[Immunomodulatory treatment with beta-interferon in patients with cervical intraepithelial neoplasia and human papillomavirus infection: long-term follow-up]. / Tratamiento inmunomodulador con interferón beta en pacientes con neoplasia cervical intraepitelial e infección por virus del papiloma humano. Seguimiento a largo plazo.

The aim of this study was to evaluate the long-term efficacy of beta-interferon treatment in the management of cervical intraepithelial neoplasia associated with human papillomavirus (HPV) infection in a selected group of patients. Thirty-nine patients who had histologically proven cervical intraepithelial neoplasia I or II with concurrent HPV infection were administered 27,000,000 IU of intramuscular beta-interferon. Periodical controls were carried out based on Papanicolaou smears and/or colposcopic examination and DNA HPV determination was performed by hybridation test, for a maximum of 8 years' follow-up. An initial complete response rate of 75% was obtained, with a recurrence rate of 25%, cervical intraepithelial neoplasia with late manifestation was of higher grade. Treatment interruption due to side-effects was not necessary. Associated viral infections appeared to be a recurrence risk factor, but not smoking or parity. While immunomodulatory treatment with beta-interferon has good long-term results in cervical intraepithelial neoplasia I/II treatment, wider randomized studies are required to obtain conclusive results.

Tratamiento inmunomodulador con interferón beta en pacientes con neoplasia cervical intraepitelial e infección por virus del papiloma humano. Seguimiento a largo plazo / Immunomodulatory treatment with beta-interferon in patients with cervical intraepithelial neoplasia and human papillomavirus infection: Long-term follow-up

El objetivo del estudio fue valorar la eficacia a largo plazo del interferón beta en el tratamiento de las lesiones cervicales intraepiteliales asociadas a infección por el virus del papiloma humano (VPH) en un grupo de pacientes seleccionadas. Se administraron 27.000.000 UI de interferón beta intramuscular a 39 pacientes con diagnóstico histopatológico de neoplasia cervical intraepitelial I-II y determinación de VPH positiva. Se realizaron controles periódicos posteriores mediante citología o colposcopia (o ambas) y detección del DNA-VPH, por un plazo máximo de 8 años. Se logró un porcentaje de respuesta completa inicial del 75% y una tasa de recidivas del 25%, siendo de neoplasia cervical intraepitelial de mayor grado las producidas más tardíamente. En ningún caso tuvo que suspenderse el tratamiento por sus efectos secundarios. La existencia de coinfecciones virales parece confirmarse como un factor de riesgo de la recidiva, no así la multiparidad ni el hábito tabáquico. La inmunomodulación con interferón beta parece obtener buenos resultados a largo plazo en el tratamiento de la neoplasia cervical intraepitelial I-II, aunque son necesarios estudios aleatorizados más amplios para conseguir resultados concluyentes

The aim of this study was to evaluate the long-term efficacy of beta-interferon treatment in the management of cervical intraepithelial neoplasia associated with human papillomavirus (HPV) infection in a selected group of patients. Thirty-nine patients who had histologically proven cervical intraepithelial neoplasia I or II with concurrent HPV infection were administered 27,000,000 IU of intramuscular betainterferon. Periodical controls were carried out based on Papanicolau smears and/or colposcopic examination and DNA HPV determination was performed by hybridation test, for a maximun of 8 years’ follow-up. An initial complete response rate of 75% was obtained, with a recurrence rate of 25%; cervical intraepithelial neoplasia with late manifestation was of higher grade. Treatment interruption due to side-effects was not necessary. Associated viral infections appeared to be a recurrence risk factor, but not smoking or parity. While immunomodulatory treatment with beta-interferon has good long-term results in cervical intraepithelial neoplasia I/II treatment, wider randomised studies are required to obtain conclusive results

[Synchronous and bilateral inverted papilloma of the kidney pelvis. Conservative treatment]. / Papiloma invertido bilateral y sincrónico de pelvis renal. Tratamiento conservador.

Contribution of a new case of inverted papilloma (IP) of the upper urinary tract (UUT) with the idiosyncrasy of being bilateral and synchronic, a fact not found in the reviewed literature, treated with radical surgery on the left side and conservatively on the right one. Discussion on this pathology is addressed, emphasising its benign biological behaviour, which does not eliminate some cases of malignization. Treatment has to be conservative, and so we stress the relevance of defining a suspicion state to make pre- and peri- operative diagnosis in which endourological methods, that allow both direct visualization and the taking of a biopsy, play a preeminent role. Subsequent strict monitoring is essential due to the likelihood of relapse and malignant changes.