Taran O. The cervical neoplasia: the criterias for prognostic-diagnostic monitoring and treatment.

Українська версія

Thesis for the degree of Doctor of Science (DSc)

State registration number

0517U000396

Applicant for

Specialization

  • 14.01.01 - Акушерство та гінекологія

01-06-2017

Specialized Academic Board

Д 26.613.02

Essay

The thesis has discovered the theoretical generalization and new approach to solve of scientific problems that have manifested in more effective treatments of of cervical precancerous conditions by optimizing the diagnostic and therapeutic measures based on a comprehensive analysis and systematization of the molecular-biological factors that were associated with neoplastic transformation of the cervical epithelium. It was justified causes and predictors of criteria of risk factors for LSIL, which increased when CD34 expression is present in the stroma (? = 0,518; p<0.001), with an increase of biomarkers of endothelial dysfunction: DEC (? = 0,430; p<0.001), VEGF (? = 0.271; p = 0,002), VE - cadherin (? = 0.157; p = 0.019) with increasing multiplicity HPV infection (? = 0.238; p = 0.004) and smoking more than 5 cigarettes per day (? = 0.269; p = 0.01); likely to develop HSIL increases with an increase in cervical mucus concentration of IFN-? (? = 0,759; p<0.001) and Ig A (? = 0,208; p = 0,004), VE-cadherin values (? = 0,214; p = 0.008) levels MDA (? = 0,24, p = 0.041) and decrease of SOD in the cervical biopsies (? = - 0,381; p<0.001), and the presence of CD34 expression in the stroma (? = 0,675; p<0.001), expression PgR ( ? = 0,17, p = 0.04), vaginal dysbiosis (? = 0,242; p = 0.015) and bilirubinemia (? = 0,175; p = 0.043).In the prospective clinical trial is scientifically proved, the clinical efficacy of medicine administration containing 1 mg alloferon 1.0 subcutaneously every day №3 before surgical destruction, after the eschar abruption repeated drug every other day №3, which led to a reduction of the period of eschar abruption, better results of complete epithelialization in 5-6 weeks; normalization of local immunity (significant reduction of regulatory cytokines IFN - ?, IFN - ?, TNF - ? and IgA); complete elimination of HPV infection and pathogenic organisms; restore vaginal microecology (increase in the number of cases normalisation of vaginal microflora and the number of lactobacilli). Acording to result of our scientific research for practical public health, an advanced complex of step-by-step diagnostic and therapeutic measures was developed and introduced in the cervical precancerous pathology, which did it possible to used a differentiated approach to diagnosing these pathologies and conducted optimal therapy in women of reproductive growth, taking into account molecular genetic factors, which increased the effectiveness of treatment of cervical pathology.

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