Condylomata Acuminata

尖锐湿疣
  • 文章类型: Journal Article
    目的总结人乳头瘤病毒(HPV)与HPV相关疾病的类型分布,并通过总结谱系的流行情况,探讨HPV52和58高流行的潜在原因。次谱系,和中国女性的变异。我们搜索了PubMed,EMBASE,CNKI,和万方从一月开始,2012年6月,2023年确定所有符合条件的研究。我们排除了接受HPV疫苗接种的患者。数据汇总在表格和云/雨地图中。共提取102项报告HPV分布的研究和15项报告HPV52/HPV58变体的研究。在中国女性中,与宫颈癌(CC)相关的前5种流行HPV类型为HPV16,18,58,52和33.在患有阴道癌和癌前病变的患者中,最常见的HPV类型为16和52,其次为58.对于患有尖锐湿疣(CA)的女性,最常见的HPV类型是11和6.在中国患有HPV感染的女性中,谱系B在HPV52中最突出,谱系A在HPV58中最常见。除了全球流行的HPV16型,我们的研究结果揭示了在患有HPV相关疾病的中国女性中HPV52/58的独特高患病率.HPV52变体主要偏向于谱系B和亚谱系B2,并且HPV58变体强烈偏向于谱系A和亚谱系A1。需要进一步研究HPV52/58中的高流行谱系和亚谱系与癌症风险之间的关联。我们的发现强调了在中国接种九价HPV疫苗的重要性。
    To summarize the distribution of types of human papillomavirus (HPV) associated with HPV-related diseases and investigate the potential causes of high prevalence of HPV 52 and 58 by summarizing the prevalence of lineages, sub-lineages, and mutations among Chinese women. We searched PubMed, EMBASE, CNKI, and WanFang from January, 2012 to June, 2023 to identify all the eligible studies. We excluded patients who had received HPV vaccinations. Data were summarized in tables and cloud/rain maps. A total of 102 studies reporting HPV distribution and 15 studies reporting HPV52/HPV58 variants were extracted. Among Chinese women, the top five prevalent HPV types associated with cervical cancer (CC) were HPV16, 18, 58, 52, and 33. In patients with vaginal cancers and precancerous lesions, the most common HPV types were 16 and 52 followed by 58. For women with condyloma acuminatum (CA), the most common HPV types were 11 and 6. In Chinese women with HPV infection, lineage B was the most prominently identified for HPV52, and lineage A was the most common for HPV58. In addition to HPV types 16, which is prevalent worldwide, our findings revealed the unique high prevalence of HPV 52/58 among Chinese women with HPV-related diseases. HPV 52 variants were predominantly biased toward lineage B and sub-lineage B2, and HPV 58 variants were strongly biased toward lineage A and sub-lineage A1. Further investigations on the association between the high prevalent lineage and sub-lineage in HPV 52/58 and the risk of cancer risk are needed. Our findings underscore the importance of vaccination with the nine-valent HPV vaccine in China.
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  • 文章类型: Review
    目的:肛门尖锐湿疣是肛门人乳头瘤病毒感染的表现,可与癌前病变和鳞状细胞癌相关。已经描述了几种治疗方法,包括氩等离子体凝固。对有关该主题的证据进行了叙述性审查。
    方法:使用PubMed进行搜索,Scopus,和WebofScience数据库。
    结果:5项研究报道了氩离子凝固术治疗肛门/肛周尖锐湿疣。在其中3项研究中,与其他治疗方法进行了比较(添加咪喹莫特,电脉冲,还有电灼术,分别)。研究之间的氩气血浆凝固设置有所不同。这种类型的治疗对于消融是有效的。研究之间的复发率和随访时间差异很大。无重大并发症,如疼痛,疤痕,性功能障碍,或严重出血被描述。
    结论:研究表明,氩离子凝固术是治疗肛门和肛周尖锐湿疣的有效和安全的方法。
    OBJECTIVE: Anal condylomas are a manifestation of anal human papillomavirus infection and can be associated with precancerous lesions and squamous cell carcinomas. Several methods have been described for treatment, including argon plasma coagulation. A narrative review of the evidence published on this topic was conducted.
    METHODS: A search was conducted using PubMed, Scopus, and Web of Science databases.
    RESULTS: Five studies reported on anal/perianal condyloma treatment with argon plasma coagulation. In 3 of these studies, there was a comparison with other treatment methods (addition of imiquimod, electrofulguration, and electrocautery, respectively). Argon plasma coagulation settings varied between studies. This type of treatment was effective for ablation. Recurrence rates and follow-up times varied largely between studies. No major complications, such as pain, scarring, sexual dysfunction, or severe bleeding were described.
    CONCLUSIONS: Studies indicate that argon plasma coagulation is an effective and safe therapy for anal and perianal condylomas.
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  • 文章类型: Journal Article
    背景:由人乳头瘤病毒(HPV)引起的肛门生殖器疣(AGW)是HPV感染的常见表现。治疗策略通常包括通过手术或其他手段促进疣消退或去除的局部疗法。这些策略是有效的,但与高复发率相关。已知HPV疫苗可有效预防AGW,但初步数据表明它们可能为活性AGW的消退提供治疗益处。
    目的:本研究旨在确定HPV疫苗治疗活性AGW的功效。
    方法:对PubMed的系统搜索,Embase,和Cochrane系统审查数据库于2023年7月进行,对发布日期没有限制。对已确定的文章和相关评论文章的参考文献进行人工审查,以补充搜索。如果他们报告至少一名患有活性AGW的患者接受至少一剂任何HPV疫苗,则包括文章。感兴趣的主要结果是AGW在任何时间段内的完全或部分消退。评估符合纳入标准的每项研究的偏倚风险。
    结果:共7篇。这些包括1项随机对照试验(RCT),1个非RCT,3个案例系列,2例病例报告。所有这些都被认为有很高的偏倚风险。研究结果表明,HPV疫苗可能为具有活性AGW的人提供治疗益处。研究报告了病灶内和全身给药疫苗的结果。根据AGW的部分和完全回归,结果报告有所改善。
    结论:本综述发现,有证据表明HPV疫苗可能在活性AGW的治疗中发挥作用。研究结果支持应向以前未接种疫苗的患者提供疫苗的观点,但对接种疫苗的患者进行病灶内给药的作用尚不清楚。
    BACKGROUND: Anogenital warts (AGWs) caused by the human papillomavirus (HPV) are a common manifestation of HPV infection. Treatment strategies generally include topical therapies to promote wart regression or removal through surgical or other means. These strategies are effective but are associated with high rates of recurrence. HPV vaccines are known to be effective for prevention of AGWs yet preliminary data suggest they may offer therapeutic benefit for regression of active AGWs.
    OBJECTIVE: This study aimed to determine the efficacy of HPV vaccines for treatment of active AGWs.
    METHODS: A systematic search of PubMed, Embase, and Cochrane Database of Systematic Reviews was conducted in July 2023 with no limits on date of publication. The search was supplemented with a manual review of references from identified articles and pertinent review articles. Articles were included if they reported at least one patient with active AGWs who received at least one dose of any HPV vaccine. The primary outcome of interest was complete or partial regression of AGWs over any time period. Risk of bias was assessed for each study meeting inclusion criteria.
    RESULTS: Seven articles were included. These included 1 randomized controlled trial (RCT), 1 non-RCT, 3 case series, and 2 case reports. All were deemed to have a high risk of bias. Study results showed evidence that HPV vaccines may offer therapeutic benefits to those with active AGWs. Studies reported outcomes for both intralesional and systemically administered vaccines. Outcomes reported improvement according to both partial and complete regression of AGWs.
    CONCLUSIONS: This review found that there is evidence that HPV vaccines may have a role in the treatment of active AGWs. Findings support the notion that the vaccine should be offered to previously unvaccinated patients but the role of intralesional administration of the vaccine to vaccinated patients is still unclear.
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  • 文章类型: Systematic Review
    背景:肛门生殖器疣(AGW)是最常见的性病。许多治疗选择是可用的,但没有编码。系统评价(SRs)和荟萃分析(MAs)有助于制定有关AGW管理的建议。我们研究的目的是使用三种国际工具评估SRs在当地管理AGW的质量和一致性。
    方法:从开始到2022年1月10日搜索了七个电子数据库。感兴趣的干预是AGW的任何局部治疗。语言和人口没有限制。方法的质量,报告质量和偏倚风险(ROB)纳入SRs的局部治疗AGW由两名研究者独立评估与测量工具评估系统评价版本II(AMSTARII),系统评价中的偏差风险(ROBIS)和系统评价和荟萃分析的首选报告项目(PRISMA)。
    结果:22个SR/MA符合所有纳入标准。根据AMSTARII的结果,九项纳入的评论被评为低质量,只有五个是高质量的。基于ROBIS工具,只有9个SR/MA的ROB较低。领域评估的“研究资格标准”大多被评为低ROB,与其他领域不同。有了PRISMA,十个SR/MA的报告清单相对完整,但是摘要的主题仍然存在一些报道缺陷,协议和注册,ROB和资金。
    结论:几种治疗方案可用于AGW的局部治疗,并得到了广泛的研究。然而,由于这些SR/MA的ROB较多,质量较低,其中只有少数具有足够的方法学质量来支持指南。
    CRD42021265175。
    Anogenital warts (AGWs) are among the most common STDs. Many therapy options are available but are not codified. Systematic reviews (SRs) and meta-analyses (MAs) are helpful to elaborate recommendations on the management of AGWs. The objective of our study was to assess the quality and consistency of SRs for the local management of AGWs using three international tools.
    Seven electronic databases were searched from inception to 10 January 2022 for this SR. The intervention of interest was any local treatment of AGWs. There was no restriction on language and population. The methodological quality, reporting quality and risk of bias (ROB) of the included SRs for the local treatments of AGWs were assessed independently by two investigators with A Measurement Tool to Assess systematic Reviews version II (AMSTAR II), Risk of Bias in Systematic Reviews (ROBIS) and Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA).
    Twenty-two SRs/MAs met all inclusion criteria. According to the results of the AMSTAR II, nine included reviews were rated critically as being of low quality, and only five were of high quality. Based on the ROBIS tool, only nine SRs/MAs had a low ROB. The domain-assessed \'study eligibility criteria\' were mostly rated at a low ROB, unlike the other domains. With PRISMA, the reporting checklist was relatively complete for ten SRs/MAs, but some reporting weaknesses remained in the topics of the abstract, protocol and registration, ROB and funding.
    Several therapy options are available for the local management of AGWs and are widely studied. However, due to the many ROB and low quality of these SRs/MAs, only a few of them have the sufficient methodological quality to support guidelines.
    CRD42021265175.
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  • 文章类型: Systematic Review
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  • 文章类型: Review
    目的:了解女性生殖器疣患者性功能的变化。
    方法:在本综述研究中,搜索的数据库包括:PubMed,科学直接,Scopus,WebofScience,Cochrane系统评论图书馆,谷歌学者,ProQuest,威利,和Highwire出版社。初始搜索没有应用研究设计限制,包括2005年至2021年发表的定性和定量研究。
    结果:选择了19篇文章并进行了叙述分析。研究的质量几乎很好。研究结果分为三类:生殖器疣(GWs)和人乳头瘤病毒(HPV)女性性功能障碍的患病率;生殖器疣女性性功能障碍的类型,和相关因素;生殖器疣的性心理影响。
    结论:本研究提供了生殖器疣女性性功能变化的最新证据。尽管大多数研究的结果表明,患有生殖器疣的妇女几乎在所有方面都经历了性功能障碍,研究设计和研究人群的差异使得很难确定特定类型的疾病,如性欲,或者这些女性的觉醒障碍。根据这篇综述的结果,建议今后在这一领域进行更多的研究。
    背景:(PROSPERO:CRD42020188584,https://www.crd.约克。AC.uk/prospro/display_record.php?RecordID=188584)。
    OBJECTIVE: To provide an understanding of the changes in sexual function in women with genital warts.
    METHODS: In this review study, databases searched included: PubMed, Science Direct, Scopus, Web of Science, Cochrane Library of Systematic Reviews, Google Scholar, ProQuest, Wiley, and Highwire Press. No study design limitations were applied to the initial search, and qualitative and quantitative studies published between 2005 and 2021 were included.
    RESULTS: 19 articles were selected and analyzed narratively. The quality of the studies was almost good. The findings were classified into three groups: The prevalence of sexual dysfunction in women with genital warts (GWs) and Human Papillomavirus (HPV); Types of sexual dysfunction in women with genital warts, and associated factors; Psychosexual effects of genital warts.
    CONCLUSIONS: This study provides up-to-date evidence of the changes in sexual function in women with genital warts. Although the results of most studies showed that women with genital warts experienced sexual dysfunction in almost all dimensions, differences in study design and study population made it difficult to determine the specific type of disorder such as libido, or arousal disorders in these women. Based on the findings of this review, more research in this field is recommended for the future.
    BACKGROUND: (PROSPERO: CRD42020188584, https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=188584 ).
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  • 文章类型: Journal Article
    背景:尖锐湿疣(CA)是一种性传播感染,在不同年龄的男性和女性中,与性精神病发病率相关的患病率很高。到目前为止,治疗方式产生低清除率和复发率(RR),也被认为是低质量证据.光动力疗法(PDT)是一种新颖且有前途的疗法,可有效治愈和预防CA复发。
    方法:根据系统评价和荟萃分析的首选报告项目(PRISMA)报告本系统评价,并注册到国际前瞻性系统评价注册中心(PROSPERO)(CRD42022332760)。
    结果:本系统综述包括10项研究。在接受多次PDT治疗后,生殖器疣患者的完全反应(CR)的显着值在63-100%之间。在所有10项研究中,复发率相对较低,RR低于17%。纳入研究的质量评估报告大多是高质量的研究。
    结论:与其他治疗相比,PDT治疗导致更高的CR和更低的RR。因此,PDT可以是低RR和最小副作用的CA的替代治疗。额外的研究,特别是各国的随机临床试验,需要进一步证实这种治疗并制定明确的方案。
    Condylomata acuminata (CA) is a sexually transmitted infection with a high prevalence associated with psychosexual morbidity in both men and women of various age. Up to now, treatment modalities yield low clearance and recurrence rate (RR) and are also deemed low quality evidence-wise. Photodynamic therapy (PDT) is a novel and promising therapy to effectively cure and prevent CA recurrence.
    This systematic review was reported according to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) and registered to the International Prospective Register of Systematic Review (PROSPERO) (CRD42022332760).
    Ten studies were included in this systematic review. A significant value of complete response (CR) ranging from 63-100% in patients with genital warts after receiving several sessions of PDT. A relatively low recurrence rate was seen in all 10 studies, with an RR of less than 17%. Quality assessment of included studies reported mostly high-quality research.
    PDT therapy resulted in a higher CR with significantly lower RR compared to other therapies. Thus, PDT can be an alternative treatment of CA with low RR and minimal side effects. Additional research, especially randomized clinical trials in various countries, is needed to further substantiate this treatment and formulate definitive protocols.
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  • 文章类型: Case Reports
    生殖器疣是由几种人类乳头状瘤病毒引起的。尽管在大多数情况下无症状,他们可能会在心理和身体上困扰患者。最近,使用不同抗原的病灶内免疫疗法,例如BacilleCalmette-Guerin疫苗,念珠菌抗原和麻疹,腮腺炎,和风疹(MMR)疫苗-在生殖器疣的治疗中显示出有希望的疗效。我们报告了阿曼男性的两例病例,他们向Barka综合诊所的皮肤科就诊,患有顽固性生殖器疣,通过病灶内注射MMR疫苗完全解决。
    Genital warts are caused by several strains of Human Papilloma Viruses. Although asymptomatic in most cases, they can be psychologically and physically distressing for patients. Recently, intralesional immunotherapy using different antigens-such as Bacille Calmette-Guerin vaccine, candida antigen and measles, mumps, and rubella (MMR) vaccine-have shown promising efficacy in the treatment of genital warts. We report two cases in Omani males who presented to the Dermatology Department at Barka Polyclinic with recalcitrant genital warts that resolved completely with intralesional injection of the MMR vaccine.
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  • 文章类型: Journal Article
    背景:在人群中,由人乳头瘤病毒(HPV)感染引起的疣的发生率很高。光动力疗法(PDT),作为一种新兴的疣治疗方法,越来越多的研究证明是有效和安全的。对先前文献的荟萃分析旨在研究PDT作为疣的一线治疗的潜力。
    方法:为了从相关文献中获取适当和准确的信息,PubMed的四个数据库,Embase,搜索了WebofScience和Cochrane图书馆。分析疣清除率和患者治愈率作为主要结果。复发率,同时记录患者满意度和不良反应.
    结果:根据我们的检索策略,共纳入19项随机对照试验(RCT)。在手足疣组中,与安慰剂相比,PDT显示出疣清除率的统计学显着改善(P=0.02),其他激光器(P<0.0001),冷冻治疗(P<0.009)。PDT在尖锐湿疣组中的使用在疣清除率方面并不优越,值低于二氧化碳(CO2)激光(P=0.003)和电外科发生器(P<0.00001)。然而,所有研究均提到PDT后复发率显著降低.在飞机疣组中,在治愈率方面,PDT优于安慰剂(P=0.003)和冷冻疗法(P=0.007)。
    结论:我们的研究表明,PDT提供了一些好处,包括但不限于积极的临床结果,低复发率和轻微的不良反应。可以推荐使用PDT作为一线治疗。
    BACKGROUND: The incidence of warts caused by human papilloma virus (HPV) infection is very high in the population. Photodynamic therapy (PDT), as an emerging method for wart treatment, has been demonstrated to be effective and safe by an increasing number of studies. This meta-analysis of previous literature aimed to investigate the potential of PDT as a first-line treatment for warts.
    METHODS: To acquire proper and accurate information from relevant literature, the four databases PubMed, Embase, Web of Science and the Cochrane Library were searched. The wart clearance rate and patient cure rate were analysed as the primary outcomes. The recurrence rate, patient satisfaction and adverse reactions were also recorded.
    RESULTS: A total of 19 randomized controlled trials (RCTs) were included based on our search strategy. In the hand and foot wart group, PDT showed a statistically significant improvement in the wart clearance rate compared with placebo (P = 0.02), other lasers (P < 0.0001), and cryotherapy (P < 0.009). PDT use in the condyloma acuminatum group was not superior in terms of the wart clearance rate, with a value lower than that of the carbon dioxide (CO2) laser (P = 0.003) and electrosurgical generator (P < 0.00001). However, all studies mentioned a significant decrease in the recurrence rate after PDT. In the plane wart group, PDT demonstrated its superiority over placebo (P = 0.003) and cryotherapy (P = 0.007) in terms of the cure rate.
    CONCLUSIONS: Our study demonstrated that PDT provided several benefits, including but not limited to positive clinical outcomes, low recurrence rates and minor adverse reactions. The use of PDT as first-line therapy can be recommended.
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  • 文章类型: Case Reports
    尖锐湿疣(CA)是由人乳头瘤病毒(HPV)引起的病理。它表现为外阴疣的出现,耻骨,和肛门直肠区域,但可能发生在其他领域。这是一种常见疾病,可以通过使用避孕套或疫苗等措施来预防。Topical,当地,药理学,外科,和切除治疗可用于这种病理。宏观上,它看起来像植物肿瘤,具有向外围分支的单个植入基部,有花椰菜的外观。CA在显微镜下由棘皮病定义,角化不全,乳头状瘤和肾细胞增多症。免疫组织化学研究可以检测各种HPV毒株或病毒抗原的存在,并且可以强调某些特定特征;例如,在这项研究中提出的案例中,我们观察到,由于用抗分化簇(CD)34抗体鉴定的强血管碱基,肿瘤具有暴发性进化,由于上皮细胞的存在具有高度的细胞增殖,正如抗Ki67抗体所证明的那样,肿瘤抑制基因的失活和抗p53抗体的免疫标记的出现,通过对p63的强烈免疫反应性,揭示了具有发育异常和肿瘤转化潜力的细胞的存在,而且还通过检测与HPV存在相关的p16INK4a的免疫标记。此外,肿瘤对细胞角蛋白(CK)AE1/AE3具有免疫反应性,对基底层的CK5/6具有部分免疫反应性,对CK7呈阴性,这表明所述肿瘤的鳞状上皮起源。已经确定了炎症系统的上上皮细胞,如用抗CD68抗体免疫标记的巨噬细胞,用抗CD3抗体免疫标记的T淋巴细胞和用抗CD20抗体免疫标记的罕见B淋巴细胞,这证明了从结构中去除病毒的强烈细胞反应。手术和切除治疗对患者有帮助,因为她能够恢复正常的性活动和排便,另一方面,微观研究显示CA恶性转化的潜力。
    Condyloma acuminatum (CA) is a pathology caused by the human papillomavirus (HPV). It is manifested by the appearance of warts in the vulvar, pubic, and anorectal regions, but can occur in other areas. It is a common disease that can be prevented by using measures such as condoms or vaccine. Topical, local, pharmacological, surgical, and excisional therapy options are available for this pathology. Macroscopically, it appears as a vegetative tumor, with a single implantation base that branches towards the periphery, with a cauliflower appearance. CA is defined microscopically by acanthosis, parakeratosis, papillomatosis and koilocytosis. Immunohistochemical studies can detect the presence of various HPV strains or viral antigens and can emphasize certain specific characteristics; e.g., in the case presented in this study, we observed that the tumor had a fulminant evolution due to a strong vascular base identified with anti-cluster of differentiation (CD) 34 antibody, by the existence of epithelial cells with a high degree of cell proliferation, as evidenced by the anti-Ki67 antibody, the inactivation of the tumor suppressor gene and the appearance of immunolabeling for the anti-p53 antibody, by the strong immunoreactivity for p63 which reveals the existence of cells with dysplastic and neoplastic transformation potential, but also by detecting the immunolabeling for p16INK4a that is associated with the existence of HPV. Also, the tumor was immunoreactive for cytokeratin (CK) AE1∕AE3, partially immunoreactive for CK5∕6 in the basal layer and negative for CK7, which demonstrates the squamous epithelial origin of the described tumor. Subepithelial cells of the inflammatory system have been identified, such as macrophages immunolabeled with anti-CD68 antibody, T-lymphocytes immunolabeled with anti-CD3 antibody and rare B-lymphocytes immunolabeled with anti-CD20 antibody, which demonstrates the strong cellular response to remove the virus from the structure. Surgical and excisional treatment was helpful for the patient, because she was able to resume normal sexual activity and defecation, and on the other hand, microscopic studies showed the potential for malignant transformation of CA.
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