Effect Of ALA-PDT On Bcl-2 And Survivin Expression In Condyloma Acuminatum

Background and ObjectiveCondyloma acuminatum(CA),coused by human papillomavirus(HPV), is one of the common sexually transmitted disease(STD) nowadays. In recent years, its incidence continues to rise, ranking second in STD, which is related to its transmission, the sex of opening up in recent years and the biological behavior of human papillomavirus.This phenomenon has attracted worldwide attention. HPV is found in the smallest double hammer type DNA virus, specifically infects human, causing skin and mucosal lesions. HPV types have been found more than 180 kinds, but more than 90% of CA is caused by type HPV6, 11. CA is mainly transmitted through sexual contact and young men and women sexually active are mainly infected objects. The incubation period ranged from 20 days to 6 months, averaging three months. Typical clinical manifestations show as a pale red papule or wart, if secondary infection can appear odor, erosion, itching or pain. The disease can occur malignant, so patients have heavy economic pressure and psychological burden. Nowadays, HPV can not be directly eliminatesd and the main treatment for the disease is to remove the wart. In recent years, photodynamic therapy(PDT) is applied to cure genital warts, especially some special parts, and have achieved good effect with reducing recurrence. 5-aminolevulinic acid photodynamic therapy(ALA-PDT) is used more in dermatology. Clinical data confirmed that this method had some advantage: less-invasive, safer, well tolerated, reducing relapse and relieve physical and mental suffering of patients. Bcl-2 and Survivin is clear apoptosis inhibitory factor and it is highly expressed in a variety of tumor tissues but little research in CA tissues. Specific mechanisms for PDT treatment of genital warts is not clear, we detect Bcl-2 and Survivin expression before and after detection of ALA-PDT treatment to explore the mechanisms of ALA-PDT treatment of genital warts.Materials and Methods1 Materials48 cases of specimens are collected from patients of The First Affiliated Hospital of Zhengzhou University dermatology outpatient department from September 2014 to September 2015, including 28 males and 20 females, aged from 18 to 60, averaging 33.25; disease duration from 15 to 120 days with an average of 53.10 days. All patients had typical clinical CA features, acetic acid white test positive, laboratory examinations showed HPV infection, pathology consistent. All patients had no other systemic diseases, without any pre-treatment.2 Methods48 cases of CA patients taken ALT-PDT treatment established pre-treatment as a control group and after treatment for the experimental group. Use Immunohistochemical SP method to detect the expression of Bcl-2 gene and Survivin in CA tissue cells.Results of Evaluation: The expression of Bcl-2 located in the cytoplasm, the positive expression of Survivin was mainly localized in the cytoplasm and nucleus, both showed a pale yellow to brown granular calm. Coloring strength and the percentage of cells positive expression was observed, tinting strength rating criteria: 0,1,2,3 points respectively not colored, yellow, brown or tan; percentage of positive cells of total cells: 0 1,2,3,4 points, followed by the corresponding ≤10%, 11% ~ 25%, 26% ~ 50%, 51% ~ 75%, ≥76%. Results were considered by multiplying their total score, judge as follows: 0 representatives negative(-), 1-4 scores on behalf of weak positive(+), 6-8 scores on behalf of the positive(++), 9-12 scores on behalf of the strong positive(+++).3 Statistical analysesUse SPSS21.0 statistical software for statistical analysis of the acquired data. Bcl-2 and Survivin expression rate before and after treatment ALT-PDT compared using χ~2 test, the positive expression intensity were compared using the rank sum test. This experiment set P < 0.05 was considered statistically significant.Results1 The expression of Bcl-2 before and after photodynamic in CA tissuesBefore ALA-PDT treatment Bcl-2 positive expression is 42 cases, the positive rate was 87.50%(42/48), the expression intensity is positive or strong positive(++ ~ +++); after treatment Bcl-2 positive expression is 18 cases, the positive rate was 37.50 %(18/48), the intensity of expression is weak positive(+).The positive expression rate between the two groups was statistically significant(χ~2 = 25.60, P <0.001) and two sets of positive expression intensity difference was statistically significant(H=38.40,P<0.001).2 The expression of Survivin before and after photodynamic in CA tissuesBefore ALA-PDT treatment Survivin positive expression is 38 cases, the positive rate was79.16%(38/48), the expression intensity is positive or strong positive(++ ~ +++). After treatment Bcl-2 positive expression is 20 cases, the positive rate was 41.67%(20/48), the intensity of expression is weak positive(+).The positive expression rate between the two groups was statistically significant(χ~2 =14.11, P <0.001) and two sets of positive expression intensity difference was statistically significant(H = 19.72, P <0.001).3 The correlation analysis in expression of Bcl-2 and Survivin in CA tissue cells after photodynamic48 cases in the CA cells after ALA-PDT treatment, Bcl-2 of 18 cases is positive expression and 30 cases is negative expression. 48 cases in the CA cells after ALA-PDT treatment, Survivin of 20 cases is positive expression and 28 cases is negative expression. After Spearman correlation analysis, we found that after ALA-PDT treatment of 48 CA tissue cases Bcl-2 and Survivin expression was positively correlated(r=0.48,P<0.05).Conclusions 1 After ALA-PDT treatment, positive expression rate and expression intensity of Bcl-2 were decreased significantly in CA tissues; suggesting that ALA-PDT therapy can promote CA cells apoptosis, inhibit proliferation.2 After ALA-PDT treatment, positive expression rate and expression intensity of Survivin were decreased significantly in CA tissues; suggesting that ALA-PDT therapy can promote CA cells apoptosis, inhibit proliferation.3 After ALA-PDL treatment, Bcl-2 and Survivin all decreased and was positively correlated in CA tissues, suggesting that after ALA-PDT, Bcl-2 and Survivin may have synergistic effect on promoting CA cells apoptosis and inhibiting abnormal proliferation.