞免疫功能低下,胸腺肽治疗获较好疗效。     

尖锐湿疣患者HPV型别及DNA载量与复发的关系

目的研究天津地区尖锐湿疣（CA）患者人乳头瘤病毒（HPV）6/11、16/18型及DNA载量与复发的关系。方法采用实时荧光定量聚合酶链反应（FQ-PCR）检测CA患者皮损中HPV型别及DNA载量,并随访至少3个月观察有无复发。结果83例CA标本中,HPV阳性80例（96.4%）,其中单纯HPV6/11型63例,单纯HPV16/18型4例,HPV6/11型和HPV16/18型混合感染13例,不同型别复发率比较无统计学差异（P〉0.05）。HPV6/11阳性标本中,复发组与未复发组DNA载量比较有统计学差异（P〈0.05）。结论CA患者的HPV感染以HPV6/11型为主,患者疣体中HPV DNA载量与复发有关。