高频电刀治疗尖锐湿疣18例观察(附11例治疗前后HPVDNA检测的研究)

尖锐湿疣（ＣＡ）是由人乳头瘤病毒（ＨＰＶ）感染所致的一种常见性传播疾病，其治疗方法很多，但复发相当常见，且有些ＣＡ与生殖器恶性肿瘤密切相关。因此，如何提高治愈率、减少复发是当前研究的重要课题。我们对１８例ＣＡ患者进行高频电刀治疗并用多聚酶链反应（ＰＣ...     

电灼治疗尖锐湿疣亚临床感染98例疗效观察

电灼治疗尖锐湿疣亚临床感染９８例疗效观察钟影①唐明雄①为探索降低尖锐湿疣（ＣＡ）复发的方法，我科对９８例经电灼治疗的ＣＡ患者，在治疗ＣＡ显性皮损的同时采用电灼凝固焦化处理亚临床感染（ＳＰＩ）皮损，进行临床疗效观察，现报告如下。临床资料：９８例ＣＡ，男...     

原发性皮肤CD^＋30间变性大T细胞淋巴瘤1全

报告１例罕见的原发皮肤Ｔ细胞淋巴瘤。患者女，１８岁，头顶部不明原因的反复出现 结节状肿物。病理检查，免疫组织化学染色瘤细胞ＣＤ＾＋３０、ＣＤ＾＋３、ＬＣＡ＾＋、ＥＭＡ＾＋、ＣＥＡ＾－、ＣＤ２＾－２０。对肿瘤局部放射治疗效果满意。     

包皮环切术治疗和预防尖锐湿疣复发

尖锐湿疣（ＣＡ）是由人乳头瘤病毒引起的性传播疾病，由于缺乏特异性较强的治疗而存在较高的复发率和亚临床感染，尤其是在男性伴有包皮过长和包皮嵌顿的ＣＡ患者。为此，我们采用了包皮环切术以治疗和预防ＣＡ复发，获得较好疗效。现将结果报告如下。临床资料：１９９６...     

刮术治疗尖锐湿疣的临床与实验观察

目的 观察刮术治疗对泌尿生殖系尖锐湿疣（ＣＡ）的疗效、刮术深度与ＣＡ复发和瘢痕形成的关系，以及利术后外周血单核细胞（ＰＢＭＣ）人类乳头瘤病毒（ＨＰＶ）感染的可能性。方法 对２３０例泌尿生殖系ＣＡ刮术治疗，并对部分疣组织病理观察，用聚合酶链反应（ＰＣＲ）检测术后≤１周及≥２周以上病例的ＰＭＢＣ ＨＰＶ－ＤＮＡ。结果 （１）、２２５例患者皮损１次治愈，５例２次治愈。半年内复发率为６．９％，尿道口内最高     

尖锐湿疣经二氧化碳激光治疗碳化物中HPV—DNA的PCR检测

近年来 ,性传播疾病 (ＳＴＤ)在我国呈明显上升趋势 ,1999年发病率为 6 7.6 4 / 10万人 ,其中尖锐湿疣(ＣＡ)跃居第二位 ,发病率为 16 .73/ 10万人 ,已越来越引起人们的重视[1] 。治疗中首选物理疗法 (包括二氧化碳激光、液氮冷冻、微波等 ) ,同时配合全身治疗及局部用药。ＣＡ治疗中最大的问题是复发 ,复发率达90 %以上[2 ] 。复发的原因之一可能为激光亚临床感染及治疗后残余的ＨＰＶＤＮＡ[3] 。本实验研究的目的是了解ＣＡ在ＣＯ2 激光治疗后能否完全破坏ＨＰＶ ＤＮＡ。1　资料与方法1.1　同等大小的 2 0个新鲜标本分别取自 2 0例ＣＡ…     

CO2激光治疗尖锐湿疣后防止创面感染的体会

尖锐湿疣（ＣＡ）是常见的性传播疾病。治疗此病方法颇多。本文作者１９９９年－２０００年采用ＣＯ２激光治疗ＣＡ疣体后，点涂１０％碘酊，以防止创面感染，降低复发率，取得较好的效果。现总结报告如下。１ 病例情况 选取我院皮肤科尖锐湿疣患者１３４例。其中治疗组８３例，男５６例，女２７例；初发６６例，复发１７例；年龄１７岁－５８岁，平均３０．４岁；疣体最小似芝麻粒，最大１ｃｍ×２ｃｍ。对照组５１例，男３６例，女１５例；初发３９例，复发１２例；年龄１８岁－５１岁，平均２７．２岁；疣体米粒至蚕豆大小。２ 治疗 治疗…     

CO＿2激光治疗尖锐湿疣复发的原因探讨

ＣＯ_２激光治疗尖锐湿疣复发的原因探讨章伟，张贤明，丁杨峰，苏敬泽上海市皮肤病性病防治中心（邮政编码２０００５０）ＣＯＺ激光是目前治疗尖锐湿疣的常用方法，但存在复发问题，其原因有多种说法。我们观察了１０２例经ＣＯ。激光治疗后复发的尖锐湿疣患者，对其原...     

激光合并IL-2治疗尖锐湿疣107例的复发观察

尖锐湿疣 (ＣＡ)目前治疗方法甚多 ,但复发率很高 ,造成ＣＡ复发 ,难于根治的原因可能与患者的细胞免疫功能低下有关 ,尤其是与白细胞介素 - 2 (ＩＬ - 2 )水平降低有关。笔者通过强激光大范围气化联合应用ＩＬ - 2治疗ＣＡ患者 ,对降低ＣＡ的复发率收到了显著效果 ,现报告如下。1　资料与方法1 1　临床资料　在本站门诊正规治疗 ,资料完整并观察结束的 10 7例患者中 ,男 6 9例 ,女 38例 ,年龄 16～ 6 6岁 ,平均 30 6岁 ;病程 0 5个月～ 18个月 ,平均 2 7个月 ;首次发病者 72例 ,复发者 35例。男性皮损以冠状沟、包皮、龟头及肛门为主 ;…     

肠病性肢端皮炎52例临床分析

目的：探讨白念珠菌与肠病性肢端皮炎发病之间的关系。方法：将５２例患者分为Ａ、Ｂ、Ｃ三组，分别给予补锌、补锌加制霉菌素、制霉菌素治疗。结果：Ａ组与Ｂ组无显著性差异，Ａ组与Ｃ组、Ｂ组与Ｃ组均有显著性差异。结论：白念珠菌感染不是其发病原因。     

In situ DNA hybridization analysis of human papillomavirus (HPV) sequences in benign oral mucosal lesions

Summary A series of 144 surgically treated benign oral mucosal lesions were analysed using an in situ DNA hybridization technique with ³⁵S-labeled human papillomavirus (HPV) DNA probes to demonstrate the DNA of HPV types 6, 11, 13, and 16, in routinely processed, paraffin-embedded biopsy specimens. These lesions and an additional 62 benign oral mucosal biopsy specimens (total, 206 specimens) were also assessed by the indirect immunoperoxidase (IP-PAP) technique to detect the expression of HPV structural proteins (viral antigens). A total of 54/206 (26.2%) lesions were observed to express HPV antigens, being found in 45/92 (48.9%) of the squamous cell papillomas/condylomas, in 1/54 fibrous hyperplasias, in 1/8 true fibromas, and in 7/8 (87.5%) of the focal epithelial hyperplasia (FEH) lesions. Of the HPV DNA-positive lesions, 15/45 (33.3%) expressed HPV antigens, the expression not being related to any particular HPV type. HPV DNA sequences were found in 45/144 (31.3%) of the lesions. HPV DNA was present with the highest frequency in FEH (83.3%), papillary hyperplasia (28.6%), fibrous hyperplasia (24.4%), and true fibromas (14.3%). The most frequent HPV type was HPV 11, representing 37.8% of the DNA-positive lesions. HPV 13 DNA, previously regarded as specific to FEH, was disclosed as a single HPV type in seven cases, and as a double infection by HPV 11 and 13 in an additional three cases, including all five morphologically distinct entities. Noteworthy is the discovery, of the high-risk HPV type 16 DNA in 17.8% of the DNA-positive lesions, four papilloma/condyloma lesions, three fibrous hyperplasias, and one FEH. The results confirm the previously reported evidence regarding HPV involvement in oral mucosal lesions. The implications of these findings are discussed in terms of the epidemiology, HPV etiology, and proper classification of the oral mucosal lesions, with special emphasis on the discovery of the high-risk HPV type 16 in the benign lesions as well as in oral cancer. The use of the in situ DNA hybridization as a powerful tool in detecting the specific HPV DNA sequences in routinely processed oral biopsy specimens is strongly recommended.     

Detection of human papillomavirus in cutaneous extragenital Bowen's disease in immunocompetent patients

INTRODUCTION: A specific link between human papillomavirus (HPV) types 16, 18, 31, and 33 and genital carcinomas and between HPV type 5 and cutaneous extragenital carcinomas in patients with epidermodysplasia verruciformis and renal transplant has been previously found. The aim of this prospective study was to detect HPV in cases of cutaneous extragenital Bowen's disease (BD) from non-immunosuppressed patients. PATIENTS AND METHODS: Twelve cases of cutaneous extragenital BD or Bowen's carcinoma (BC), seen in the period 1994-1996 and confirmed by histologic examination, were included in the study. Tissue sections were studied by in situ hybridization with a mixture of HPV DNA probes and specific HPV DNA probes. In addition, study on fresh materiel from 1995 included: Southern blot hybridization with various usual HPV probes (6, 11, 16, 18, 31, 33, 35, 39, 42), polymerase chain reaction (PCR) with hybridization using consensus HPV probes and probes specific for HPV types 6, 11, 16, 18 and 33. In positive samples with conventional PCR, in situ PCR with probes specific for HPV types 6/11 and 16 was performed on tissue sections. RESULTS: In situ hybridization was negative in all the cases. Southern blot hybridization was negative in our 9 studied cases. Three cases studied by consensus PCR were positive. PCR with specific HPV probes revealed positivity on two of these cases: HPV 6 in one, and HPV 16 in another. In situ PCR was positive with a mixed 6/11 HPV probe in the third positive consensus PCR case. DISCUSSION: Our study revealed the presence of HPV in 3 out of 12 cases of cutaneous extragenital BD and BC. HPV type 16, found in BC of skull, was the most usually found type in the literature. HPV types 6/11, detected in 2 cases, were rarely found in cutaneous extragenital BD and BC and these results are in favor of the oncogenic effect of these virus types. In our study, in situ hybridization and Southern blot hybridization were negative in all the cases; HPV was only found in 3 cases by conventional PCR and in 1 case by in situ PCR. The low range of detection of HPV in cutaneous extragenital BD may be due to the used methods, to difficulties related to sampling and/or to a low number of copies of the HPV genoma.     

No evidence of human papillomavirus DNA in actinic keratosis

Human papillomaviruses (HPVs) are involved in premalignant and malignant skin diseases as well as in a variety of benign cutaneous and mucosal lesions. Actinic keratosis (AK) is a common premalignant disease. Its association with HPV infection has recently been evaluated in a few studies, but the results are contradictory. For further assessment of the role of HPVs in AK, a series of 100 paraffin-embedded biopsy specimens taken from subjects with AK were studied for the presence of HPV types 1, 2, 3, 4, 5, 7, 12, 15, 26, 36, 37 and 59 DNA using in situ hybridization (ISH) under high stringency conditions (Tm -10°C). All specimens were definitely negative for all biotinylated HPV DNA probes tested. One-fifth of the specimens were studied using the polymerase chain reaction (PCR) with general primers to confirm the negative results. All cases were also negative in the PCR. Our results suggest that HPVs are not directly involved in the aetiology of AK.     

Premalignant lesions and cancers of the skin in the general population: evaluation of the role of human papillomaviruses

To evaluate the role of human papillomaviruses (HPV) in the development of premalignant lesions and cancers of the skin in the general population, 314 biopsies obtained from 227 patients with benign neoplasms, premalignant lesions, and cancers of the skin and from 25 patients with squamous cell carcinoma of the lip were analyzed by Southern blot hybridization. DNA probes specific for various cutaneous and genital HPV types were used in hybridizations conducted under nonstringent or stringent conditions. HPV DNA sequences were only detected in eight specimens obtained from six patients: HPV 34 in one case of periungual Bowen's disease, HPV 36 and an as yet uncharacterized HPV in two cases of actinic keratosis, HPV 20 in one case of basal cell carcinoma, an as yet unrecognized HPV in one case of squamous cell carcinoma, and HPV 16 in one case of squamous cell carcinoma of the lip. None of the specimens of cutaneous horn and keratoacanthoma contained detectable HPV DNA. In contrast, HPV DNA sequences, mostly HPV 16, were detected in 13 of 23 cases of anogenital Bowen's disease and invasive Bowen's carcinoma. HPV DNA sequences were not detected in 90 cutaneous samples further analyzed by the polymerase chain-reaction technique, using amplification primers that contain conserved sequences among the genomes of HPV. These results strongly suggest that the known HPV types play only a minor role, if any, in skin carcinogenesis in the general population.     

The prevalence of "high-risk" HPV types in penile condyloma-like lesions: correlation between HPV type and morphology.

OBJECTIVE--To evaluate the prevalence of "high-risk" human papilloma virus (HPV) types in penile condyloma-like lesions and to correlate HPV types with clinical and histological features. DESIGN--The study included 94 male patients with signs of penile HPV infection. From acuminate, papular and macular lesions, specimens were collected for HPV DNA hybridisation, using the dot blot and Southern blot techniques. Biopsy specimens from 51 cases were examined by light microscopy for signs of koilocytosis and dysplasia. SETTING--The STD outpatient clinic of the Department of Dermatovenereology of Sahlgrenska Hospital, Göteborg, Sweden. RESULTS--In 79 (90%) of 88 patients HPV DNA was detected by dot blot. Of 51 cases examined by histology 88% disclosed an evident koilocytosis. "High-risk" HPV types (16, 18, 31, 33, 35) were demonstrated in 8% of acuminate, 24% of papular and 56% of macular lesions. In 29% of 51 lesions examined histologically moderate to severe dysplasia was observed. There was a significant correlation between "high-risk" HPV types and dysplasia. CONCLUSION--"High-risk" HPV types are prevalent in papular and especially macular penile condyloma-like lesions. The histological finding of koilocytosis concomitant with dysplasia strongly indicates infection with a "high-risk" HPV type. Although the risk of penile cancer is low, it is from an epidemiological point of view important to diagnose these lesions. Until simple tests for HPV typing are available, biopsy for light microscopy (histology) should be obtained liberally from papular and macular condyloma-like lesions. In atypical cases of balanoposthitis HPV aetiology should also be considered.     

Anal condylomas in men. 1. Histopathological and virological assessment.

A series of 128 biopsy specimens from anal condylomas in 73 homosexual or bisexual and 38 heterosexual men (mean (SD) age 31.8 (9.6) years) were subjected to histological assessment and human papillomavirus (HPV) typing by in situ DNA hybridisation with 35S-labelled HPV 6, 11, 16, 18, 31, and 33 probes. Most patients were also tested serologically for antibodies to human immunodeficiency virus (HIV). As evaluated on light microscopy, most (74%, 95/128) of the lesions were exophytic (papillary) acuminate warts, 15% (19) were flat, and 11% (14) were pigmented papulous lesions. No signs of anal intraepithelial neoplasia (AIN) were seen in 70% (90) of the 128 biopsy specimens (NAIN), 27% (35) were classified as showing AIN I, and another 2% (three) as AIN II. AIN was significantly (p less than 0.05) more often associated with papulous lesions, only 43% (6/14) of which showed NAIN compared with 72% (68/98) of acuminate condylomas. The duration of disease was directly related to the presence and severity of AIN in the lesions; thus in 47 lesions that had been present for more than 12 months, NAIN was found in 31 (66%), AIN I in 14 (30%), and AIN II in two (4%). HPV DNA of at least one of the six types tested for was detected in 109/125 (87%) lesions. HPV 6 and HPV 11 were the two most common types, comprising 57% (62) and 37% (40), respectively, of the 109 HPV DNA positive cases. Only seven (6%) biopsy specimens were associated with any of HPV types 16, 18, 31, or 33, which carry a high risk of potential malignant transformation. No association was found between sexual preferences of patients and the incidence of any of the various HPV types. Neither did the distribution of the various HPV types differ between men with antibody to HIV and those without antibody. All the men with antibody to HIV were homosexual or bisexual. On microscopy, 93% (38) of 41 lesions containing HPV 11 and 75% (48/64) of HPV 6 lesions were of the acuminate wart type; in comparison, the remaining 16 HPV 6 lesions were equally either flat or papulous (eight, 13% each). Of the 64 HPV 6 and 41 HPV 11 associated lesions, 73% (47) and 63% (26), respectively, were classified as NAIN. Only two lesions were associated with HPV 16, and both showed mild dysplasia. On the other hand, two HPV 6 induced lesions were associated with AIN II. No differences were found between HPV 6 and HPV 11 in duration of disease; (39%, and 27% respectively, had been present for more than 12 months). The results showed that overt anal wart disease was associated with HPV types 6 and 11 in most cases. Although HPV types considered as being of higher oncogenic potential were detected relatively rarely, the associated AIN in a relatively high proportion (31% 32/105) of HPV 6 or 11 induced lesions indicated that a malignant potential, even for HPV 11 associated anal warts, cannot be excluded.     

The detection of human papillomavirus DNA in skin tags

Human papillomavirus (HPV) is associated with benign cutaneous or mucosal lesions and with malignant tumours, but none of the HPV types has so far been related to skin tags. Skin biopsy specimens from 49 Caucasian patients suffering from the presence of multiple soft fibromas were analysed by means of dot blot hybridization and by polymerase chain reaction assays aimed at detecting all known HPV types. The results revealed the presence of HPV DNA type 6/11 in 88% of the skin tags examined. This result supports the hypothesis that HPV plays a part in the progression of cutaneous soft fibromas, as previously reported for laryngeal papillomas.     

Detection of human papillomavirus type 16 in Bowen's carcinoma of the toe

Background Human papillomavirus (HPV) is known to cause cervical cancer. Because it has been detected in lesions of Bowenoid papulosis, Bowen’s disease, and Bowen’s carcinoma, HPV infection has been implicated in the pathogenesis of these diseases. Methods A 44‐year‐old man was diagnosed clinicopathologically with Bowen’s carcinoma of the right great toe. He developed multiple organ metastases and died. We examined HPV DNA in skin biopsy specimens from the primary and skin metastatic lesions by polymerase chain reaction (PCR) and in situ hybridization (ISH). The PCR assay was carried out using primer sets specifically designed for detecting the E6 and E7 genes of the HPV types associated with malignancy. Purified and cloned PCR products were subjected to DNA sequence analysis. The ISH studies used INFORM^® HPV III probes. Results We found HPV DNA in specimens from both the primary and the skin metastatic lesions. DNA sequencing detected HPV type 16. We compared the base sequences of viral DNA from the primary and metastatic lesions. Point mutations of the base sequences of the E6 and E7 genes were observed in viral DNA from metastases but not in that from primary lesions. The E6 gene had mutated from G to A in the 383rd base sequence, causing a Glu‐to‐Lys amino acid change. Results of ISH showed punctuate signals in the nuclei of tumor cells. Conclusions We suspect an association between HPV 16 infection and the development of this malignant occurrence.     

鲍温样丘疹病中hTERT蛋白表达与高危型HPV感染的相关性研究

目的研究hTERT蛋白在鲍温样丘疹病中的表达及与高危型HPV存在的相关性。方法通过原位杂交法研究HPV的存在和免疫组化法检测hTERT蛋白在鲍温样丘疹病中的表达,并探讨hTERT蛋白表达与高危型HPV存在的相关性。结果在26例鲍温样丘疹病标本中,18例(69.2%)为HPV16/18阳性,其中1例HPV16/18阳性标本也有HPV6/11阳性。3例(11.5%)为HPV31/33/35阳性,2例(7.7%)为未定型HPV阳性,21例有高危型HPV存在的标本是hTERT阳性,16例高危型HPV感染的标本呈现了强而弥漫性hTERT蛋白表达。hTERT蛋白表达与高危型HPV的存在显著相关。结论高危型HPV可能诱导了hTERT蛋白的高表达。     

Detection of genital human papillomavirus (HPV) DNA by PCR and other conventional hybridisation techniques in male partners of women with abnormal Papanicolaou smears.

OBJECTIVE--To study the prevalence of human papillomavirus (HPV) infection, using several different hybridisation techniques, in men whose female sexual partners had cervical HPV and/or cervical intraepithelial neoplasia (CIN). METHODS--The male genital area was examined colposcopically and areas suspicious of HPV changes were biopsied. Each biopsy was subjected to histological examination and HPV DNA analysis by conventional DNA analysis such as Southern, reverse and dot blot as well as with polymerase chain reaction (PCR). RESULTS--Colposcopic examination of men showed 133 to be normal whilst 82 (38%) had clinical or subclinical lesions. Of 55 colposcopically directed biopsies from the male lesions taken, detection of HPV DNA by hybridisation with conventional techniques and by PCR showed HPV DNA in 29 (53%) and 47 (85%) of biopsies respectively. Overall HPV types 6/11 were the predominant types. In 18 (33%) biopsies positive by PCR, multiple types were found. CONCLUSION--HPV DNA was present in the majority of biopsy specimens taken, with HPV 6/11 being the predominant type. Among methods for HPV DNA detection, PCR was the most sensitive and useful technique.