The Condyloma Acuminatum’s Recurrence Can Be Reduced by Lesional Auto-Transplantation

Background: Condyloma acuminatum (CA), also known as a genital wart (GW), is a sexually transmitted disease caused by human papillomavirus (HPV). HPV lesions, recurrence tendency, and risk of malignant formation are primarily dependent on the person’s immunity level. GW recurrence is a major challenge in CA treatment. The aim of this study was to explore how lesional auto-transplantation (LT) can be used to treat CA and decrease its recurrence. Methods: We treated CA through the preparation and implantation of tissue from nine CA patients in our dermatology clinic. Transplantation of small pieces of HPV lesions to the subcutaneous fat of the inguinal region was carried out with the help of a simple surgical method under local anesthesia. Patients were followed up for six to eight months. We searched PubMed and the Web of Science for treatment options for CA to compare our treatment method recurrence rate with existing treatment options. Results: During three months of follow-up, seven patients experienced no recurrence of condyloma lesions, while two patients experienced recurrence of small lesions of condyloma acuminatum. The recurrence rate of CA once treated by auto-transplantation was relatively low compared to other CA treatment options. Conclusions: Transplantation of HPV lesions to the inguinal area reduces the recurrence rate in sexually active individuals. The 2/9 recurrence after implantation could be due to poor hygiene, sexual relationships or immune factors.

Perianal Giant Condyloma Acuminatum:A Case Report

Rare giant condyloma acuminatum （CA） reported by this paper is an interesting unusual case in China. Giant CA is a tumor that primarily affects the genital and perianal areas. Its feature is the high rate of local recurrence and transformation into squamous cell carcinoma. Making choice of wide surgical excision and using interferon as antiviral and immunoenhancement for CA after operation, we obtain satisfactory functional and cosmetic results.

A comparative study on the angiogenic activity of condyloma acuminatum and basal cell carcinoma

Recently, the study on the extraction, component analysis and function of angiogenic factor (AF) has become an important subject in anti-tumor research and made a great progress. Therefore, the imitation of the tumor's angiogenic activity (AGA) possibly helps to find a new method to treat ischemic diseases by blood vessel proliferation. Most of the parenchymatous malignant tumors have AGA. We studied the early stage condyloma acuminatum (CA) . After transplanting CA onto the chorioallantoic membrane (CAM) of chick embryos, we observed the AGA of CA and carefully compared it with that of basal cell carcinoma which is generally considered to have strong AGA. Meanwhile, we explored the way by which the AF of CA comes into being. The results demonstrated that CA, a benign neoplastic lesion, at its early stage, also has AGA. It is postulated that the responsible material is a certain form of AF. Therefore, the study on AGA of benign lesions (such as CA) and its physical basis will have potential clinical significance.

Unusual presentation of penile giant condyloma acuminatum with spontaneous prepuce perforation: A case report

BACKGROUND Giant condyloma acuminatum(GCA)is an uncommon condition affecting the anogenital area.CASE SUMMARY Here,we report an 88-year-old male patient who presented with a 5-year history of a progressive appearance of multiple cauliflower-like warts over his penile shaft,pubis region,and groin as well as urine leakage along the distal penile shaft.Physical examination revealed an ulcerative skin perforation with pus discharge under the distal prepuce base,which was initially suspected to be a urethral fistula.However,during surgery,it was discovered that the perforation was caused by a giant condyloma lesion that had obliterated the prepuce opening,with infection and high pressure causing subsequent skin perforation.He underwent circumcision and wide excision with electrocauterization of the warts.He was discharged after the surgery,and the residual lesion was treated with imiquimod and low-dose oral tegafur-uracil.CONCLUSION Penile GCA can cause prepuce perforation and can be postoperatively treated with imiquimod and low-dose oral tegafur-uracil.

A Correlative Analysis of Cervical Lesions in Patients with Vulva Condyloma Acuminatum

OBJECTIVE To analyze the relation ship among vulva condyloma acuminatum, high-risk human papillomavirus （HPV） infections and cervical epithelium lesions. METHODS From May 2002 to April 2004 patients with vulva condyloma acuminatum were examined employing vulva biospy, colposcopy, highrisk HPV-DNA test and cervical bioscopy. RESUTS In 418 cases of vulva condyloma acuminatum, verified by pathologic analysis, high-risk HPV （＋） infections were detected in 68.7% （287/418） of the cases. Among those patients, 20,6% （59/287） had concurrent subclinical cervical intraepithelial neoplastic （CIN） lesions. Among the high-risk HPV（-） 31.3 % （131）, patients 7,6% （10/131） had concurrent subclinical CIN lesions, Pathological examination results： cervicitis, 167 （40.0%）; cervical HPV infection, 182 （43.5%）; CIN-Ⅰ, 51（12.2%）; CIN- Ⅱ, 16 （3.83%）; CIN-Ⅲ, 2 （0,5%）; cervical cancer, none. Another patient had vulva condyloma acuminatum with valva intraepithelial neoplasia （VIN） Ⅱ-Ⅲ, CONCLUSION It was concluded that simultaneous cervical HPV infection of many types,was rather common in patients with vulva condyloma acuminatum. Vulva condyloma acuminatum is the chief clinical symptom which hints at a high possibility of infection with high-risk HPV. The patients are at high-risk for CIN and cervical cancer. We must pay more attention to the cervix in cases with vulva condyloma acuminatum.

MICROSTRIP APPLICATOR FOR TREATMENT OF CERVICAL EROSION AND CERVICAL CONDYLOMA ACUMINATUM

This Paper introduces a microstrip applicator for treatment of cervical erosion and cervical condyloma acuminatum with microwave tissue coagulationmethod. The principle of the applicator,the theoretical calculation of near field distribution of the applicator covered with a lossy dielectric, the experimental resultsfor its performance of the impedance matching and for microwave leakage energyare reported. Finally,the therapeutic method and effects are presented.

Fas and Bc1-2 EXpression on T Lymphocyte Subsets in the Peripheral Blood of Relapsing Patients with Condyloma Acuminatum

Objective: To study the expression of Fas and Bcl-2proteins on T lymphocyte subsets in the peripheralblood of relapsing patients with condyloma acuminatum(CA) and healthy controls. Methods: Flow cytometry (permeabization andstaining procedure with conjugated antibodies) wasused. Results: We observed that the expression of Fasprotein on CD4^+ T lymphocyte subset of CA patientswas significantly higher than that of healthy controls(P<0.01). Conclusions: Increased expression of Fas proteinon CD4^+ T lymphocyte subset may be a cause of de-creased percentage of CD4^+ T lymphocyte subset. Thisinduces the increased ratio of CD4^+/CD8^+.

Observation of Ultrastructure in Lesions of Condyloma Acuminatum

Objective: To explore the effect of morphological changes in the development of condyloma acuminatum (CA) Materials and Methods: Lesions in five patients with CA were observed . Results: Upon electron microscopy, the most characteristic feature of the lesions important for diagnosis, was the presence of distinct perinuclear vacuolizations, or so-called koilocytes, among some epithelial cells. These cells possessed hyperchromatic nuclei, swollen mitochondria, dilated endoplasmic reticulum and dissolved glycogen. There were interchromatin granules and perichromatin granules in some nuclei. Moreover some virus particles were also seen in the nuclei of some infected cells. Conclusions: The ultrastructural findings may be used to histopathologically explain the pathogenesis and mechanism of this disease, and it is helpful for diagnosis of CA .

Effect of Activation-induced Cell Death of Peripheral Blood Mononuclear cells in Patients with Condyloma Acuminatum

Objective: To investigate the effect of activation-induced cell death (AICD) on cellular immune function in the condyloma acuminatum(CA). Methods: Peripheral blood mononuclear cells (PBMC) were isolated from normal healthy individuals (control group) and patients with CA. PBMC were cultured with PHA-P for 48h in vitro. Apoptosis of the PBMC was detected by flow cytometry. Supernatant cytokines (IL-2 and IL-10) were assayed by ELISA. Results: The rate of PBMC apoptosis in both CA group and control group in fresh PBMC was very low and similar in both groups(P>0.05). The rate of PBMC apoptosis within the CA group was noticeably increased compared to that of the control (P<0.001)af-ter PBMC were cultured for 48h. The level of IL-2 was significantly lower in the CA group than in the control group (P<0.001), The level of IL-10 was significantly higher in the CA group compared to thecontrol group(P<0.001). Conclusion: Study results indicate that AICD may affect cellular mediated immune function and play an important role in the pathogenesis of CA.

The Lymphoblastoid Cell Lines of Recurrence Condyloma Acuminatum Patients Produce Lower Level of Tumor Necrosis Factor Stimulated with LPS

To study the mechanism of Condyloma acuminatum (CA) recurrence, and the association of CA recurrence with the ability of the host derived lymphoblastoid cell lines (LCL) stimulated by LPS to produce tumor necrosis factor (TNF), EBV-transformed B LCL were used as TNF producing cells The ability of LCL stimulated by LPS to produce TNF was measured by bioassay The results showed that the LCL from CA patients (including recurrent and non-recurrent CA patients) produced similar level of TNF stimulated by LPS to that of normal controls (29 54%±11 28% vs 34 31%±11 46%, P =0 1498) The LCL of CA recurrent patients produced significantly lower amount of TNF than that of non-recurrent CA patients (23 72%±7 41% vs 37 33%±11 10%, P =0 0032) Compared with the normal controls, CA recurrent patients showed a decreased ability to produce TNF (23 72%±7 41 vs 34 31%±11 46, P =0 0054), whereas CA non recurrent patients had the similar ability to the controls (37 33%±11 10 vs 34 31%±11 46, P =0 4914) It was concluded that the onset of CA was not relevant to the individual's ability to produce TNF But the recurrence of CA was associated with the ability to produce TNF It was also indicated that the TNF involved cellular immunity might play an important role in the clearance of the residual HPV by the host after treatment

Telomerase Activity in Condyloma Acuminatum Tissue with Different HPV Types

Summary: The telomerse activity in condyloma acuminatum (CA) tissue with human papillomavirus (HPV) types of 6/11 and 16/18 was detected to investigate the function of telomerase in the occurrence, development and carcinogenesis of genital CA. Forty-two biopsies from patients with gennital CA and 30 control tissue samples were tested for telomerase activity, HPV presence and types. The telomerase activity was determined by modified telomerase repeat amplification protocol (TRAP) assay and HPV typing by polymerase chain reaction (PCR) with typing-specific primers. Results showed that HPV-DNA was negative and the expression rate of telomerase was 16.7 % in all normal skin samples. All CA samples were positive for HPV (6/11 type was found in 32 cases, 16/18 in 3 and mixed type in 7). Telomerase activity was detectable in all CA patients. The telomerase activity in CA of 16/18 type was apparently higher than in CA of 6/11 type. It was concluded that the hyperplasia in CA might be increased as a result of HPV infection, suggesting that the activation of telomerase by HPV, especially by 16/18 type may play a role in the etiology and carcinogenesis of genital CA.

The Efficacy of Podophyllin Cautery Added to Surgical Excision for Eradication of Vulvar Condylomata Accuminata;Randomized Controlled Trial

Context: Condyloma acuminatum is a common morbidity caused by human papillomavirus infection. Objective: To compare the recurrence rate after surgical excision with or without podophyllin cautery. Design, Setting, Participants: Sixty women were enrolled in a study that was conducted in Cairo from Jan-2017 to Mar-2018. Interventions: All women received the same preparations. After randomization;in the study group (N = 30), podophyllin cautery was added to surgical removal in the follow-up period. In the control group (N = 30), only surgical removal was used. Main Outcome Measure: The main outcome measure was the estimation of the recurrence of the lesion during the follow-up period. The secondary outcome measures were the incidence of adverse events. Results: Both groups were comparable (p-value > 0.05) with regard to the age and BMI. Recurrence was significantly lower (P = 0.001) in the study group than the control group. In the study group, five cases (17.2%) have recurrence whereas, in the control group, 18 (60.0%) had suffered recurrence. The ARR was 42.8% (CI 95%: 18% - 60.9%) with RR of 0.29 (CI 95%: 0.12% - 0.67%) and NNT2 (CI 95%: 6% - 2%). During the follow-up period, 19 cases (65.5%) of the study group experienced pain versus only eight cases (26.7%) in the control group (p = 0.003). However, the development of scars was less in the study group 7 (24.1%) than in the control group 19 (63.3%), (p = 0.002). Conclusion: Podophyllin cautery, when added to surgical removal, is effective in decreasing the incidence recurrence in cases with condylomata acuminata.

Expression of CD40 and CD40L on Peripheral Blood Mononuclear Cells in Patients with Condyloma Acuminatum

To observe the expression of CD40/CD40L on peripheral blood mononuclear cells （PBMC） in patients with eondyloma aeuminatum （CA）, flow eytometry was employed to examine the expression of CD40 and CD40L on PMBC in 36 patients with CA and 20 healthy controls. Our results showed that mean level of CD40 expression in CA patients was significantly lower than that in the controls （6.58 %±2.74 % vs 14.81 %±6.12 %, t=5. 703, P〈0.05）; the average level of CD40L in CA patients was also significantly lower than that in the controls （0.73 % ±0.54 % vs 2.67 %±2.43 %, t=3. 532, P〈0.05）. Our resutls suggest that the reduced costimulatory interaction of CD40 and CD40L in CA patients may be one of the important factors responsible for the low cellular immunity.

Changes of Circulating Platelet-Derived Growth Factor and Granulocyte Colony-Stimulating Factor in Patients with Condyloma Acuminatum

Objective: To study the expression levels of platelet-derived growth factor (PDGF) and granulocyte colony-stimulatingfactor (G-CSF) in peripheral blood and their role in thepathogenesis of Condyloma acuminatum (CA). Methods: Sera were taken from 70 patients with Condylomaacuminatum and compared with 35 healthy controls. PDGFand G-CSF in serum were quantitated using a dual antibodysandwich enzyme-linked immunoabsorbent assay (ELISA). Results: Serum concentrations of PDGF and G-CSF weresignificantly increased in patients with Condylomaacuminatum (CA) compared to controls (P<0.001 and P<0.005respectively). Serum levels of PDGF and G-CSF correlatedwith clinical severity of CA, but no significant difference wasobserved between different duration of disease groups. Asignificant positive correlation was noticed between neutrophilcount and G-CSF levels (γ=0.38, P<0.001), and the neutrophilcount showed no significant correlation with PDGE Conclusion: The results indicated that increased expressionof PDGF an -CSF in peripheral blood might be involved in pathogenesis of CA.

CO_(2)LASER PLUS PHOTODYNAMIC THERAPY VERSUS CO_(2)LASER IN THE TREATMENT OF CONDYLOMA ACUMINATUM:A RANDOMIZED COMPARATIVE STUDY

To compare the efficacy and safety of CO_(2)laser plus 5-aminolevulinic acid(ALA)photodynamic therapy(PDT)with CO_(2)laser for the treatment of multiple condyloma acuminatum(CA),120 patients with multiple CA were allocated into two groups—combined group(CO_(2)laser plus ALA-PDT,n=60)and CO_(2)laser group(CO_(2)laser plus placebo-PDT,n=60).After CO_(2)laser,a 20%ALA or a placebo solution was applied to the CA area 3 h before illumination with red light(635 nm,100mW/cm^(2),80 J/cm^(2)).The treatment was repeated seven days after the first treatment if the lesions were not completely resolved.The complete response rate,recurrence rate and adverse effects in the two groups were analyzed.After two treatments,the complete response rates in the CO_(2)laser group and combined group were 100%(509/509)and 100%(507/507)in the CA(p>0:05),respectively.The recurrence rates in the CO_(2)laser group and combined group were 44.9%(229/509)and 10.6%(54/507)in the CA(p<0:05),respectively.The adverse effects in CO_(2)laser group was more than that in combined group.The combined group is a more effective treatment for multiple CA compared with CO_(2)laser group.T/S.Style the highlighted text as abstract.

Effect of hTERC and FOXP3 gene magnification in condyloma acuminate lesion on the immune response and cell apoptosis

Objective:To study the effect of hTERC and FOXP3 gene amplification in condyloma acuminate lesions on the immune response and cell apoptosis.Methods:The condyloma acuminate lesions diagnosed between May 2014 and October 2016 and the normal skin tissue from circumcision during the same period were collected to extract RNA and then determine hTERC, FOXP3 and apoptosis-related gene mRNA amplification, and after protein extraction, the protein levels of immune response-related cytokines were determined.Results:hTERC, FOXP3, Livin and Survivin gene mRNA amplification as well as IL-4 and IL-10 protein levels in condyloma acuminatum lesions were significantly higher than those in normal skin tissue while TRAIL, Caspase-3 and PDCD4 mRNA amplification as well as IL-2 and TNF-α protein levels were significantly lower than those in normal skin tissue;IL-2 and TNF-α protein levels in condyloma acuminatum lesions with high FOXP3 mRNA expression were significantly lower than those in condyloma acuminatum lesions with low FOXP3 mRNA expression while IL-4 and IL-10 protein levels were significantly higher than those in condyloma acuminatum lesions with low FOXP3 mRNA expression;Livin and Survivin mRNA amplification in condyloma acuminatum lesions with high hTERC mRNA expression were significantly higher than those in condyloma acuminatum lesions with low hTERC mRNA expression while TRAIL, Caspase-3 and PDCD4 mRNA amplification were significantly lower than those in condyloma acuminatum lesions with low hTERC mRNA expression.Conclusion:Highly expressed hTERC and FOXP3 genes in condyloma acuminatum lesions can inhibit apoptosis and inhibit antiviral immune response respectively.

CA患者HPV基因分型检测及复发相关因素分析

目的了解从化地区尖锐湿疣患者HPV基因型别的分布情况,并观察复发与性别、HPV基因型别有无相关性。方法采用PCR-反向点杂交法对163例初发尖锐湿疣患者进行HPV基因检测,并在完全清除疣体后连续观察3个月、6个月,记录有无复发。结果 163例尖锐湿疣患者HPV-DNA阳性率达91.41%,共检测出20种HPV基因类型,比较常见的分别是HPV6(43.62%),HPV 11(41.61%),HPV16(12.75%)和HPV43(10.60%)。低危型HPV检出率为86.58%,高危型HPV检出率为41.61%。男女之间高危型检测率差异有统计学意义(P=0.012)。单一感染发生率(63.76%)高于混合感染(36.24%)。随访3个月时,复发35例,6个月时复发44例。在3个月及6个月时,男女之间、高低危型之间、单一感染与混合感染之间复发率差异均无统计学意义(P>0.05))。结论本地区尖锐湿疣患者以HPV6,11,16型感染为主,尖锐湿疣复发和性别、HPV基因型别无相关性。

TRAIL和Caspase-3在尖锐湿疣组织中的表达

目的观察尖锐湿疣(CA)组织中肿瘤坏死因子相关凋亡诱导配体(TRAIL)和半胱氨酸蛋白酶-3(Caspase-3)的表达情况并探讨其意义。方法采用免疫组化SP法检测30例CA患者组织中和20例正常包皮组织中TRAIL和Caspase-3的表达情况,并进行相关性分析。结果 CA组织中TRAIL阳性表达率(73.33%)和表达强度(+～3+)明显高于正常包皮组织(20.00%和+～2+),差异均有统计学意义(P均<0.05)。CA组织中Caspase-3阳性表达率(60.00%)略低于正常包皮组织(65.00%),差异无统计学意义(P>0.05);但是CA组织中的Caspase-3表达强度(+～2+)低于正常包皮组(2+～3+),差异也有统计学意义(P<0.05)。CA组织中TRAIL和Caspase-3的阳性表达呈现正相关(P<0.05)。结论 CA组织中均存在TRAIL和Caspase-3异常表达,该两者可能共同参与了CA的发生和发展。

CD1a和E-cadherin分子在尖锐湿疣皮损中的表达

目的:研究CD1a和E-cadherin分子在尖锐湿疣(CA)皮损中的表达情况及相互关系,探讨CA皮损局部免疫微环境的变化。方法:采用免疫组化法检测38例CA患者皮损和12名正常人包皮中CD1a和E-cadherin分子的表达。结果:CA皮损中CD1a和E-cadherin分子表达水平较正常包皮显著降低,CD1a和E-cadherin分子的表达呈正相关。结论:CA患者皮损CD1a和E-cadherin分子表达降低可能导致人乳头瘤病毒(HPV)抗原递呈障碍,在HPV逃逸机体免疫监视的过程中可能发挥重要作用。

尖锐湿疣和鲍温样丘疹病中Livin,Caspase-3的表达及相关性分析

目的探讨尖锐湿疣(CA)和鲍温样丘疹病(BP)中凋亡抑制蛋白(Livin),半胱氨酸蛋白酶-3(Caspase-3)的表达,并进行相关性分析。方法选取CA,BP皮损和正常成年人包皮组织各30例,采用免疫组化法检测Livin,Caspase-3蛋白的表达。结果 Livin在BP组中阳性率(3.833±1.533)高于CA组(3.033±1.866)及正常对照组(2.733±1.112),Caspase-3在正常对照组中阳性率(3.833±1.556)高于CA组(1.733±1.856)及BP组(2.000±1.640),差异均有统计学意义(P均<0.05)。在CA,BP及正常对照组中Livin与Caspase-3的表达均无相关性(P均>0.05)。结论 Livin,Caspase-3可能在HPV感染相关的皮肤增殖性疾病中发挥一定作用。