Intracellular Processes in Cervical Neoplasia in Women of Childbearing Potential

Aim. To evaluate changes in intracellular processes in reproductive-age patients with intraepithelial lesions against the background of human papillomavirus. Design. Prospective study. Materials and methods. This study involved 140 women of reproductive age: the control group included 42 conditionally healthy women without cervical pathology and without human papillomavirus, the main group — 98 patients with cervical pathology (cervical intraepithelial neoplasia II (CIN II), confirmed histologically) and human papillomavirus. All participants were examined in accordance with regulatory documents, and to achieve the stated goal — study and analysis of apoptotic fluctuations in the cervix — levels of apoptosis markers in CIN II (caspases 3, 8 and 9), as well as human papillomavirus. Results. All test parameters significantly differed from one another: caspase 3 levels significantly differed from caspase 9 and 8 levels, while caspase 8 and 9 levels significantly differed from one another as well as within each group and when study groups were compared with one another: apoptotic indices were significantly higher in patients with CIN II against the background of HPV. At the next stage, all patients in the group with viral load were randomly divided into subgroups: subgroup A — 49 patients who underwent only surgical treatment of CIN II, and subgroup B — 49 patients who were prescribed surgical treatment of CIN II and drug therapy. The studied parameters measured 3, 9 and 12 months after the start of the work differed significantly from each other, significantly differed from the values of the control group and the baseline indices. The minimum values were achieved only after 12 months in subgroup B, while in patients of subgroup A, caspase concentrations after 3 and 9 months also decreased, but not as rapidly as in the subgroup with complex treatment. It should be noted that after 12 months, the values of the studied caspase 8 and caspase 9 within the subgroup with one stage of treatment began to have a tendency to increase. In subgroup A, the maximum treatment effect was achieved after 9 months of observation in 80% of the subjects, and in subgroup B, a decrease in viral load less than clinically significant was recorded in 94% of participants after 3 months, in 86% after 9 and in 84% after 1 year. Conclusion. The obtained results of the study emphasize the need for an expanded approach to the treatment of patients with viral load and moderate neoplasia, which should include both the surgical stage and the use of approved drugs with antiviral activity. This approach is more successful and will ensure delayed favorable treatment results. Keywords: reproductive age, reproductive function, apoptosis, cervical pathology, caspase 3, caspase 8, caspase 9, polymerase chain reaction, genotyping.