血清白介素-23、干扰素-γ水平与尖锐湿疣患者5-氨基酮戊酸-光动力疗法治疗后复发的相关性

Correlation between serum IL-23,IFN-γlevels and recurrence of patients with condyloma acuminatum after 5-aminolevulinic acid-photodynamic therapy treatment

目的探讨尖锐湿疣患者5-氨基酮戊酸-光动力疗法(ALA-PDT)治疗后复发与血清白介素-23(IL-23)、干扰素-γ(IFN-γ)水平的相关性。方法选取2018年5月至2020年12月大连市第三人民医院收治的156例尖锐湿疣患者作为研究对象。所有患者均行ALA-PDT治疗,并在治疗前检测血清IL-23、IFN-γ水平,治疗后随访3个月,根据患者复发情况分为复发组与未复发组,比较两组基线资料、血清IL-23和IFN-γ水平,分析血清IL-23、IFN-γ水平与尖锐湿疣患者ALA-PDT治疗后复发的关系。结果ALA-PDT治疗后3个月,156例尖锐湿疣患者中复发16例,复发率为10.26%;复发组高危或混合型人乳头瘤病毒(HPV)感染状态高于未复发组,免疫球蛋白A(IgA)、免疫球蛋白G(IgG)及血清IL-23、IFN-γ水平均低于复发组,差异具有统计学意义(P<0.05);多元Logisitic回归分析结果显示,尖锐湿疣患者ALA-PDT治疗前HPV感染状态及血清IgA、IgG、IL-23、IFN-γ水平与患者治疗后复发具有相关性,其中高危及混合型HPV感染为危险因子(OR>1,P<0.05),血清IgA、IgG、IL-23、IFN-γ水平高为保护因子(OR<1,P<0.05)。结论血清IL-23、IFN-γ水平与尖锐湿疣患者ALA-PDT治疗后复发有关,治疗前检测上述指标可预测患者的复发风险。

Objective To investigate the relationship between the recurrence of patients with condyloma acuminatum after 5-aminolevulinic acid-photodynamic therapy(ALA-PDT)and the levels of serum interleukin-23(IL-23)and interferon-γ(IFN-γ).Methods 156 patients with condyloma acuminatum treated in Dalian No.3 People′s Hospital from May 2018 to December 2020 were selected and treated with ALA-PDT.Serum IL-23 and IFN-γlevels were detected before treatment.After treatment,the patients were followed up for 3 months,then divided them into a recurrence group and a non-recurrence group.The baseline data,serum IL-23 and IFN-γlevels were compared between the two groups,and the relationship between serum IL-23 and IFN-γlevels and recurrence after ALA-PDT treatment was analyzed.Results 3 months after ALA-PDT treatment,among 156 patients with condyloma acuminatum,16 cases recurred,the recurrence rate was 10.26%.The infection status of high-risk or mixed human papilloma virus(HPV)in recurrence group was higher than that in non-recurrence group,and the levels of immunoglobulin A(IgA),immunoglobulin G(IgG),serum IL-23 and IFN-γin recurrence group were lower than those in recurrence group(P<0.05).Multiple Logistic regression analysis showed that HPV infection status,serum IgA,IgG,IL-23,IFN-γbefore ALA-PDT treatment were statistically associated with recurrence of patients with condyloma acuminatum after treatment,and high-risk or mixed HPV infection was its risk factor(OR>1,P<0.05),high serum IgA,IgG,IL-23 and IFN-γlevels were protective factors(OR<1,P<0.05).Conclusions Serum levels of IL-23 and IFN-γare related to the recurrence of patients with condyloma acuminatum after ALA-PDT treatment,pre-treatment detection of these indicators can predict the risk of recurrence.