Оптимизация предоперационной подготовки ВПЧ-позитивных пациенток с сочетанной патологией тела и шейки матки

Abstract

Objective. To improve surgical outcomes in human papillomavirus (HPV)-positive patients with combined pathology of the uterine corpus and cervix by optimizing preoperative preparation. Patients and methods. The study included patients (n = 151) who were observed and treated at the Moscow Regional Research Institute of Obstetrics and Gynecology. All patients were referred for a hysterectomy, the indication for which was the presence of combined pathology of the uterine corpus and cervix. Patients underwent pre- and postoperative screening, including the detection of high carcinogenic risk (HCR) HPV, liquid-based cytology, colposcopy, and vaginoscopy (6 months after a hysterectomy). Histological methods were also used. Results. We revealed a high rate (26.5%) of HCR HPV in patients with combined pathology of the uterine corpus and cervix, predominantly combined lesions (two or more HCR HPV types in 55%), prevalent HCR HPV type 16 (62.5%), and a high viral load before a hysterectomy. Conclusion. This study demonstrates the necessity of a thorough preoperative examination (cervical cytology, HPV testing, extended colposcopy and vaginoscopy) and the advisability of including immunomodulatory agents with antiviral cytokine activity in the preoperative preparation of such patients (the efficacy and safety of Superlymph was proven in the study). Key words: hysterectomy, human papillomavirus, cervical and vaginal neoplasms, immunity, cytokines, Superlymph