Particular features of the clinical course of the papilloma viral infection depending on quantitative indices of human papilloma viruses of a high carcinogenic risk
- Authors: Rakhmatulina M.R.1, Bolshenko N.V.2, Kuevda D.A.3, Trofimova O.B.3
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Affiliations:
- State Research Center of Dermatovenereology and Cosmetology, Ministry of healthcare of the Russian Federation
- Russian Medical Academy of Postgraduate Studies, Ministry of Health Russian Federation
- Central Research Institute of Epidemiology, Russian Inspectorate for Protection of Consumer Right and Human Welfare
- Issue: Vol 90, No 3 (2014)
- Pages: 95-104
- Section: CLINICAL PRACTICE GUIDELINES
- Submitted: 24.08.2017
- Published: 24.06.2014
- URL: https://vestnikdv.ru/jour/article/view/38
- DOI: https://doi.org/10.25208/0042-4609-2014-90-3-95-104
- ID: 38
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Full Text
Abstract
Goal of the study. To study the dependence of the clinical course of the papilloma viral infection and cytological characteristics of lesions in the cervical mucosa on the quantitative indices of human papilloma virus (HPV). Materials and methods. The study involved 175 female patients with HPV of a high carcinogenic risk including 125 subjects with clinical forms of the papilloma viral infection (PVI) and 50 subjects with subclinical and latent forms of the disease. Laboratory tests were carried out with the use of the polymerase chain reaction including real-time PCR for the quantitative determination of HPV. Cytological examinations of scrapes from the exocervical and endocervical mucosa were carried out according to Leishman I, and the results were interpreted according to Bethesda. Results. The authors established an association between clinical forms of PVI and infection with two or more HPV genotypes, and latent and subclinical forms of the disease and infection with one HPV genotype; HPV Genotype 16 prevails within the structure of HPV of a high carcinogenic risk. It was shown that patients infected with two or more HPV genotypes as well as subjects with subclinical and latent forms of the disease underwent reliably higher viral loads than subjects with anogenital warts and patients infected with one HPV genotype only. A higher HPV viral load was also noted in case of a persisting course of PVI and in patients with high-grade squamous intraepithelial lesions (H-SIL). Conclusion. Women with latent and subclinical forms, persistent PVI course and infected with two or more HPV genotypes of a high carcinogenic risk belong to the high-risk group developing expressed epithelial affections in the cervical mucosa. Quantitative HPV indices exceeding 5 lg of copies of HPV DNA per 100,000 cells belong to unfavorable predictors for the development of intraepithelial affections in the cervical mucosa and stipulate the need to conduct an additional examination (colposcopy or cytology) to exclude their development.
Keywords
генотипирование, количественное определение вирусов папилломы человека высокого онкогенного риска, папилломавирусная инфекция, цитологическое исследование, онкологическая патология, genotyping, quantitative determination of the human papilloma virus of a high carcinogenic risk, papilloma viral infection, cytologic examination, cancer pathology
About the authors
M. R. Rakhmatulina
State Research Center of Dermatovenereology and Cosmetology, Ministry of healthcare of the Russian Federation
Author for correspondence.
Email: sanabol@mail.ru
Россия
N. V. Bolshenko
Russian Medical Academy of Postgraduate Studies, Ministry of Health Russian Federation
Email: sanabol@mail.ru
Россия
D. A. Kuevda
Central Research Institute of Epidemiology, Russian Inspectorate for Protection of Consumer Right and Human Welfare
Email: sanabol@mail.ru
Россия
O. B. Trofimova
Central Research Institute of Epidemiology, Russian Inspectorate for Protection of Consumer Right and Human Welfare
Email: sanabol@mail.ru
Россия
References
- Kuznetsova Y.N., Evstigneyeva N.P., Oboskalova T.A. Complex therapy of clinical manifestations of urogenital papilloma-virus infection. Modern probl of dermatovenereol, immunol and med cosmetol 2009; 3 (6): 27-31
- Soloviyov A.M. Immunotherapy with isoprinosine as an adjuvant or independent method of treatment for patients with papilloma viral infection. Vestn dermatol i venerol 2011; 5: 146-151.
- Rahmatulina M.R. Experience of the combined therapy of anogenital (veneral) warts. Vestn dermatol i venerol 2012; 4: 105-110.
- Kaprin A.D. Zlokachestvennye novoobrazovaniya v Rossii v 2012 godu (zabolevaemost' i smertnost') / Pod redaktsiey A.D. Kaprina, V.V. Starinskogo, G.V. Petrovoy. M: FGBU «MNIOI im. P.A. Gertsena» Minzdrava Rossii, 2014.
- Mayrand M-H., Duarte-Franco E., Rodrigues I. et al. Human Papillomavirus DNA versus Papanicolaou Screening Tests for Cervical Cancer. New England Journal of Medicine 2007; 357: 1579-1588.
- Solomon D., Nayar R. The Bethesda System for reporting cervical cytology. Definition, criteria, and explanatory notes. Springer 2004; XXIII: 191.
- Minkina G.N., Shabalova I.P. Klassifikatsiya patologicheskikh izmeneniy sheyki matki. Morfologicheskaya terminologiya. Profilaktika raka sheyki matki. Rukovodstvo dlya vrachey pod redaktsiey G.T. Sukhikh. M: 2012. 38-45.
- Kitchener H.C., Peto J., Wheeler P. et al. ARTISTIC: a randomized train of human papillomavirus (HPV) testing in primary cervical screening. Health Technol Assess 2009 Nov; 13 (51): 1-150.
- Ronco G., Biggeri A., Confortini M. et al. Health technology assessment report: HPV DNA based primary screening for cervical cancer. Epidemiol Prev 2012 May-Aug; 36 (3-4 Suppl): e1-72.
- Ronco G., Dillner J., Elfsröm K.M. et al. Efficacy of HPV-based screening for prevention of invasive cervical cancer: follow-up of four Europeen randomized controlled trials. The Lancet 2014 February; 383: 9916: 524-532.
- Pileggi C., Flotta D., Bianco A., et al. Is HPV DNA testing specificity comparable to that of cytological testing in primary cervical cancer screening? Results of a meta - analysis of randomized controlled trials. HYPERLINK "http:// www.ncbi.nlm.nih.gov/pubmed/?term=Is+HPv+ DNA+testing+specificity+comparable+to+that+o f+cytological+testing+in+primary+cervical+can cer+screening%3F+Results+of+a+meta+%E2% 80%93+analysis+of+randomized+controlled+tri als" o "International journal of cancer. Journal international du cancer." Int J Cancer 2014 Jul 1; 135 (1): 166-77.
- Kim J.J., Wright T.C., Goldie S.J. Cost - effectiveness of alternative triage studies for atypical squamous cells of undetermined significance. JAMA 2002; Vol. 287: 2382-2390.
- Kim J.J., Wright T.C., Goldie S.J. Cost-effectiveness of human papillomavirus DNA testing in the United Kingdom, the Netherlands, France and Italy. Journal of the National Cancer Institute 2005; 97 (12): 888-895.
- Shipulina O.Yu. Algoritm diagnostiki virusa papillomy cheloveka. Spravochnik zaveduyushchego KDL 2010; 1: 3-11.
- World Health Organization (WHO). Comprehensive cervical cancer control: a guide to essential practice. Geneva, 2010