Misson Daniela Ribeiro, Abdalla Douglas Reis, Borges Ariana Melo, Shimba Denis Sakamoto, Adad Sheila Jorge, Michelin Márcia Antoniazi, Murta Eddie Fernando Candido
Oncology Research Institute (IPON)/Discipline of Gynecology and Obstetrics, Federal University of the Triângulo Mineiro (UFTM), Avenida Getúlio Guaritá, s/n° Uberaba (MG), Brazil, CEP 38025-440, Bairro Abadia.
Tumori. 2011 Sep-Oct;97(5):578-84. doi: 10.1177/030089161109700507.
Cervical intraepithelial neoplasia (CIN) grade II-III is being diagnosed in younger women and, because of the reproductive age range for women and the habits associated with a modern lifestyle, is now affecting a broad age range. Surgical treatment for CIN has been associated with premature amenorrhea, low birth weight, and premature labor and birth. It is therefore imperative to develop clinical treatments for CIN, such as conservative treatment with interferons. The object of the present study was to evaluate the behavior of cytokines (IFN- g, IL-1β, IL-2, IL-4, IL-6, IL-8, IL-10, IL-12, TNF-α, TGF β) in the serum of patients with an initial diagnosis of CIN II-III.
Ten patients with CIN-CIN II (60%, n = 6) and CIN III (40%, n = 4), 23 to 51 years of age and who had not received any prior treatments, were evaluated. The patients were given 3 million/UI (per cm2 of colposcopic lesion) of human recombinant IFN-α 2b by intralesional administration (18 applications on alternate days). Before treatment, in the 6th, 12th, and 18th applications, blood was collected from the patients for cytokine analysis using ELISA.
Half of the patients had a good pathologic response; the other half, all of whom were smokers, had therapeutic failure. The average concentration of IL-12 (pg/ml) in the serum of patients who responded well to therapy was elevated from the 12th and 18th application of IFN-α 2b compared to patients who experienced therapeutic failure: 1804.0 ± 1020 vs 391.2 ± 722.3 and 1738.0 ± 2426.0 vs 448.5 ± 407.2, respectively, P <0.05.
CIN II-III treated with intralesional IFN-α 2b achieved a good response in non-smoking patients and was associated with an increase in IL-12 serum levels.
宫颈上皮内瘤变（CIN）II - III级在年轻女性中被诊断出来，由于女性的生育年龄范围以及与现代生活方式相关的习惯，现在其影响的年龄范围很广。CIN的手术治疗与过早闭经、低出生体重以及早产和分娩有关。因此，开发针对CIN的临床治疗方法，如用干扰素进行保守治疗势在必行。本研究的目的是评估初诊为CIN II - III级患者血清中细胞因子（IFN - g、IL - 1β、IL - 2、IL - 4、IL - 6、IL - 8、IL - 10、IL - 12、TNF - α、TGF β）的变化情况。
对10例年龄在23至51岁、未接受过任何先前治疗的CIN患者进行评估，其中CIN II级6例（60%），CIN III级4例（40%）。通过病灶内注射给予患者3百万国际单位/平方厘米（阴道镜下病变面积）的重组人干扰素α - 2b（隔日注射18次）。在治疗前、第6次、第12次和第18次注射时，采集患者血液，采用酶联免疫吸附测定法进行细胞因子分析。
一半患者有良好的病理反应；另一半患者均为吸烟者，治疗失败。与治疗失败的患者相比，对治疗反应良好的患者血清中IL - 12（pg/ml）的平均浓度在第12次和第18次注射干扰素α - 2b后升高：分别为1804.0 ± 1020对391.2 ± 722.3以及1738.0 ± 2426.0对448.5 ± 407.2，P <0.05。
病灶内注射干扰素α - 2b治疗CIN II - III级在非吸烟患者中取得了良好反应，且与血清IL - 12水平升高有关。
