The impact on cervical epithelialization in destructive treatment in patients with cervical intraepithelial neoplasia, recurrent bacterial vaginosis and papillomavirus infection
Stolyarova U.V., Khvorostukhina N.F., Novichkov D.A., Suvorova G.S., Odnokozova O.S.
Objective: To evaluate the combined approach in the treatment of patients with mild cervical intraepithelial neoplasia (CIN I) accompanied by concomitant papillomavirus infection and recurrent bacterial vaginosis (BV) during destructive treatment of cervical pathology.
Materials and methods: The study included 100 patients aged 22 to 45 years with CIN I combined with papillomavirus infection and recurrent BV. The patients of group I (n=50) were prescribed suppositories Superlymph 25 IU intravaginally as perioperative therapy, the patients of group II (n=50) were administered traditional antiviral therapy and vaginal suppositories with dexpanthenol and chlorhexidine. Visual assessment of the cervix, colposcopy, cytological examination, human papillomavirus (HPV) testing, biopsy and determination of cytokine concentration in cervical mucus by enzyme immunoassay were performed. The statistical analysis was conducted using Microsoft Excel and Statistica 7.0 software.
Results: The complete elimination of HPV was noted 3 months after treatment in group I and negative test was observed after 6 months in 96% of patients; this parameter exceeded the indicator of group II by 1.6 times (p<0.001). The risk of recurrence of BV symptoms in group I was reduced by 2-5 times in the period from 1 to 6 months (p<0.05). The levels of TNFa, IFN-γ, and IL-6 were significantly lower in group I than those in group II after 1 and 3 months (p<0.001). The complete healing of the damaged area of the cervix was more frequently observed in group I. After 10 days, it was seen 1.4 times more often (p=0.04) and after 15 days, it was 1.3 times more common (p=0.04).
Conclusion: The use of Superlymph as a perioperative therapy for patients with mild CIN can increase the effectiveness of destructive treatment methods. This is achieved by completely eliminating HPV after three months and maintaining a negative HPV test after six months in 96% of cases. Additionally, Superlymph helps reduce levels of local pro-inflammatory cytokines and decrease the risk of bacterial vaginosis recurrence that in turn improves cervical epithelialization processes after surgery.
Authors’ contributions: Stolyarova U.V., Khvorostukhina N.F. – developinng the concept and design of the study; Stolyarova U.V., Suvorova G.S., Odnokozova O.S. – collecting and processing the material; Khvorostukhina N.F., Novichkov D.A. – statistical data processing; Stolyarova U.V., Novichkov D.A. – writing the text; Khvorostukhina N.F. – editing the article.
Conflicts of interest: The authors declare that there are no conflicts of interest.
Funding: The study was conducted without sponsorship.
Patient Consent for Publication: The patients signed informed consent for the publication of their data.
Authors' Data Sharing Statement: The data supporting the findings of this study are available on request from the corresponding author after approval from the principal investigator.
For citation: Stolyarova U.V., Khvorostukhina N.F., Novichkov D.A., Suvorova G.S., Odnokozova O.S.
The impact on cervical epithelialization in destructive treatment in patients with cervical intraepithelial neoplasia, recurrent bacterial vaginosis and papillomavirus infection.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2025; (10): 136-142 (in Russian)
https://dx.doi.org/10.18565/aig.2025.264
Keywords
cervical pathology
destructive treatment
ablation
bacterial vaginosis
papillomavirus infection
Superlymph
References
- Министерство здравоохранения Российской Федерации. Клинические рекомендации. Цервикальная интраэпителиальная неоплазия, эрозия и эктропион шейки матки. 2024. [Ministry of Health of the Russian Federation. Clinical guidelines. Cervical intraepithelial neoplasia, cervical erosion, and cervical ectropion. 2024. (in Russian)].
- Андреев А.О., Байрамова Г.Р., Зарецкий А.Р., Ребриков Д.В. Современные представления о ВПЧ как о мультифакторном предикторе развития плоскоклеточных интраэпителиальных поражений шейки матки. Акушерство и гинекология. 2022; 11: 60-6. [Andreev A.O., Bayramova G.R., Zaretsky A.R., Rebrikov D.V. Modern concepts of HPV as a multifactorial predictor of the development of squamous intraepithelial lesions of the cervix. Obstetrics and Gynecology. 2022; (11): 60-6 (in Russian)]. https://dx.doi.org/10.18565/aig.2022.11.60-66
- Shen T.T., Long C.Y., Wu M.P. Favorable cervical cancer mortality-to-incidence ratios of countries with good human development index rankings and high health expenditures. BMC Women's Health. 2023; 23(1): 284. https://dx.doi.org/10.1186/s12905-023-02423-y
- Zhou Y., Shi X., Liu J., Zhang L. Correlation between human papillomavirus viral load and cervical lesions classification: a review of current research. Front. Med. 2023; 10: 1111269. https://dx.doi.org/10.3389/fmed.2023.1111269
- World Health Organization. WHO guideline for screening and treatment of cervical pre-cancer lesions for cervical cancer prevention. Second edition. Available at: https://www.who.int/publications/i/item/9789240030824
- Kojalo U., Tisler A., Parna K., Kivite-Urtane A., Zodzika J., Stankunas M. et al. An overview of cervical cancer epidemiology and prevention in the Baltic States. BMC Public Health. 2023; 23(1): 660. https://dx.doi.org/10.1186/s12889-023-15524-y
- Siegel R.L., Miller K.D., Fuchs H.E., Jemal A. Cancer statistics, 2022. CA Cancer J. Clin. 2022; 72(1): 7-33. https://dx.doi.org/10.3322/caac.21708
- Селина Н.Н., Роговская С.И., Созаева Л.Г., Тумгоева Л.Б., Фадеев И.Э. Индукторы мукозального иммунитета в комбинации с радиоволновой эксцизией шейки матки при лечении пациенток с тяжелыми интраэпителиальными поражениями шейки матки. Клинические и иммунологические аспекты. Российский вестник акушера-гинеколога. 2018; 18(2): 107-13. [Selina N.N., Rogovskaia S.I., Sozaeva L.G., Tumgoeva L.B., Fadeev I.E. Inductors of mucosal immunity in combination with radiowave cervical excision in the treatment of patients with high-grade cervical intraepithelial lesions. Clinical and immunological aspects. Russian Bulletin of Obstetrician-Gynecologist. 2018; 18(2): 107-13 (in Russian)]. https://dx.doi.org/10.17116/rosakush2018182107-113
- Зароченцева Н.В., Баринова И.В., Джиджихия Л.К. Возможности применения противовирусной терапии у пациенток с цервикальными интраэпителиальными неоплазиями тяжелой степени (CIN II+/HSIL) при эксцизионных методах лечения. Вопросы практической кольпоскопии. Генитальные инфекции. 2024; 1: 18-25. [Zarochentseva N.V., Barinova I.V., Dzhidzhikhiya L.K. The possibilities of using antiviral therapy in patients with severe cervical intraepithelial neoplasia (CIN II+/HSIL) with excisional treatment methods. Issues of Practical Colposcopy & Genital Infections. 2024; 1: 18-25 (in Russian)]. https://dx.doi.org/10.46393/27826392_2024_1_18
- Хворостухина Н.Ф., Новичков Д.А., Степанова Н.Н. Новые возможности комплексного лечения осложненного эктропиона шейки матки. Медицинский совет. 2021; 13: 12-22. [Khvorostukhina N.F., Novichkov D.A., Stepanova N.N. New possibilities of complex ttreatment of cervical ectropion. Medical Council. 2021; 13: 12-22 (in Russian)]. https://dx.doi.org/10.21518/2079-701X-2021-13-12-22
- Рогожина И.Е., Столярова У.В., Нейфельд И.В. Оптимизация лечения патологии шейки матки у женщин с рецидивирующими неспецифическими цервицитами и вагинитами. Фарматека. 2017; 3(336): 31-5. [Rogozhina I.E., Stolyarova U.V., Neifeld I.V. Optimization of treatment of cervical pathology in women with recurrent nonspecific cervicitis and vaginitis. Pharmateca. 2017; 3(336): 31-5 (in Russian)].
- Ткаченко Л.В., Свиридова Н.И., Костенко Т.И., Гриценко И.А., Шишиморова С.Г. Современный подход к тактике ведения пациенток с цервикальной интраэпителиальной неоплазией легкой степени. Гинекология. 2020; 22(6): 56-61. [Tkachenko L.V., Sviridova N.I., Kostenko T.I., Gritsenko I.A., Shishimorova S.G. Modern approach to tactics of management of patients with cervical intraepitital neoplasia of easy degree. Gynecology. 2020; 22(6): 56-61 (in Russian)]. https://dx.doi.org/10.26442/20795696.2020.6.200504
- Столярова У.В., Рогожина И.Е., Скупова И.Н., Кузнецова М.В., Кузнецов Н.С., Асыркин А.С. Оптимизация тактики обследования и лечения женщин репродуктивного возраста с патологией шейки матки при хронических цервицитах и вагинитах. Эффективная фармакотерапия. 2021; 17(19): 8-15. [Stolyarova U.V., Rogozhina I.E., Skupova I.N., Kuznetsova M.V., Kuznetsov N.S., Asyrkin A.S. Optimization of examination and treatment tactics for women of reproductive age with cervical pathology in chronic cervitis and vaginitis. Effective pharmacotherapy. 2021; 17(19):8-15 (in Russian)]. https://dx.doi.org/10.33978/2307-3586-2021-17-19-8-14
- International Federation for Cervical Pathology and Colposcopy. Available at: https://ifcpc.org/
- Шперлинг Н.В., Шперлинг И.А. Лечение бактериального вагиноза, ассоциированного с бессимптомной формой папилломавирусной инфекции. Medline.ru. 2021; 22: 677-88. [Shperling N.V., Shperling I.A. Treatment of bacterial vaginosis associated with asymptomatic papillomavirus infection. Medline.ru. 2021; 22: 677-88. (in Russian)].
- Зароченцева Н.В., Белая Ю.М. Заболевания шейки матки у молодых женщин. Вопросы практической кольпоскопии. Генитальные инфекции. 2023; (1): 32-7. [Zarochentseva N.V., Belaya Yu.M. Cervical diseases in young women. Colposcopy Issues & Genital Infections. 2023; (1): 32-7 (in Russian)]. https://dx.doi.org/10.46393/27826392_2023_1_32
- Научно-практическая конференция «Миссия возможна: фокус на профилактику и раннее выявление рака шейки матки». Эффективная фармакотерапия. 2024; (6): 104-12. [Scientific and practical conference «Mission possible: focus on prevention and early detection of cervical cancer». Effective pharmacotherapy. 2024; (6): 104-12 (in Russian)]. https://umedp.ru/upload/iblock/1d7/Alcea.pdf
- Столярова У.В., Рогожина И.Е., Хворостухина Н.Ф., Скупова И.Н., Сергеева О.Н., Колесникова Е.А., Нейфельд И.В. Патология шейки матки – диагностика, клиника, лечение. Учебное пособие. Саратов: Саратовский государственный медицинский университет имени В.И. Разумовского, 2021. 44 с. [Stolyarova U.V., Rogozhina I.E., Khvorostukhina N.F., Skupova I.N., Sergeeva O.N., Kolesnikova E.A., Neifeld I.V. Pathology of the cervix uteri – diagnostics, clinic, treatment. Study guide. Saratov: Saratov State Medical University named after V.I. Razumovsky, 2021. 44 p. (in Russian)].
- Байрамова Г.Р., Перемыкина А.В., Андреев А.О., Добровольская Д.А. Плоскоклеточные интраэпителиальные поражения шейки матки: есть ли связь с микробиомом? Вопросы практической кольпоскопии. Генитальные инфекции. 2022; (1): 60-5. [Bayramova G.R., Peremykina A.V., Andreev A.O., Dobrovolskaya D.A. Squamous intraepithelial lesions of the cervix: is there a connection with the microbiome? Colposcopy Issues & Genital Infections. 2022; (1): 60-5 (in Russian)]. https://dx.doi.org/10.46393/27826392_2022_1_60
- Минкина Г.Н. Бактериальный вагиноз как фактор риска цервикального канцерогенеза. Вопросы гинекологии, акушерства и перинатологии. 2024; 23(4): 71-80. [Minkina G.N. Bacterial vaginosis as a risk factor for cervical carcinogenesis. Gynecology, Obstetrics and Perinatology. 2024; 23(4): 71-80 (in Russian)]. https://dx.doi.org/10.20953/1726-1678-2024-4-71-80
- Юшкова Т.А., Слабинская Е.В., Яковлев А.А. Клиническая фармакология Суперлимфа при заболеваниях урогенитального тракта через призму уровней реализации его эффектов. Эффективная фармакотерапия. 2023; 19(37): 44-53. [Yushkova T.A., Slabinskaya E.V., Yakovlev A.A. Clinical pharmacology of Superlimf in diseases of the urogenital tract through the prism of the levels of its effects. Effective pharmacotherapy. 2023; 19(37): 44-53 (in Russian)]. https://dx.doi.org/10.33978/2307-3586-2023-19-37-44-53
- Календжян А.С., Хамошина М.Б., Шеленина Л.И., Петрова В.Д., Союнов М.А. Коррекция нарушений биоценоза влагалища после деструкции шейки матки. Доктор.Ру. 2015; 14(115): 12-20. [Kalendzhyan A.S., Khamoshina M.B., Shelenina L.I., Petrova V.D., Soyunov M.A. Treating imbalance in vaginal microbiota following destruction of cervix. Doctor.Ru. 2015; 14(115): 12-20 (in Russian)].
- Global Cancer Observatory. World. 2022. Available at: https://gco.iarc.who.int/media/globocan/factsheets/populations/900-world-fact-sheet.pdf (accessed February 15, 2024).
- Дикке Г.Б., Суханов А.А., Кукарская И.И., Остроменский В.В. Иммуноопосредованные механизмы воспалительного ответа при сочетанных инфекциях нижнего отдела полового тракта у женщин. Акушерство, гинекология и репродукция. 2021; 15(3): 245-57. [Dikke G.B., Sukhanov A.A., Kukarskaya I.I., Ostromenskii V.V. Immune-mediated mechanisms of the inflammatory response in women with combined infections of the lower genital tract. Obstetrics, Gynecology and Reproduction. 2021; 15(3): 245-57 (in Russian)]. https://dx.doi.org/10.17749/2313-7347/ob.gyn.rep.2021.209
Received 23.09.2025
Accepted 03.10.2025
About the Authors
Ulyana V. Stolyarova, PhD, Associate Professor, Associate Professor at the Department of Obstetrics and Gynecology of the Pediatric Faculty, V.I. Razumovsky Saratov State Medical University, Ministry of Health of Russia, 112 Bolshaya Kazachya str., 410012, Saratov, Russia, stolyarova.ulyana@yandex.ru, Scopus Author ID: 57836087500,https://orcid.org/0000-0001-7684-1584
Natalia F. Khvorostukhina, Dr. Med. Sci., Professor, Head of the Department of Obstetrics and Gynecology of the Pediatric Faculty, V.I. Razumovsky Saratov State Medical University, Ministry of Health of Russia, 112 Bolshaya Kazachya str., 410012, Saratov, Russia, +7(927)277-79-35, Khvorostukhina-NF@yandex.ru,
Scopus Author ID: 56801899300, https://orcid.org/0000-0002-5864- 3397
Denis A. Novichkov, PhD, Associate Professor, Associate Professor at the Department of Obstetrics and Gynecology of the Pediatric Faculty, V.I. Razumovsky Saratov State Medical University, Ministry of Health of Russia, 112 Bolshaya Kazachya str., 410012, Saratov, Russia, dnovichkov@mail.ru, https://orcid.org/0000-0001-6945-835X
Galina S. Suvorova, PhD, Associate Professor, Associate Professor at the Department of Obstetrics and Gynecology of the Pediatric Faculty, V.I. Razumovsky Saratov State Medical University, Ministry of Health of Russia, 112 Bolshaya Kazachya str., 410012, Saratov, Russia, gs78@mail.ru, https://orcid.org/0000-0001-8092-020X
Oksana S. Odnokozova, PhD, Associate Professor, Associate Professor at the Department of Obstetrics and Gynecology of the Pediatric Faculty, V.I. Razumovsky Saratov State Medical University, Ministry of Health of Russia, 112 Bolshaya Kazachya str., 410012, Saratov, Russia, oxano4ka5@mail.ru, https://orcid.org/0000-0001-8092-020X
Corresponding author: Ulyana V. Stolyarova, stolyarova.ulyana@yandex.ru
Similar Articles
