Эффективность вакцинации против ВПЧ в профилактике рецидивов цервикальных интраэпителиальных неоплазий после эксцизионных методов лечения

Abstract

Objective. To evaluate the results of surgical treatment of patients with cervical intraepithelial neoplasia (CIN) using excisional techniques and post-operative implementation of a quadrivalent human papillomavirus (HPV) vaccine. Patients and methods. Excisional treatment methods were used in 150 patients with CIN: 60 patients received a quadrivalent vaccine against HPV (type 6, 11, 16, 18) after surgery and 90 patients were not vaccinated. Post-operative examination was performed 3, 6, 12, 18, and 24 months after surgery and annually thereafter. Detection of CIN within 12 months after surgery was considered as a residual lesion, and more than 12 months after surgery – as a recurrence of the disease. Results. The post-operative follow-up periods for the vaccinated patients ranged from 6 to 93 months (median: 34 months), without vaccination: 6 to 202 months (median: 54 months). Residual lesions were not revealed among vaccinated patients and were revealed in 13.3% (12/90) of unvaccinated patients (p = 0.039). Recurrence of CIN among patients with follow-up for 12 months or more was noted in 3.3% (2/60) of vaccinated patients and 34.6% (27/78) of unvaccinated patients (p = 0.016). Conclusion. Vaccination against HPV (types 6, 11, 16, 18) after excisional treatment methods has significantly (approximately ten-fold) reduced the probability of CIN recurrence and may be considered as an effective approach to improve the results of treating patients with CIN. Key words: human papillomavirus, cervical intraepithelial neoplasia, vaccine, excisional treatment methods