Influence of Therapy of Cervical Neoplasias on Immunological and Apoptotic Parameters

Abstract

Aim: Evaluation of immune response factors in the treatment of mild cervical neoplasia against the background of human papillomavirus in patients of childbearing age. Design: Prospective study. Materials and methods. The study included a survey of 210 patients of fertile age. Among them were 150 patients with human papillomavirus (HPV) and cervical intraepithelial neoplasia, established by histological examination. Patients underwent Pap test, extended colposcopy, determination of HPV type and viral load. Patients with suspected pathology of the cervical zone underwent multifocal biopsy of the cervix. When analyzing changes in the cervix zone, the levels of interferon-γ, interleukin-18, caspase 3 and 9 were evaluated. Results. Among patients with cervical neoplasia of the first degree, the concentration of caspase 3, caspase 9 and interferon-γ at the first stage of the examination was higher (p < 0.05) than the values in the control group (among conditionally healthy women without viral load), while interleukin-18 was significantly lower (p < 0.05). In subgroups I and II, after 3 and 12 months, the concentrations of the studied parameters significantly differed from those in the control group and values before treatment (p < 0.05), while, after 12 months, the values of caspase 3 and caspase 9 in the subgroup where therapy was carried out (subgroup II) were significantly lower than in subgroup I. Also, among the patients, there was a statistical difference in the values of the cytokine series, however, the level of interleukin-18 in subgroup II after 10 days and 12 months was significantly higher than in subgroup I. fluctuations in indicators made it possible to justify the use of immunocorrective therapy for the treatment of a mild neoplastic process of the cervical zone. Conclusion. The results of the study allow optimizing approaches to the treatment of women of childbearing age with mild cervical neoplasia on the background of HPV. Keywords: genotyping, caspase-3, caspase-9, apoptosis, cervical neoplasia, polymerase reaction, interleukin-18, tumor necrosis factor-α, viral load.