Lakatosh V. Modern Approaches to Diagnosis, Treatment and Prediction of Uterine Cervix Diseases Associated with Papillomavirus Infection.

Women (348 persons) with cervix uteri (CU) diseases associated with papillomavirus infection: 178 patients with benign processes associated with PVI, 132 women with cervical intraneoplasia (CIN) of the I and II degree of gravity associated with human papillomavirus (HPV), 38 women with CIN III and preinvasive cancer of cervix uteri associated with PVI have been investigated. It has been established than young women of active reproductive age mainly suffer from papillomavirus diseases. Early appearance of menarche in patients with benign processes associated with HPV were registered 4.8 times more often in pa-tients with cancer in situ, that associated with PVI - 2.1 times more often than in healthy women. Potentialities of colpocytomorphological method of HPV persistence diagnostics have been established. Peculiarities of ultrastructure organization of mucosa in CUs damaged by HPV have been revealed using electron-mi-croscopic methods. The results of DNA-polymerase chain reaction have confirmed that HP V 6 and 11 are characteristic of benign CU processes, and HPV 16, 18 and 31 are typical of precancer and malignant processes. The state of organism immunoreactivity plays a certain part in pathogenesis of CU diseases induced by HPV. It has been established that at PVI of CU the indices of nonspecific antivirus resistance of the sick woman organism change. Under the CU diseases associated with HPV one can observe certain stimuli in the patients' peripheral blood. These stimuli lead to fun-ctional reorganization of phagocitiс system cells - monocytes and neutrophyles (indices of oxygen-dependent bacteriocide activity of neutophyles sharply increase, while reserve poten-tialities of phagocytosis are suppresed). The ratio of T- and B-lymphocytes as well as their subpopulations, characteris-tic of healthy women, changes in peripheral blood of patients. The value of the index of CD4 + /CD8 + ratio changes at papillomavirus lesions of СU. Production of a- and g-interferon by the cells of peripheral blood decreases i n the patients. The decrease of interferonogenic activity of cells is accompa-nied by the change of cell immunity indices. The results obtained have become a theoretical substantiation of a necessity of immunocorrecting therapy in the complex treatment of CU diseases associated with HPV. The author recommends new highly efficient methods of treatment of CU diseases induced by HPV. Depending on the disease gravity and its distribution the following combinations of treatment methods may be used: local cytostatic therapy in a complex with local interferonotherapy; local cytostatic therapy in a complex with cryodestruction and local or system inteferonotherapy; CO2-laser vaporization in a complex with the system interferonotherapy; local cytostatic therapy in a complex with diathermoconisation and system interferonotherapy. As the result of the offered complex treatment of CU diseases associated with HPV, the treatment efficiency has decreased by 20 %, indices of the total and local organism immu-nity have normal ized, frequency of relapses of CU diseases has decreased by 14 %, and this allows the given approach to treat-ment of patients to be recommended for the use in practical medicine.