scholarly journals EXPERIENCE OF IMMUNOCORRECTIVE TREATMENT IN THE MANAGEMENT OF PATIENTS WITH CERVICAL INTRAEPITHELIAL NEOPLASIA ON THE BACKGROUND OF GENITAL PAPILLOMAVIRUS INFECTION

2021 ◽  
pp. 48-53
Author(s):  
N. M. ROZHKOVSKA ◽  
I. Z. GLADCHUK ◽  
N. M. KASHTALYAN ◽  
Ia. V. ROZHKOVSKYI
Keyword(s):  
Cervical Cancer ◽  
Cervical Intraepithelial Neoplasia ◽  
Cold Plasma ◽  
Intraepithelial Neoplasia ◽  
Hpv Infection ◽  
Immunomodulatory Therapy ◽  
Complex Treatment ◽  
Papillomavirus Infection ◽  
Plasma Ablation ◽  
Interferon Status

Introduction. Human papillomavirus (HPV), its highly oncogenic types, is considered to be the initiating factor in the development of dysplasia and cervical cancer The role of immunomodulatory therapy in reducing the risk of cervical cancer in women with cervical intraepithelial neoplasia (CIN) associated with HPV infection remains in the focus of researchers. Aim of the study: to evaluate the effectiveness of the use of the immunomodulator Allokin-alfa in the complex treatment of cervical intraepithelial neoplasia against the background of genital papillomavirus infection. Materials and methods. We examined 60 women who received CIN1- 2 treatment on the background of HPV infection of high oncogenic risk in the multidisciplinary medical center of the Odessa National Medical University. The patients were divided into 2 groups: 1 (main) group consisted of 30 women who received cold plasma ablation of cervical dysplasia in combination with immunomodulatory therapy with alloferon, group 2 (comparison) consisted of 30 patients who received standard cold plasma ablative treatment without immunomodulators. The control group consisted of 30 healthy women. All women underwent cytomorphological examination of the cervical epithelium, HPV testing, colposcopy, and targeted biopsy. Immunological status was assessed by indicators of cellular and humoral immunity, the content of α- and γ-interferon. Results. In patients with CIN1-2 against the background of HPV, an increase in the level of serum Ig A, CD8 level, a decrease in the CD4 content and immunoregulatory index, CD19 content were revealed, which indicated immunosuppression. Immunocorrective therapy witn alloferon (Allokin-alfa) in complex, with cold plasma ablation, treatment of CIN1-2 promoted the normalization of the parameters of immunity and interferon status, which contributed to the acceleration of epithelialization, (OR — 15,48; 95% CІ: 2,05-136,45; р=0,0094). a decrease in the frequency of residual lesions, and a HPV elimination. Conclusions. Complex treatment of CIN1-2 using cold plasma ablation and immunocorrection by perioperative administration of alloferon (Allokin-alfa) is accompanied by better functional results, compared only with the use of cold plasma ablation: accelerated epithelialization, improved colposcopic picture, decreased frequency of relapses, elimination of HPV, normalization of immunе and interferon status.

The specific features of cervical intraepithelial neoplasia associated with persistent HPV infection

GYNECOLOGY ◽  
2019 ◽  
Vol 21 (3) ◽  
pp. 35-39
Author(s):  
Tatiana V Klinyshkova ◽  
Mariia S Buyan
Keyword(s):  
Human Papillomavirus ◽  
Prospective Study ◽  
Cervical Intraepithelial Neoplasia ◽  
Intraepithelial Neoplasia ◽  
Hpv Infection ◽  
Complex Treatment ◽  
Human Papillomavirus Infection ◽  
Papillomavirus Infection ◽  
Laboratory Features ◽  
Hpv Types

Aim. Of the study was to assess the clinical and laboratory features of cervical intraepithelial neoplasia (CIN) with persistent human papillomavirus infection and the development of prognostic criteria for persistence of HPV. Materials and methods. The prospective study included 63 patients with HPV-associated CIN. Assessment of persistence of HPV was based on detection of HPV when retesting 12 months. Depending on the results of retesting there were 2 groups: group 1A (main group, n=26), including patients with CIN and HPV persistence after treatment, mean age - 33.69±1.92 years; group 1B (comparison, n=37) - patients with CIN without HPV persistence after treatment, mean age - 34.43±2.09 years. Results. According to the results of the first HPV genotyping (before treatment) among patients of group 1A there was a predominance of two or more HPV types (34.6% vs 16.2% of patients of group 1B; p0.05). According to the results of the second genotyping (12 months after complex treatment) there was a 3.5-fold prevalence of patients with mono-infection against HPV co-infection in group 1A (p

scholarly journals Human papillomavirus genotype distribution in cervical intraepithelial neoplasia 2/3 and invasive cervical cancer among Hakka women in southern China

2019 ◽  
Author(s):  
Xiaodong Gu ◽  
Ruiqiang Weng ◽  
Jing Liu ◽  
Sudong Liu
Keyword(s):  
Cervical Cancer ◽  
Cervical Intraepithelial Neoplasia ◽  
Southern China ◽  
Invasive Cervical Cancer ◽  
Intraepithelial Neoplasia ◽  
Hpv Infection ◽  
Histological Diagnosis ◽  
Infection Prevalence ◽  
Genotype Distribution ◽  
Hpv Genotypes

Abstract Background: To investigate HPV genotype distribution in cervical intraepithelial neoplasia 2/3 (CIN2/3) and invasive cervical cancer (ICC) among Hakka women in southern China. Methods: Results of HPV genotypes from women with histological diagnosis of CIN2/3 and ICC were collected from January, 2017 to December, 2018. HPV genotypes were analyzed by flow cytometry method. Association of HPV infection and lesions severity was estimated using prevalence ratio (PR). Results: Overall, 1,408 Hakka women with histological diagnosis of CIN2/3 and ICC were enrolled in this study. HPV infection prevalence was 92.92% in CIN2, 95.77% in CIN3 and 95.88% in ICC. Most frequent genotypes for CIN2 were HPV52 (31.42%), HPV16 (22.12%) and HPV58 (22.12%); for CIN3 were HPV16 (41.90%), HPV52 (20.77%) and HPV58 (18.31%); and for ICC were HPV16 (49.67%), HPV18 (11.25%) and HPV52 (9.80%). PR of HPV16 and HPV33 were significantly higher in CIN3 compared with CIN2 (PR = 2.372, 95%CI = 1.598-3.524; PR = 2.577, 95%CI = 1.250-5.310; respectively). HPV16 and HPV18 prevalence were significantly increasing in SCC compared with CIN3 (PR = 2.517, 95%CI = 1.095-5.786; PR = 2.473, 95%CI = 1.840-3.324; respectively). Most HPV infections were found in women aged 40 – 49 years in CIN2/3 and women aged 50 - 59 years in ICC. Conclusions: This is the first study of genotypes and age specific distribution of HPV infection among Hakka women with CIN2/3 and ICC in southern China. Our results provide available information for HPV vaccine development in China.

scholarly journals Analysis of the results of combined treatment of cervix precancerous pathology in reproductive aged women

2021 ◽  
pp. 83-88
Author(s):  
I.Z. Gladchuk ◽  
I.Z. Gladchuk ◽  
N.M. Kashtalian
Keyword(s):  
Cold Plasma ◽  
Medical Center ◽  
Combined Treatment ◽  
Cervical Dysplasia ◽  
Functional Results ◽  
Hpv Infection ◽  
Reproductive Age ◽  
Immunomodulatory Therapy ◽  
Plasma Ablation ◽  
Oncogenic Hpv

Aim of the study. Comparative analysis of the results of cervical epithelial neoplasia (CIN) I and II levels (p16ink4a-negative) (LSIL in LAST terminology) treatment against the background of highly oncogenic HPV infection using cold plasma ablation and immunomodulatory therapy with Аllokin-alpha.Materials and methods. We examined 60 women who received treatment for CIN I and CIN II (p16ink 4A negative) at the Multidisciplinary Medical Center of Odessa National Medical University. All women were of reproductive age, had mild dysplasia, high-risk HPV infection (HPV 16, 18, 31, 45) and histological confirmation of CIN I and CIN II (p16ink 4A negative). The patients were divided into 2 groups: 1 (main) group consisted of 30 women who received cold plasma ablation of cervical dysplasia in combination with immunomodulatory therapy with Аllokin-alpha (1 mg subcutaneously every other day, 3 injections before surgery and 3 injections after ablation), Group 2 (control) consisted of 30 patients who received standard cold plasma ablative treatment without prescribing immunomodulators. All women underwent cytomorphological examination of the cervical epithelium, HPV testing by RealTime PCR and colposcopy with mandatory targeted biopsy at the preoperative stage.Results. The use of combined cold plasma ablative treatment of CIN I and CIN II (p16ink 4A negative) in combination with the administration of the immunomodulator Аllokin-alpha significantly reduced the duration of discharge after ablation to 5.44 ± 1.03 days (95% CI: 4.96–6.05), the timing of epithelialization is up to 29.31 ± 1.12 days (95% CI: 26.81–32.32), and to exclude cases of recurrence of genital warts and cervical keratosis. Chances of HPV elimination 6 months after treatment (OR – 5.48; 95% CI: 1.56–29.03; p = 0.0075) and 12 months after treatment (OR – 15.48; 95% CI : 2.05–136.45; p = 0.0094), significantly higher with the combined with immunomodulation method of treatment, in contrast to only cold plasma ablation.Conclusion. Combined, with the use of cold plasma ablation and immunomodulation by perioperative management of Аllokin-alpha, LSIL treatment against the background of highly oncogenic HPV infection in women of reproductive age is accompanied by better functional results, compared with the use of cold plasma ablation alone: reduction in the duration of discharge, acceleration of epithelialization, normalization of the colposcopic and cytologic picture, decrease in the frequency of relapses, a significant increase in the frequency of HPV elimination.

Intralesional Beta-Interferon Treatment of Cervical Intraepithelial Neoplasia Associated with Human Papillomavirus Infection

1994 ◽  
Vol 80 (2) ◽  
pp. 146-150 ◽  
Author(s):  
Carlo Penna ◽  
Maria Grazia Fallani ◽  
Rodolfo Gordigiani ◽  
Lorella Sonni ◽  
Gian Luigi Taddei ◽  
...  
Keyword(s):  
Human Papillomavirus ◽  
Side Effects ◽  
Cervical Intraepithelial Neoplasia ◽  
Treatment Options ◽  
Intraepithelial Neoplasia ◽  
Hpv Infection ◽  
Cure Rate ◽  
Papillomavirus Infection ◽  
Before And After ◽  
Ifn Therapy

Aims and backround Interferons (IFN) have offered considerable advances in the therapy of genital warts even those associated with cervical intraepithelial neoplasia (CIN); intralesional therapy either alone or in combination with other modalities such as cryosurgery and laser surgery provides improved clearing and cure of these often recalcitrant lesions. The purpose of this study was to evaluate the effectiveness of intralesional IFN therapy in patients with CIN associated with human papillomavirus (HPV) infection. Methods Beta-IFN was injected intra-perilesionally into the cervix in 41 patients with CIN associated with HPV infection. Results The regimen of 3 million international units (IU) injected intralesionally daily in the 1st week and 3 times a week in the 2nd and 3rd weeks for a total of 11 injections and a total dosage of 33 million IU yielded an 80 percent cure rate and may be more advantageous than other treatment options in certain instances. Cytocolposcopic and histologic examination was carried out before and after treatment and 24 lesions were also analyzed for type-specific papillomaviruses using in situ DNA hybridization. CIN disappeared in 33 patients 6 months after the end of therapy. Side effects of intralesional IFN therapy are dose related and for the most part readily tolerated. Conclusions Intralesional IFN proved to be effective treatment for CIN associated with HPV infection (cure rate: 80%) and well accepted because hospitalization is not required and no important side effects occur.

scholarly journals Comprehensive genomic variation profiling of cervical intraepithelial neoplasia and cervical cancer identifies potential targets for cervical cancer early warning

2018 ◽  
Vol 56 (3) ◽  
pp. 186-194 ◽  
Author(s):  
Jian Huang ◽  
Zhaoyang Qian ◽  
Yuhua Gong ◽  
Yanzhou Wang ◽  
Yanfang Guan ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Human Papillomavirus ◽  
Cervical Intraepithelial Neoplasia ◽  
Molecular Mechanisms ◽  
Mutational Analysis ◽  
Deep Understanding ◽  
Genomic Analysis ◽  
Intraepithelial Neoplasia ◽  
Hpv Infection ◽  
Genomic Variation

BackgroundTo better understand the pathogenesis of cervical cancer (CC), we systematically analysed the genomic variation and human papillomavirus (HPV) integration profiles of cervical intraepithelial neoplasia (CIN) and CC.MethodsWe performed whole-genome sequencing or whole-exome sequencing of 102 tumour-normal pairs and human papillomavirus probe capture sequencing of 45 CCs, 44 CIN samples and 25 normal cervical samples, and constructed strict integrated workflow of genomic analysis.ResultsMutational analysis identified eight significantly mutated genes in CC including four genes (FAT1, MLL3, MLL2 and FADD), which have not previously been reported in CC. Targetable alterations were identified in 55.9% of patients. In addition, HPV integration breakpoints occurred in 97.8% of the CC samples, 70.5% of the CIN samples and 42.8% of the normal cervical samples with HPV infection. Integrations of high-risk HPV strains in CCs, including HPV16, 18, 33 and 58, also occurred in the CIN samples. Moreover, gene mutations were detected in 52% of the CIN specimens, and 54.8% of these mutations occurred in genes that also mutated in CCs.ConclusionOur results lay the foundation for a deep understanding of the molecular mechanisms and finding new diagnostic and therapeutic targets of CC.

scholarly journals The Epidemiology of Human Papillomavirus Infection and Cervical Cancer

2007 ◽  
Vol 23 (4) ◽  
pp. 213-227 ◽  
Author(s):  
F. Xavier Bosch ◽  
Silvia de Sanjosé
Keyword(s):  
Cervical Cancer ◽  
Invasive Cervical Cancer ◽  
Intraepithelial Neoplasia ◽  
Hpv Infection ◽  
Human Papillomaviruses ◽  
Transmitted Infection ◽  
Hpv Dna ◽  
Sexually Transmitted ◽  
Papillomavirus Infection ◽  
Simplex Virus

Cervical cancer has been recognized as a rare outcome of a common Sexually Transmitted Infection (STI). The etiologic association is restricted to a limited number of viral types of the family of the Human Papillomaviruses (HPVs). The association is causal in nature and under optimal testing systems, HPV DNA can be identified in all specimens of invasive cervical cancer. As a consequence, it has been claimed that HPV infection is a necessary cause of cervical cancer. The evidence is consistent worldwide and implies both the Squamous Cell Carcinomas (SCC), the adenocarcinomas and the vast majority (i.e. > 95%) of the immediate precursors, namely High Grade Squamous Intraepithelial Lesions (HSIL)/Cervical Intraepithelial Neoplasia 3 (CIN3)/Carcinomain situ. Co-factors that modify the risk among HPV DNA positive women include the use of oral contraceptives (OC) for five or more years, smoking, high parity (five or more full term pregnancies) and previous exposure to other sexually transmitted diseases such as Chlamydia Trachomatis (CT) and Herpes Simplex Virus type 2 (HSV-2). Women exposed to the Human Immunodeficiency Virus (HIV) are at high risk for HPV infection, HPV DNA persistency and progression of HPV lesions to cervical cancer.

scholarly journals Features of papillomavirus infection in HIV-infected women

2012 ◽  
Vol 17 (4) ◽  
pp. 9-11
Author(s):  
E. S Sverdlova ◽  
T. V Dianova
Keyword(s):  
Cervical Cancer ◽  
Significant Contribution ◽  
Intraepithelial Neoplasia ◽  
Hpv Infection ◽  
Hiv Positive ◽  
Papillomavirus Infection ◽  
Hiv Positive Women ◽  
Selection Of Patients ◽  
Selection Of ◽  
Hiv Negative

As participation of immune system in the protection of human papillomavirus (HPV) has been proven, the incidence of HPV infection leading to cervical intraepithelial neoplasia (CIN) among HIV-positive women is 4 times higher than in HIV-negative cases. In the presence of HIV HPV implements oncoprogram during 6-12 months. Сytokine imbalance makes a significant contribution to the progression of HIV in combination with HPV. The criteria of selection of patients with HIV for therapy cytokines in CIN 2-3 (Roncoleukin used in the author's scheme). Using Ronkoleukin in combination with HAART in HIV-positive women can delay the progression of CIN 2-3 in cervical cancer. The criteria of selection of HIV female patients for the therapy with cytokines at the 2-3 stage of CIN ( Roncoleukin was used in the author's scheme) have been detected. Application Roncoleukin in combination with HAART in HIV-positive women can delay the progression of cervical cancer at the CIN 2-3 stage.

Effect of inosine pranobex on p16, Ki-67 expression in patients with HPV-associated cervical intraepithelial neoplasia

GYNECOLOGY ◽  
2018 ◽  
Vol 20 (4) ◽  
pp. 29-34
Author(s):  
T V Klinyshkova ◽  
O N Mironova
Keyword(s):  
Cervical Intraepithelial Neoplasia ◽  
Latent Infection ◽  
Comparison Group ◽  
Intraepithelial Neoplasia ◽  
Hpv Infection ◽  
Control Group ◽  
Complex Treatment ◽  
Inosine Pranobex ◽  
Ki 67 ◽  
And Control

The aim of the study - to determine the dynamics of expression of р16, Ki-67 in patients with HPV-associated cervical intraepithelial neoplasia (CIN) in the complex treatment with inosine pranobex. Materials and methods. The study included 62 patients with cervical HPV infection, the main group consisted of 47 patients with confirmed CIN 1 and CIN 2-3 associated to HPV high-risk, the comparison group - patients with latent HPV infection and 13 women of the control group. At the 2nd stage, a group of women with CIN 2-3 was divided into two groups: 2A (n=17) included patients who received excision treatment in combination with inosine pranobex; 2B group (n=9) patients after excision treatment (LEEP or LLETZ) without inosine pranobex. Traditional methods of examination of cervical pathology were used, including HPV genotyping, and dynamic immunocytochemical examination to determine p16, Ki-67. Results. Comparative analysis (n=75) allowed to establish the absence of differences in the expression of р16, Ki-67 and co-expression in HPV-associated CIN 1 relative to the comparison and control group. CIN 2-3 was characterized by a predominance of the levels of biomarkers in comparison with CIN 1 and latent infection (p

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