The role of HPV in the development of cervical intraepithelial neoplasia and cervical cancer

Аннотация

Despite impressive achievements in the field of molecular biology, which made it possible to reveal the main mechanisms and stages of carcinogenesis and to significantly improve the capabilities of instrumental diagnostics, every year there is a disappointing trend in the world towards an increase in the number of patients with oncological diseases. Keywords: Oncological diseases, stages of carcinogenesis. Introduction: Despite impressive achievements in the In Karakalpakstan, the incidence of cervical cancer field of molecular biology, which made it possible to ranks second after breast cancer among the female reveal the main mechanisms and stages of population. A malignant tumor of the cervix in 2020 carcinogenesis and to significantly improve the claimed the life of 71 women in Karakalpakstan. capabilities of instrumental diagnostics, every year Despite the widespread use in clinical practice of there is a disappointing trend in the world towards an various destructive and excisional methods of increase in the number of patients with oncological treatment of cervical intraepithelial neoplasia (CIN) and diseases. carcinoma in situ, a number of patients subsequently According to the World Health Organization (WHO), the revealed the persistence of human papillomavirus average annual increase in human papillomavirus (HPV) of high carcinogenic risk, which contributes to infection exceeds 2.5-3 million, the frequency of the recurrence of the disease and repeated surgical asymptomatic virus carriage in the world is high and interventions on the cervix [9; 10]. amounts to 15.5% in Russia; in the USA - 28.6%; in In order to accurately diagnose the severity of CIN, Europe - 2-12%. HPV-associated cervical cancer is the assess the prognosis of the course of small forms of third most common cancer among women in the world, cervical lesions, and select the most optimal with -70% of cases due to infection with HPV types 16 management tactics for patients, it is necessary to and 18. Compared to other gynecological diseases, search for effective biomarkers with high diagnostic cervical cancer is more common in young women, with and prognostic significance. an average age of about 49 years. Over the past 50 Currently, the human genome and transcriptome are years, the introduction of "... Pap smear testing and widely studied to search for biomarkers of CIN and PCM HPV vaccination in developed countries has reduced [2;3]. morbidity and mortality by 75% ...". Despite widely implemented prevention programs, the prevalence of The purpose of the study cervical cancer continues to remain high. To develop differentiated approaches to the Cervical cancer is a dangerous disease, the second most management of patients with cervical intraepithelial common type of cancer among women in Uzbekistan. neoplasia of varying severity based on the study of In 2021, 1,827 new cases were identified, 997 women clinical, morphological methods. died. Morbidity and mortality are steadily increasing, METHODS and cervical cancer is projected to cause 2,100 new According to the inclusion and exclusion criteria, 110 cases and 1,300 deaths per year by 2030. [1]. patients were recruited into a single-stage prospective American Journal Of Biomedical Science & Pharmaceutical Innovation 7 https://theusajournals.com/index.php/ajbspi American Journal of Applied Science and Technology (ISSN: 2771-2745) cohort study. Depending on the results of histological diseases, general examination and gynecological examination of cervical biopsies, 4 groups were examination, calculation of body mass index (BMI), formed: chronic cervicitis in combination with HPV examination and palpation of the mammary glands. infection (n=30), LSIL (n=30), HSIL (n=30) and cervical 2. Cytological method (liquid cytology). cancer (n=20). 3. Molecular genetic methods (genotyping of 21 HPV Research methods types with determination of viral load by real-time Mandatory research methods: PCR). 1. A clinical study that includes the collection of 4. Advanced colposcopy. complaints, anamnesis, assessment of reproductive function and risk factors for HPV-associated cervical Table 1 Classification of HPV depending on oncogenicity (IARC, 2003) The degree of oncogenicity of HPV Type of HPV Highly oncogenic 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68, 73, Highly oncogenic Low-oncogenic 82 MLeodwiu-mon ocnocgogeenniicc 6, 11, 40, 42, 43, 44, 54, 61, 70, 72, 81 Medium oncogenic 26, 53, 66 German physician and scientist Harald zur Hausen was In 2012, the IARC identified 3 groups of oncogenic HPV: awarded the Nobel Prize in Physiology or Medicine for group 1 - high carcinogenic risk, group 2 A - probable his study of HPV and its role in the pathogenesis of carcinogenic risk, group 2B - possible carcinogenic risk breast cancer. (Table 2). It is known that the human papillomavirus plays a key role in the development of breast cancer. In 2008, Carcinogenic risk groups depending on the type of HPV (IARC