Analysis of immune status changes and prognostic factors in patients with persistent cervical intraepithelial neoplasia Ⅰtreated with Ella-Photodynamic therapy
10.3969/j.issn.1000-484X.2025.10.010
- VernacularTitle:持续性宫颈低级别上皮内瘤变患者艾拉-光动力疗法治疗后免疫状态变化及预后影响因素分析
- Author:
Jinsheng HAN
1
;
Xiaohui ZHAO
1
Author Information
1. 河北省沧州中西医结合医院综合外科,沧州 061000
- Publication Type:Journal Article
- Keywords:
Persistent cervix intraepithelial neoplasia Ⅰ;
Ella-Photodynamic therapy;
Therapeutic effect;
Prognostic factors
- From:
Chinese Journal of Immunology
2025;41(10):2360-2367
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate immune status changes and prognostic factors of patients with persistent cervix intraepi-thelial neoplasia Ⅰ(CINⅠ)after Ella-Photodynamic(ALA-PDT)treatment.Methods:A total of 160 patients with persistent CINⅠwho were admitted to Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine from June 2020 to October 2022 were selected as study objects,and divided into good prognosis group(n=100)and poor prognosis group(n=60)according to recurrence 12 months after operation.General data,clinical indicators affecting poor prognosis and therapeutic effect of ALA-PDT were compared between two groups.Risk factors affecting poor prognosis was analyzed by multivariate Logistic regression and nomogram model was established.Logistic regression and clinical decision analysis(DCA)curve were used to analyze predictive value of prognostic factors,and danger stratification was performed by X-tile software.Results:Total effective rate was 96.88%,and inflammatory condition were improved after treatment(P<0.05).After ALA-PDT treatment,expressions of IL-2,IFN-γ,CD3+T,CD4+T and CD8+T were signifi-cantly higher than before treatment,and expression of IL-4 was significantly lower than before treatment(P<0.05).There were signifi-cant differences in expressions of IL-2,IL-4,IFN-γ,CD3+T,CD4+T and CD8+T when severe cervical erosion occurred and lesions involved glands.Patients with persistent CINⅠ had lesions involving glands and severe cervical erosion,increased IL-4 level and decreased IL-2,IFN-γ,CD3+T,CD4+T and CD8+T levels at 6～12 months after treatment with ALA-PDT were independent risk factors for poor prognosis(P<0.05).Prediction nomogram model based on independent influencing factors had high differentiation,accuracy and clinical applicability.Conclusion:ALA-PDT has an ideal therapeutic effect for persistent CINⅠ.If patients have lesions involving glands and severe cervical erosion,abnormal IL-2,IL-4,IFN-γ,CD3+T,CD4+T and CD8+T after treatment,attention should be paid to occurrence of poor prognosis.
