ABSTRACT
Objective@#To evaluate the clinical efficacy of hematoporphyrin monomethyl ether-based photodynamic (HMME-PDT) therapy for the treatment of port-wine stain (PWS) and its sonographic changes.@*Methods@#A total of 45 patients with confirmed PWS were enrolled from the Department of Dermatology, Third Affiliated Hospital of Soochow University from March 2017 to June 2018, including 5 with pink PWS, 39 with purplish red PWS and 1 with thickened PWS. All the patients received 3 sessions of HMME-PDT therapy. The skin thickness and density were compared before and after the treatment by using high-frequency ultrasound. Ranked data were analyzed by using nonparametric test. Measurement data were expressed as mean ± standard deviation, and analyzed using ony-way analysis of variance. Multiple comparisons were performed using Student-Newman-Keuls-q (SNK-q) test. The results were considered to be statistically significant if P < 0.05.@*Results@#Among the 45 patients with PWS who completed the treatment and follow-up, 10 were cured, 21 received marked improvement, 12 received improvement, and 1 showed no response. The total response rate was 97.78%, and the response rate in the patients with pink PWS was higher than that in the patients with purplish red PWS (U = 12.50, P < 0.001) . The difference value of the skin thickness or skin density before and after the treatment significantly differed among the cured patients, patients receiving marked improvement and those receiving improvement (skin thickness:0.65 ± 0.21, 0.56 ± 0.88, 0.37 ± 0.12 mm respectively; skin density: -8.65 ± 2.19, -6.86 ± 2.79, -4.92 ± 2.91 g/cm3 respectively; F = 14.528, 5.428 respectively, both P < 0.001) , and the difference values of the skin thickness and density were significantly higher in the cured patients than in those receiving improvement (q = 5.82, 4.63, both P < 0.05) . Erythematous swelling to different extents occurred at the laser-exposed sites in the zygomatic and cheek region in 23 patients with PWS and in the frontal-zygomatic region in 6 with PWS after the HMME-PDT therapy, but gradually regressed about 1 week later. Pale brown crusts were observed at the laser-exposed sites in 35 patients, and shed spontaneously about 3 weeks later. Post-inflammatory hyperpigmentation at the laser-exposed sites was observed in 4 patients, and gradually regressed after 2-month follow-up.@*Conclusions@#HMME-PDT therapy is effective for the treatment of PWS, with high safety and few adverse reactions. High-frequency ultrasound can be used for objectively evaluating the clinical efficacy of HMME-PDT therapy.
ABSTRACT
Objective To evaluate the clinical efficacy of hematoporphyrin monomethyl etherbased photodynamic (HMME-PDT) therapy for the treatment of port-wine stain (PWS) and its sonographic changes.Methods A total of 45 patients with confirmed PWS were enrolled from the Department of Dermatology,Third Affiliated Hospital of Soochow University from March 2017 to June 2018,including 5 with pink PWS,39 with purplish red PWS and 1 with thickened PWS.All the patients received 3 sessions of HMME-PDT therapy.The skin thickness and density were compared before and after the treatment by using high-frequency ultrasound.Ranked data were analyzed by using nonparametric test.Measurement data were expressed as mean ± standard deviation,and analyzed using ony-way analysis of variance.Multiple comparisons were performed using Student-Newman-Keuls-q (SNK-q) test.The results were considered to be statistically significant if P ＜ 0.05.Results Among the 45 patients with PWS who completed the treatment and follow-up,10 were cured,21 received marked improvement,12 received improvement,and 1 showed no response.The total response rate was 97.78％,and the response rate in the patients with pink PWS was higher than that in the patients with purplish red PWS (U =12.50,P ＜ 0.001).The difference value of the skin thickness or skin density before and after the treatment significantly differed among the cured patients,patients receiving marked improvement and those receiving improvement (skin thickness:0.65 ± 0.21,0.56 ± 0.88,0.37 ± 0.12 mm respectively;skin density:-8.65 ± 2.19,-6.86 ± 2.79,-4.92 ± 2.91 g/cm3 respectively;F =14.528,5.428 respectively,both P ＜ 0.001),and the difference values of the skin thickness and density were significantly higher in the cured patients than in those receiving improvement (q =5.82,4.63,both P ＜ 0.05).Erythematous swelling to different extents occurred at the laser-exposed sites in the zygomatic and cheek region in 23 patients with PWS and in the frontal-zygomatic region in 6 with PWS after the HMME-PDT therapy,but gradually regressed about 1 week later.Pale brown crusts were observed at the laser-exposed sites in 35 patients,and shed spontaneously about 3 weeks later.Post-inflammatory hyperpigmentation at the laser-exposed sites was observed in 4 patients,and gradually regressed after 2-month follow-up.Conclusions HMME-PDT therapy is effective for the treatment of PWS,with high safety and few adverse reactions.High-frequency ultrasound can be used for objectively evaluating the clinical efficacy of HMME-PDT therapy.
ABSTRACT
Objective To measure the expressions of zinc finger protein A20 and nuclear factor (NF)-κB in cutaneous squamous cell carcinoma (CSCC) tissue and their correlation with human papillomavirus (HPV) infection.Methods Tissue specimens were obtained from the lesions of 43 patients with CSCC and normal skin of 21 healthy human controls.Gene chips were used to detect the DNA of 21 HPV subtypes in these specimens.The expression levels of zinc finger protein A20 and NF-κB were determined by immunohistochemistry.The correlation between clinicopathological features of CSCC and HPV infection was estimated by Spearman rank correlation analysis.Results No significant difference was found in the expression level of either zinc finger protein A20 or NF-κB among patients of different age groups,gender,and with CSCC of different primary sites or histological grade (all P ＞ 0.05).However,there was a significant difference in the expression levels of zinc finger protein A20 and NF-κB between 39 patients with histological grade Ⅰ or Ⅱ and 4 patients with grade Ⅲ (25.85 ± 3.84 vs.48.34± 7.69 for zinc finger protein A20,46.64 ± 8.93 vs.57.34 ± 10.02 for NF-κB,both P ＜ 0.05),and between 3 patients with nodular metastasis and 40 patients without (35.34 ± 6.02 vs.26.51 ± 4.09 for zinc finger protein A20,57.53 ± 13.32 vs.45.45 ± 9.64 for NF-κB,P ＜ 0.05 or 0.01).The expression rate was 2/8,5/13 and 1/3 for zinc finger protein A20 (P ＞ 0.05),3/8,10/13 and 2/3 for NF-κB (P ＞ 0.05),in CSCC tissue specimens infected with low-risk HPV subtypes,high-risk subtypes,concurrent low-and high-risk HPV subtypes respectively.In HPV-infected CSCC tissue,a significantly positive correlation was found between the staining scores for zinc finger protein A20 and for NF-κB p65(r =3.14,P ＜ 0.05).Conclusion The high expressions of NF-κB and zinc finger protein A20 may play an important role in the oncogenesis of CSCC induced by HPV infection.
ABSTRACT
ObjectiveTo evaluate the relationship of human papillomavirus(HPV) intection with expressions of cell cycle regulatory proteins cyclin D1,E and their dependent kinase inhibitor p27 in bowenoid papulosis(BP).MethodsTissue specimens were obtained from the lesions of 44 patients with BP,and circumcised foreskin tissue from 10 males served as the control.Gene chip was used to determine the genotypes of HPV,and immunohistochemistry to quantify the expressions of cyclin D1,E,p27,in these specimens.Results Of the 44 BP specimens,all were positive for HPV DNA,38(86.36％) for high risk types of HPV,and 6 for low risk types of HPV.Of the high risk HPV-positive specimens,30(68.18％) harbored HPV16,16 harbored single HPV 16,14 harbored other types of HPV besides HPV 16,8 harbored other high risk types of HPV.HPV 6 predominated in low risk HPV-positive specimens.The expression of cyclin D1 was significantly higher in patients with high-risk HPV(u =53.00,P＜ 0.05),with both high and low risk HPV(u =5.00,P＜ 0.01) and with low risk HPV (u =22.50,P＜ 0.05) than in normal human controls,and higher in patients with both high and low risk HPV (u =44.00,P＜ 0.01) and with low risk HPV (u =22.50,P＜ 0.05) than those with high risk HPV.In the case of cyclin E expression,patients with high risk HPV (u =0.00,P ＜ 0.01 ),with both high and low risk HPV (u =4.00,P ＜ 0.01 ),and with low risk HPV(u =1.50,P ＜ 0.01 ) were higher than normal human controls,and patients with high risk HPV were higher than those with low risk HPV(u =11.00,P ＜ 0.01).No significant difference was observed in the expression of p27 between patients with high and low risk types of HPV.A significant increase was observed in the expression of p27 in patients aged ＞ 50 years compared with patients aged 20-30 years(u =47.00,P＜ 0.05) and aged 31-50 years (u =55.50,P＜ 0.05),as well as in the expression of cyclin E in patients aged ＞ 50 years compared with those aged 20-30 years(u =45.50,P ＜ 0.05),and in female patients compared with male patients (u =137.50,P＜ 0.05).ConlusionThere is a significant difference in the expression of cyclin D1,E and p27 among patients with BP infected with different types of HPV.