The Study Of 5-aminolevulinic Acid-mediated Photodynamic Therapy Alone Or In Combination With Other Traditional Methods For The Recurrence Of Condyloma Acuminatum

Objective To explore the possible recurrence factors after the treatment of condyloma acuminatum by ALA photodynamic therapy(ALA-PDT)alone or combined with other traditional methods,and to provide feasible suggestions for clinical treatment.Methods With questionnaire survey method to collect 150 cases with outpatient hospital dermatological department of ningxia medical university since January 1,2019 to June 1,2020 clinical and(or)pathological diagnosis of condyloma acuminatum(CA),and the use of ALA PDT-or ALA PDT+liquid nitrogen frozen or ALA PDT+microwave treatment of patients with clinical data,to local mucosa lesion area visible warts disappear,back to normal for clinical cure standards,follow-up at least 6 months after cure,clinical cure to stage the original parts and around 2 cm has new wart body for recurrence standards,divided into relapse group and recurrence group,Patients’ general information,living habits,human papillomavirus(HPV)infection,skin lesions,sexual life history,combined with other sexually transmitted diseases or immune system related diseases,etc.,were analyzed to analyze the risk factors that may affect CA recurrence.Results 150 cases of CA patients meeting the inclusion criteria were collected,of which 1case was lost to follow-up and 2 cases had incomplete data.147 cases were actually included,and the age of onset was 20-29 years old(49 cases,33.3%).The anal area was most involved in 108males(40 cases,37.0%).The vagina and cervix were most involved in 39 females(21 cases,53.8%).Among 147 cases,65 cases completed HPV genotyping by PCR reverse dot hybridization before treatment,of which 3 cases were negative and 62 cases were positive.The number of low risk HPV6 infection was the largest(47 cases,75.8%).The high-risk type was HPV56(8 cases,12.9%).After 6 months of follow-up,the general situation,living habits,human papillomavirus(HPV)infection,skin lesions,sexual life history,and history of other sexually transmitted diseases or immune system related diseases were tested by chi-square test between the relapsed and non-relapsed groups.During the treatment and follow-up of smoking(P = 0.048),drinking(P = 0.007),stay up late(P = 0.007),the presence of merging the anus or genital area erosion(P < 0.001),number of sexual partners(P = 0.002),and sex partners whether infection(P= 0.028),with or without wearing a condom habits(P = 0.012),treatment and follow-up period have sex(P < 0.001),with other sexually transmitted diseases,or immune system related diseases(P < 0.001)were CA recurrence factors(all P < 0.05),Logistics single factor and multiple factors regression analysis in the treatment and follow-up period to stay up late(P = 0.024,OR = 17.931),with the anus OR genital area erosion(P = 0.009,OR = 61.754),number of sexual partners OR 2(P = 0.045,OR = 11.952),the merger partners infection(P = 0.014,OR = 66.520),treatment and follow-up period sex(P = 0.015,OR = 36.144),merging,he sexually transmitted disease OR illness associated with the immune system(P = 0.021,OR=19.164)were independent risk factors for recurrence after CA treatment(all P < 0.05,OR >1).The habit of wearing condoms during sexual life(P=0.003,OR=0.003)was an independent protective factor for recurrence after CA treatment(P < 0.05,OR < 1).Conclusion CA often occurred in the anal and genital area,sexually active people men more than women.In men,the site of the disease was anus and perianal,coronal sulcus,urethra,prepuce and perineal area.In women,the sites of infection were vagina and cervix,labia,anus and perianal/perineal area,and urethra.HPV6/11 was the main type of low risk HPV infection.HPV56 was the main high-risk type.Clinical cure stage were followed up for 6 months has a history of staying up late,the anus or genital area erosion,feculent sexual behavior with multiple partners,merger partners infection,with other sexually transmitted diseases or immune system related diseases are more likely to cause a recurrence of CA in the stage of clinical cure,and sex in time to wear a condom can reduce the risk of recurrence of CA.