docruДоктор.РуTitle1727-23782713-2994ООО "ГК "РУСМЕДИКАЛ"10.31550/1727-2378-2023-22-5-75-80docru-244Research ArticleГИНЕКОЛОГИЯGYNECOLOGYФакторы формирования неопластических процессов в шейке маткиFactors in the Formation of Neoplastic Processes in the Cervixhttps://orcid.org/0000-0002-4996-026XАртёмоваО. И.ArtemovaO. I.

Ольга Игоревна Артёмова, к. м. н., доцент кафедры

Медицинский институт

440026; ул. Красная, д. 40; Пенза

440026; 40 Krasnaya Str.; Penza

artyomovaolg@gmail.comФГБОУ ВО «Пензенский государственный университет»РоссияPenza State UniversityRussian Federation202319022025225ГИНЕКОЛОГИЯ7580Copyright © Артёмова О.И., 20252025Артёмова О.И.Artemova O.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://docru.elpub.ru/jour/article/view/244   Цель обзора

   Цель обзора: обзор литературных данных о патогенетических аспектах формирования плоскоклеточных интраэпителиальных поражений и роль иммунологических механизмов в формировании данной группы заболеваний шейки матки.

   Основные положения

   Основные положения. Рак шейки матки (РШМ) является многоэтапным процессом, которому зачастую предшествуют интраэпителиальные поражения, ассоциированные с вирусом папилломы человека. Установление причинных и следственных взаимодействий между вирусом и малигнизацией, а также исследование данных эпидемиологии приводит к формированию моделей цервикального канцерогенеза: инфицирование, персистенция, продвижение к предраковой стадии и, наконец, РШМ. Несмотря на понятный и очевидный путь малигнизации, а также наличие в арсенале практикующего врача акушера-гинеколога общедоступных методов диагностики, оценка и прогнозирование дальнейшего развития цервикальных патологией у пациенток активного репродуктивного возраста остаются затруднительными. В целом РШМ можно считать удачной моделью для формирования понимания о стадийности процессов малигнизации, которые будут в первую очередь связаны с воздействием папилломавирусной инфекции и изменением иммунологических аспектов эндо- и экзоцервикса.

   Заключение

   Заключение. Проведен анализ источников, опубликованных в системах Cochrane Librare, Google Scolare и PubMed. В последние годы оптимизировалось понимание взаимодействия опухоли, связанной с вирусом папилломы человека и с иммунной системой хозяина, поэтому разработка новых подходов, нацеленных на иммунные контрольные точки, вызвали интерес к использованию иммунотерапии при РШМ. РШМ излечим, если обнаружен на ранней стадии. Однако надежные диагностические и прогностические маркеры, относящиеся к физиологической и патологической регуляции РШМ, на данный момент недоступны. Поэтому подход к лечению РШМ остается неизменным в течение нескольких десятилетий, и в настоящее время требуются новые диагностические стратегии, обусловленные взаимодействием иммунной системы и вирусом.

   Aim

   Aim: Review the literature data on the pathogenetic aspects of the formation of squamous intraepithelial lesions and the role of immunological mechanisms in the formation of this group of cervical diseases.

   Key Points

   Key Points. Cervical cancer (CC) is a multi-stage process that is often preceded by human papillomavirus (HPV)-associated intraepithelial lesions. The establishment of causal interactions between the virus and malignancy, as well as the study of epidemiological data, leads to the formation of models of cervical carcinogenesis: infection, persistence, progression to the precancerous stage, and finally, cervical cancer. Despite the clear and obvious path of malignancy, as well as the availability of generally available diagnostic methods in the arsenal of a practicing obstetrician-gynecologist, the assessment and prediction of the further development of cervical pathologies in patients of active reproductive age remains difficult. In general, cervical cancer can be considered an excellent model for understanding the staging of malignancy processes, which will be primarily associated with the impact of human papillomavirus infection and changes in the immunological aspects of endo- and exo-cervix.

   Conclusion

   Conclusion. An analysis of sources published in the Cochrane Librare, Google Scolare and PubMed systems was carried out. In recent years, the understanding of human papillomavirus-associated tumor interaction with the host immune system has improved, so the development of new approaches targeting immune checkpoints has sparked interest in the use of immunotherapy in cervical cancer. CC is curable if detected at an early stage. However, reliable diagnostic and prognostic markers related to the physiological and pathological regulation of cervical cancer are currently not available. Therefore, the approach to the treatment of cervical cancer has remained unchanged for several decades, and new diagnostic strategies are currently required, due to the interaction of the immune system and the virus.

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The authors declare that there are no conflicts of interest present.