[Assesment of the ongoing changes among patients diagnosed with subclinical changes of an HPV infection (SPI) as well as changes in the type of CIN 1 and CIN 2]. / Zachowanie sie zmian o charakterze subklinicznej infekcji HPV (SPI), sródnablonkowej neoplazji szyjki macicy (CIN) 1 i 2. Badanie prospektywne obserwacyjne.

ABSTRACT

PURPOSE OF STUDY The aim of the study was to assess the ongoing changes of the type of regression, progression and steady state among patients diagnosed with subclinical changes of an HPV infection as well as changes in the type of CIN 1 and CIN 2. MATERIALS AND METHODS: The study was conducted in a group of 289 women between the ages of 25-60 with abnormal cytology taking part in the CIN cervical cancer prevention program. RESULTS: The patients were observed over a period of 6 years; no detectable differences were discovered in the frequency of regression between patients with SPI in comparision to patients with CIN1. In addition, no differences were identified in the frequency of regression between groups of patients with CIN1 and CIN2. In contrast, regression was more common in patients with SPI than in patients with CIN2. Steady state was more frequent in patients with CIN1 and CIN 2 than in patients with SPI. The results illustrated no differences in the progression of SPI and the CIN1 to CIN2. The group of patients with CIN2 were frequently associated with progression to CIN3 more than in the group of patients with SPI. The group of patients with CIN2 were frequently associated with progression to CIN3 more than in the group of patients with CIN1. Further investigation of cervical changes associated with SPI, CIN1 and CIN2 were dependent on the presence of transcription genes E6 and E7 of HPV. In 138 cases, the presence of these transcription genes lead to progression in 19.56% of women; more specifically in the introduction of mE6 and E7 RNA. There were changes typical of remission in 56,52% of cases primarily in the absence of transcriptor genes HPV E6 and E7. CONCLUSION: 1. The histological changes of the cervix observed in subclinical HPV infection, CIN1 and CIN2 may be subject to a higher degree of progression of CIN. In addition, these changes may progress to cervical cancer, remain stationary in a steady state, or decline into remission. 2. The types of HPV infection with high oncogenic potential are not only important in initiation of cerival changes but also in the developmental process of carcinogenesis in the cervix by several independent mechanisms.