Local cytokine therapy in a comprehensive treatment of HPV-associated cervical diseases

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Abstract

Aim. To analyze an efficacy of monotherapy and combined therapy (an immunomodulator + radio wave ablation) in patients with low-grade squamous intraepithelial lesion (L-SIL) caused by HPV infection. Materials and methods. The study included 210 women with human papillomavirus infection which was identified using real-time polymerase chain reaction (PCR). All women underwent a comprehensive examination which included history taking, general and gynecological examinations, extended colposcopy and a bacterioscopy of Gram-stained vaginal smears. A quantitative determination of vaginal microflora composition by PCR was carried out. Conclusion on either inflammatory response is present or absent was made on the basis of an inflammation index magnitude: with a value of more than 60% indicating a presence of local inflammation signs. Based on cervical cytology data a group consisting of 79 women who had L-SIL was formed. Patients were divided into 2 subgroups: the main one (n=45) who received combined treatment with radio wave ablation + an immunomodulator and a control one (n=34) who received only local monodestruction of L-SIL foci followed etiotropic treatment. Results and discussion. An efficacy of combined treatment which included radio wave ablation + an immunomodulator was higher compared to monodestruction only - 86.7% vs 64,7% respectively. It is important that by 6th month of follow-up a relapse of human papillomavirus infection occurred in 4.5 and 23.5% of patients of main and control groups respectively. Local inflammation was assessed as positive with an inflammation index of more than 60%. So after 6 months of follow-up this indicator decreased by 83.3 and 54.2% in the 1st and 2nd groups respectively. Clinical manifestations of an inflammatory process in the cervix was observed only with CIN recurrence. In addition, combined therapy provides a higher rate of human papillomavirus elimination at 6 months and faster cervix epithelization followed treatment by ablation.

About the authors

Patimat R Abakarova

V.I.Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology of the Ministry of Health of the Russian Federation

MClSc, PhD, Researcher of the Scientific and Polyclinic Department 4, Akademika Oparina st., Moscow, 117997, Russian Federation

Vera N Prilepskaya

V.I.Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology of the Ministry of Health of the Russian Federation

Email: VPrilepskaya@mail.ru
MD, PhD, Professor, Deputy director for Science, Head of the Scientific and Polyclinic Department 4, Akademika Oparina st., Moscow, 117997, Russian Federation

Elena A Mezhevitinova

V.I.Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology of the Ministry of Health of the Russian Federation

MD, PhD, DSc, Leading Researcher of the Scientific and Polyclinic Department 4, Akademika Oparina st., Moscow, 117997, Russian Federation

Andrei E Donnikov

V.I.Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology of the Ministry of Health of the Russian Federation

MClSc, PhD, Head of the Laboratory of molecular and genetic methods 4, Akademika Oparina st., Moscow, 117997, Russian Federation

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