Chronic cervicitis: current opportunities for diagnosis and treatment
Objective. To carry out a systems analysis of the data available in the literature on current opportunities for diagnosis and management tactics in patients with chronic cervicitis (CC), by using the results of clinical, colposcopic, morphological, and molecular genetic examinations.Amirkhanyan A.S., Prilepskaya V.N., Bairamova G.R., Burmenskaya O.V., Kostava M.N., Asaturova A.V.
Material and methods. The paper reviews 37 Russian and foreign articles from Pubmed and Medscape resources, which have been published since 2012.
Results. The literature describes the clinical course of CC, current diagnostic methods aimed at identifying the cause of inflammation, and the differentiated choice of therapy in relation to the etiological factor and the degree of a cervical lesion.
Conclusion. The use of current diagnostic and treatment techniques will be able to prevent the chronicity of the process, complications and to avoid overdiagnosis of the degree of a cervical lesion and unfounded invasive procedures.
Keywords
chronic cervicitis
vulvovaginitis
vaginal microbiota
liquid-based cytology
colposcopy
References
1. Серов В.Н., Сухих Г.Т., Прилепская В.Н., Радзинский В.Е., ред. Руководство по амбулаторно-поликлинической помощи в акушерстве и гинекологии. М.: ГЭОТАР-Медиа; 2016. 1136с. [Serov V.N., Sukhikh G.T., Prilepskaya V.N., Radzinskii V.E. Guide to outpatient care in obstetrics and gynecology. Moscow: GEOTAR-Media; 2016. 1136p. (in Russian)]
2. Воспалительные заболевания нижних отделов генитального тракта: диалог гинеколога и микробиолога. XVII Всероссийский научно-образовательный форум «Мать и дитя». Эффективная фармакотерапия. 2017; 13: 26-33. [Inflammatory diseases of the lower sections of the genital tract: dialogue between the gynecologist and the microbiologist. XVII All-Russian Scientific and Educational Forum “Mother and Child”. Effektivnaya farmakoterapiya. 2017; 13: 26-33. (in Russian)]
3. Caixeta R.C., Ribeiro A.A., Segatti K.D., Saddi V.A., Figueiredo Alves R.R., dos Santos Carneiro M.A., Rabelo-Santos S.H. Association between the human papillomavirus, bacterial vaginosis and cervicitis and the detection of abnormalities in cervical smears from teenage girls and young women. Diagn. Cytopathol. 2015; 43(10): 780-5.
4. Ollendorff A.T. Cervicitis. Updated: Feb 09, 2017.
5. Jayakumar N.K. Cervicitis: how often is it non-specific! J. Clin. Diagn. Res. 2015; 9(3): EC11-2.
6. Байрамова Г.Р. Рецидивирующий вульвовагинальный кандидоз: клиника, диагностика, лечение: автореф. дисс. … д-ра мед. наук. М.; 2013. 46с. [Bairamova G. R. Recurrent vulvovaginal candidiasis: clinic, diagnosis, treatment: author’s abstract. diss. ... Dr. med. science. Moscow; 2013. 46p. (in Russian)]
7. Mitra A., MacIntyre D.A., Marchesi J.R., Lee Y.S., Bennett Ph.R., Kyrgiou M. The vaginal microbiota, human papillomavirus infection and cervical intraepithelial neoplasia: what do we know and where are we going next? Microbiome. 2016; 4(1): 58.
8. Мальцева Л.И., Фаррахова Л.Н., Ахметзянова А.В., Нигматуллина Н.А. Оценка ВПЧ-ассоциированного хронического цервицита как фактора риска развития рака шейки матки. Практическая медицина. 2012; 9: 73-6. [Maltseva L.I., Farrakhova L.N., Akhmetzyanova A.V., Nigmatullina N.A. Assessment of HPV-associated chronic cervicitis as a risk factor for cervical cancer. Prakticheskaya meditsina. 2012; 9: 73-6. (in Russian)]
9. HPV Information Centre. Available at: http://www.hpvcentre.net/index.php
10. José Veríssimo Fernandes, Thales Allyrio Araújo de Medeiros Fernandes. Human papillomavirus: biology and pathogenesis. In: Davy Vanden Broeck, ed. Human papillomavirus and related diseases – from bench to bedside – a clinical perspective. In Tech; 2012: 3-40.
11. Shen G., Cheng J., Wang Y., Zhou P., Zhang G. Viral DNA load of high-risk human papilloma virus is closely associated with the grade of cervical lesions. Int. J. Clin. Exp. Med. 2014; 7(12): 5826-31.
12. Tummers B., Van Der Burg S.H. High-risk human papillomavirus targets crossroads in immune signaling. Viruses. 2015; 7(5): 2485-506.
13. Van Der Burg S.H. Immunotherapy of human papilloma virus induced disease. Open Virol. J. 2012; 6(Suppl. 2: M11) 257-63.
14. Роговская С.И., Бебнева Т.Н. Доброкачественные заболевания шейки матки. В кн.: Роговская С.И., Липова Е.В., ред. Шейка матки, влагалище, вульва. Руководство для практикующих врачей. М.: Status Praesens; 2016: 460-515. [Rogovskaya S.I., Bebneva T.N. Cervix, vagina, vulva. A Guide for Practitioners. Moscow; 2016: 460–515. (in Russian)]
15. Kyrgiou M. Imperial College London. Vaginal microbiome: its effect on cervical precancer and treatment. http://dx.doi.org10.1016/j.trsl.2016.07.004
16. Сухих Г.Т., Прилепская В.Н., ред. Профилактика рака шейки матки. Руководство для врачей. М.: МЕДпресс-информ; 2012. 192с. [Sukhikh G.T., Prilepskaya V.N., eds. Prophylaxis of cervical cancer. A guide for doctors. Moscow: MEDpress-inform; 2012. 192p. (in Russian)]
17. Байрамова Г.Р., Файзуллин Л.З., Королькова А.И., Полозников А.А., Киселев В.И. Скрининг рака шейки матки: что нового в мировой практике. Акушерство и гинекология. 2016; 7: 17-21. http://dx.doi.org/10.18565/aig.2016.7.17-21 [Bairamova G.R., Faizullin L.Z., Korolkova A.I., Poloznikov A.A., Kiselev V.I. Cervical cancer screening: What is new in global practice? Akusherstvo i ginekologiya/Obstetrics and Gynecology. 2016; (7): 17-21. (in Russian) http://dx.doi.org/10.18565/aig.2016.7.17-21]
18. Fernandes J.V., DE Medeiros Fernandes T.A., DE Azevedo J.C., Cobucci R.N., DE Carvalho M.G., Andrade V.S., DE Araújo J.M. Link between chronic inflammation and human papillomavirus-induced carcinogenesis (Review). Oncol. Lett. 2015; 9(3): 1015-26.
19. Feng Y.K., Peng Y., Zhu L., Niu X.Y. Relationship of human papillomavirus subtypes and multiple infection with different cervical precancerous diseases in Sichuan Province. Sichuan Da Xue Xue Bao Yi Xue Ban. 2015; 46(3): 422-5, 462.
20. World Health Organization. Comprehensive cervical cancer control. A guide to essential practice. 2nd ed. Geneva: WHO; 2014. http//www.who.int/repro ductivehealth/ publications/ cancers/cervical-cancer-guide/en/
21. Mirzaie-Kashani E., Bouzari M., Talebi A., Arbabzadeh-Zavareh F. Detection of human papilloma virus in chronic cervicitis, cervical adenocarcinoma, intraepithelial neoplasia and squamus cell carcinoma. Jundishapur J. Microbiol. 2014;7(5): e9930.
22. Прилепская В.Н., Байрамова Г.Р., Коган Е.А., Чернова В.Ф., Окушко А.Н. Новые возможности ранней диагностики и профилактики ВПЧ-ассоциированных поражений шейки матки. Медицинский совет. 2015; XX: 72-7. [Prilepskaya V.N., Bayramova G.R., Kogan E.A., Chernova V.F., Okushko A.N. New opportunities for early diagnosis and prevention of HPV-associated cervical lesions. Meditsinsky sovet. 2015; XX: 72-7. (in Russian)]
23. Бебнева Т.Н., Муйжнек Е.Л., Роговская С.И., Киселев В.И., Ашрафян Л.А. Патогенетическое лечение неопластических процессов шейки матки: новые подходы. Доктор.Ру. 2016; 3: 9-14. [Bebneva T.N., Muizhnek E.L., Rogovskaya S.I., Kiselev V.I., Ashrafyan L.A. Pathogenetic treatment of neoplastic processes of the cervix: new approaches. Doktor.Ru. 2016; 3(120): 9–14. (in Russian)]
24. Качалина Т.С., Шахова Н.М., Качалина О.В., Елисеева Д.Д. Хронический цервицит и ВПЧ-инфекция в репродуктивном возрасте. Пути снижения диагностической и лечебной агрессии. Акушерство, гинекология и репродукция. 2012; 6(4): 6-12. [Kachalina T.S., Shakhova N.M., Kachalina O.V., Eliseeva D.D. Chronic cervicitis and HPV infection in the reproductive age. Ways to reduce the diagnostic and therapeutic aggression. Akusherstvo, ginekologiya i reproduktsiya. 2012; 4: 6–12. (in Russian)]
25. Jahic М., Jahic Е. The diagnostic approach to patients with atypical squamous cells of undetermined significance Pap on the cervix. Med. Arch. 2016; 70(4): 296-8.
26. Унанян А.Л., Коссович Ю.М. Хронический цервицит: особенности этиологии, патогенеза, диагностики и лечения. Российский вестник акушера-гинеколога. 2012. 12(6): 40-5. [Unanyan A.L., Kossovich Yu.M. Chronic cervicitis: features of etiology, pathogenesis, diagnosis and treatment. Ros. vestn. akushera-ginekologa; 2012. 12(6): 40–5. (in Russian)]
27. Роговская С.И. Микробиоценоз влагалища и цервикальная патология. Consilium medicum. 2014; 16(6): 51-5. [Rogovskaya S.I. Vaginal microbiocenosis and cervical pathology. Consilium Medicum. 2014; 16(6): 51–5. (in Russian)]
28. Coronado P.J., Fasero M. Colposcopy combined with dynamic spectral imaging. A prospective clinical study. Eur. J. Obstet. Gynecol. Reprod. Biol. 2016; 196: 11-6.
29. Bourmenskaya O., Bayramova G., Nepsha O., Rebrikov D.,Trofimov D., Muravieva V., Sukhikh G. Vaginal smear TNF-alpha, IL18, and GATA3 mRNA levels correlate with local inflammation. Int. J. Biomed. 2014; 4(4): 204-8.
30. Рахматулина М.Р., Соколовский Е.В., Малова И.О., Аполихина И.А., Мелкумян А.Г. Федеральные клинические рекомендации по ведению больных урогенитальными заболеваниями, вызванными Ureaplasma spp., Mycoplasma hominis. М.: Российское общество дерматологов и косметологов, Российское общество акушеров-гинекологов; 2015. [Rakhmatulina M.R., Sokolovsky E.V., Malova I.O., Apolikhina I.A., Melkumyan A.G. Federal clinical guidelines for management of patients with urogenital diseases caused by Ureaplasma spp., Mycoplasma hominis. Moscow: Russian Society of Dermatologists and Cosmetologists, Russian Society of Obstetricians and Gynecologists; 2015. (in Russian)]
31. Аполихина И.А., Горбунова Е.А., Додова Е.Г., Гасанова Г.Ф. Современные аспекты комбинированной антибактериальной терапии неспецифических вагинитов и цервицитов (результаты неинтервенционного исследования BALANCE). Акушерство и гинекология. 2015; 8: 70-7. [Apolikhina I.A., Gorbunova E.A., Dodova E.G., Gasanova G.F. Current aspects of combination antibiotic therapy for nonspecific vaginitis and cervicitis: Results of the non-interventional study Balance. Akusherstvo i ginekologiya/Obstetrics and Gynecology. 2015; (8): 70-7. (in Russian)]
32. Tansarli G.S., Skalidis T., Legakis N.J., Falagas M.E. Abnormal vaginal flora in symptomatic non-pregnant and pregnant women in a Greek hospital: a prospective study. Eur. J. Clin. Microbiol. Infect. Dis. 2017; 36(2): 227-32.
33. Biernat-Sudolska M., Szostek S., Rojek-Zakrzewska D., Klimek M., Kosz-Vnenchak M. Concomitant infections with human papillomavirus and various mycoplasma and ureaplasma species in women with abnormal cervical cytology. Adv. Med. Sci. 2011; 56(2): 299-303.
34. Яковлев С.В., Рафальский В.В., Сидоренко С.В., Спичак Т.В., ред. Стратегия и тактика рационального применения антимикробных средств в амбулаторной практике. Евразийские клинические рекомендации. М.: Издательство «Пре100 Принт»; 2016. 144с. [Yakovlev S.V., Rafalsky V.V., Sidorenko S.V., Spichak T.V., ed. Strategy and tactics of rational use of antimicrobial agents in outpatient practice. Eurasian clinical recommendations. Moscow: Publishing house “Pre100 Print”; 2016. 144p. (in Russian)]
35. Huang C., Long X., Jing S., Fan L., Xu K., Wang S., Zhu W. Ureaplasma urealyticum and Mycoplasma hominis infections and semen quality in 19,098 infertile men in China. World J. Urol. 2016; 34(7): 1039-44.
36. Савельева Г.М., Сухих Г.Т., Манухин И.Б., Радзинский В.Е., ред. Гинекология. Национальное руководство. 2-е изд. М.: ГЭОТАР-Медиа; 2017. 1048с. [Savelyeva G.M., Sukhikh G.T., Manukhin I.B., Radzinsky V.E., ed. Gynecology. National guideline. 2nd ed. Moscow: GEOTAR-Media; 2017. 1048. (in Russian)]
Received 13.10.2017
Accepted 27.10.2017
About the Authors
Amirkhanyan Armine Samvelovna, post-graduate student of the scientific-polyclinic department, Research Center of Obstetrics, Gynecology, and Perinatology,Ministry of Health of Russia. 117997, Russia, Moscow, Ac. Oparina str. 4. E-mail: 07062005@mail.ru
Prilepskaya Vera Nikolaevna, doctor of medical science, Deputy Director for Science, Research Center of Obstetrics, Gynecology, and Perinatology,
Ministry of Health of Russia. 117997, Russia, Moscow, Ac. Oparina str. 4. Tel.: +74954386934
Bayramova Gyuldana Raufovna, MD, head of the department. on the clinical work of the scientific and polyclinic department, Research Center of Obstetrics,
Gynecology, and Perinatology, Ministry of Health of Russia. 117997, Russia, Moscow, Ac. Oparina str. 4. Tel.: +79099947700. E-mail: g_bairamova@oparina4.ru
Burmenskaya Olga Vladimirovna, MD, Researcher of the laboratory of molecular genetics methods, National Medical Research Center of Obstetrics, Gynecology, and Perinatology named after Academician V.I. Kulakov, Ministry of Health of Russia.
117997, Russia, Moscow, Ac. Oparina str. 4. Tel.: +74954382292. E-mail: o_bourmenskaya@oparina4.ru
Kostava Marina Nesterovna, obstetrician-gynecologist of the scientific-polyclinic department, National Medical Research Center of Obstetrics, Gynecology, and Perinatology named after Academician V.I. Kulakov, Ministry of Health of Russia. 117997, Russia, Moscow, Ac. Oparina str. 4. Tel.: +74954383044. E-mail: m_kostava@oparina4.ru
Asaturova Alexandra Vyacheslavovna, PhD, senior scientific researcher of pathology department, National Medical Research Center of Obstetrics, Gynecology, and Perinatology named after Academician V.I. Kulakov, Ministry of Health of Russia.
117997, Russia, Moscow, Ac. Oparina str. 4. Tel.: +74954382311. E-mail: a_asaturova@oparina4.ru
For citations: Amirkhanyan A.S., Prilepskaya V.N., Bairamova G.R., Burmenskaya O.V., Kostava M.N., Asaturova A.V. Chronic cervicitis: current opportunities for diagnosis and treatment. Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2018; (4): 22-7. (in Russian)
https://dx.doi.org/10.18565/aig.2018.4.22-27
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