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宫颈锥切术后局部 HPV 感染和高级别鳞状上皮内病变患者的免疫治疗。

Immunotherapy in patients with local HPV infection and high-grade squamous intraepithelial lesion following uterine cervical conization.

机构信息

Department of Gynecology, Military Medical Academy, Sofia, Bulgaria.

出版信息

Immunopharmacol Immunotoxicol. 2020 Aug;42(4):314-318. doi: 10.1080/08923973.2020.1765374. Epub 2020 May 19.

Abstract

OBJECTIVE

To establish the clearance of cervical human papillomavirus (HPV) infection following postoperative immunotherapy with inosine pranobex in women receiving surgical treatment of established high-grade squamous intraepithelial lesion (HSIL) of the uterine cervix.

MATERIALS AND METHODS

Over the six-year study period, 32 women with cervical HPV infection following electroconization (loop electrosurgical excision procedure) of the uterine cervix for established HSIL were randomly divided into two groups: I ( = 10) without and II ( = 22) with postoperative inosine pranobex immunotherapy. Follow-up after 24 and 48 months included cervical testing for HPV persistence and after 12, 24, and 48 months with cytology and colposcopy for dysplasia relapse (confirmed histologically).

RESULTS

Relapse monitoring in 32 women after 12 months revealed 1 and 0 HSIL positive in groups I and II, respectively; after 24 months an additional 3 patients in each group were positive; and after 48 months an additional 3 and 1 patients were positive in groups I and II, respectively ( < .05). The groups significantly differed ( < .05) with regard to clearing the most common high-risk HPV genotypes (HPV 16 and HPV 56).

CONCLUSIONS

Inosine pranobex immunotherapy in HPV-positive patients following cervical conization significantly increased the clearance of viral infection with high-risk genotypes and reduced relapse of HSIL.

摘要

目的

研究在接受手术治疗的高级别宫颈鳞状上皮内病变(HSIL)患者中,术后应用肌苷普拉诺辛进行免疫治疗后,清除人乳头瘤病毒(HPV)感染的情况。

材料和方法

在六年的研究期间,32 名因高级别宫颈鳞状上皮内病变而接受宫颈电切术(环形电切术)的患者中,HPV 感染持续存在。这些患者被随机分为两组:I 组(n=10)无术后肌苷普拉诺辛免疫治疗,II 组(n=22)有术后肌苷普拉诺辛免疫治疗。在 24 个月和 48 个月时进行随访,包括对 HPV 持续感染的宫颈检查,并在 12、24 和 48 个月时进行细胞学和阴道镜检查,以检测异常增生的复发(组织学证实)。

结果

在 32 名患者中,经过 12 个月的监测,I 组和 II 组分别有 1 例和 0 例 HSIL 阳性;24 个月时,每组各有 3 例患者阳性;48 个月时,每组各有 3 例和 1 例患者阳性( < .05)。两组在清除最常见的高危 HPV 基因型(HPV 16 和 HPV 56)方面存在显著差异( < .05)。

结论

在接受宫颈锥切术的 HPV 阳性患者中,肌苷普拉诺辛免疫治疗可显著提高高危基因型病毒感染的清除率,并降低 HSIL 的复发率。

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