Endometrial polyps associated with human papillomavirus: A rationale for pathogenetic therapy

Objective. To study the rate of recurrence of endometrial polyps associated with human papillomavirus (HPV) of a high oncogenic risk, and the efficacy of inosine pranobex antiviral therapy for prevention of disease recurrences. Patients and methods. Two groups of patients were singled out 2: group 1 (n = 29) – patients with recurrent glandular, glandular-fibrous endometrial polyps; group 2 (n = 35) – patients with newly diagnosed glandular, glandular-fibrous endometrial polyps. In the process of viral load description, the groups were divided into subgroups 1a and 2b. Cytological/ immunohistochemical examination was based on liquid-based cytology. Molecular-genetic examination consisted in human papillomavirus identification with the use of polymerase chain reaction. Results. In group 1, 79.3% (n = 23) of women were HPV positive; in group 2 viral load was found only in 37.1% (n = 13) (p ≤ 0.001). A positive response to protein р16ink4 was determined in 72.4% (n = 21) of patients of group 1 and in 26.0% (n = 9) of patients of group 2 (p ≤ 0.001). After antiviral therapy with Groprinosin 3 months afterwards the viral load decreased in patients of group 1 as compared with initial data up to complete elimination of virus in 18 patients (presence of virus: 17.2% after therapy vs. 79.3% before therapy). Analysis of р16ink4 immunostaining was indicative of a drop in the number of stained clones (6.9% after therapy vs. 72.4% before therapy). The cumulative logarithm of viral DNA copies showed: of 5 individuals who had HVP after therapy in subgroup 1а (n = 23) a clinically significant cumulative log was preserved in three patients (13%) out of the initially infected persons. Conclusion. HPV can be regarded as one of the predictors of recurrent endometrial polyps. The use of combined treatment (hysteroresectoscopy + antiviral therapy with inosine pranobex) permits to reduce the risks for recurrence of endometrial polyps. © 2019, Dynasty Publishing House. All rights reserved.

Авторы
Pokul L.V. 1 , Orazov M.R. 2 , Lebedeva M.G. 3 , Chugunova N.А.4 , Kovaleva М.N. 1, 4 , Akhmatova А.N. 4
Издательство
Dynasty Publishing House
Номер выпуска
6
Язык
Русский
Страницы
7-15
Статус
Опубликовано
Том
18
Год
2019
Организации
  • 1 Department of obstetrics and gynaecology with the course of perinatology, Medical Institute, People’s Friendship University of Russia (RUDN University), Novorossiysk Clinical Centre, Federal Medico-Biological Agency, 26 Sakko i Vantsetti str., Novorossiisk, 353901, Russian Federation
  • 2 Department of obstetrics and gynaecology with the course of perinatology, People’s Friendship University of Russia (RUDN University), 6 Miklukho-Maklai str., Moscow, 117198, Russian Federation
  • 3 Department of obstetrics and gynaecology with the course of perinatology, Medical Institute, People’s Friendship University of Russia (RUDN University), 6 Miklukho-Maklai str., Moscow, 117198, Russian Federation
  • 4 Novorossiysk Clinical Centre, Federal Medico-Biological Agency, 26 Sakko i Vantsetti str., Novorossiisk, 353901, Russian Federation
  • 5 Gynaecological department, Novorossiysk Clinical Centre, Federal Medico-Biological Agency, 26 Sakko i Vantsetti str., Novorossiisk, 353901, Russian Federation
Ключевые слова
Endometrial polyps; Human papillomavirus; Hysteroresectoscopy; Inosine pranobex
Дата создания
02.11.2020
Дата изменения
02.11.2020
Постоянная ссылка
https://repository.rudn.ru/ru/records/article/record/65794/