Possibilities of therapy for HPV-associated chronic cervicitis in women
Objective. To study the possibilities of the diagnosis and treatment of chronic cervicitis in women with human papillomavirus (HPV) infection in relation to the biomarkers of proliferation and carcinogenesis in the cervical epithelium.Maltseva L.I., Farrakhova L.N.
Subjects and methods. 245 female patients with HPV-associated chronic cervicitis and 20 healthy women were examined for the ratio of the urinary estrogen metabolites 2-OHE1 to 16α-ОНЕ1 (Estramet test system) and the expression of p16ink4a in the cervical epithelium by immunocytochemical assay. For the treatment of HPV-associated cervicitis, 30 patients used a combination of promisan and interferon-α or Panavir; 30 more patients received only Panavir or interferon-α.
Results. The oncoprotein р16іпк4а expression and the low 2-ОНЕ1/16α-ОНЕ1 ratio were found to be directly related to the long-term persistence of HPV and the progressive course of cervical pathology.
Conclusion. Six-month combination treatment with promisan and interferon-α led to normalization of the exchange of the estrogen metabolites, the elimination of HPV, and regression of an inflammatory response from CIN I-II to the cytological normal value in 86.7–93.3% of the women.
Keywords
human papillomavirus
cervicitis
cervical intraepithelial neoplasia
р16іпк4a
estrogen metabolites 2-hydroxyestrone and 16α-hydroxyestrone
indole-3-carbinol
epigallocatechin-3-gallate
Supplementary Materials
- Table 1. Comparison of cytological and morphological study results Chez ki nd of the uterus in p16-positive Comparison of cytological and morphological results of cervical research in p16-positive women (n = 6)
- Table 2. Dynamics of the average concentration of estrogen metabolites in patients with HPV-associated chronic cervicitis before and after treatment
- Fig. 1. Detection rate (%) CIN I - III degree in patients with persistent (1), and the transit of the secondary HPV infections (2) and the absence of virus (3)
- Fig. 2. The detection rate (%) of normal and impaired estrogen metabolism bol s GOVERNMENTAL chronic cervicitis and persistence of HPV (1) to form transient HPV infection (2), the absence of HPV (3) and in healthy women (4)
- Fig. 3. Mid 2-OHE 1 and 16α-OHE 1 (ng / ml) and their ratio in the urine of women with persistent (1), form transient HPV infection (2), the absence of HPV (3) and in healthy fo of O patients (4)
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Received 21.04.2017
Accepted 28.04.2017
About the Authors
Maltseva Larisa Ivanovna, doctor of medical sciences, Professor, Head of Department of obstetrics and gynecology № 1 Kazan State Medical Academy, Branch, Russian Medical Academy of Continuing Postgraduate Education. 420012, Russia, Kazan, Mushtari str. 11. Tel.: +79053144051. E-mail: laramalc@mail.ruFarrakhova Liliya Nailevna, candidate of medical sciences, obstetrician-gynecologist of Medical Center, OOO “Meditsina Krasoty” (The Medicine of Beauty).
420012, Russia, Kazan, Mushtari str. 11. Tel.: +79376132884. E-mail: lifara@mail.ru
For citations: Maltseva L.I., Farrakhova L.N. Possibilities
of therapy for HPV-associated chronic cervicitis in women.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2017; (6): 127-34. (in Russian)
http://dx.doi.org/10.18565/aig.2017.6.127-34
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