MODERN CONCEPTS OF PATHOGENESIS AND MORPHOLOGICAL FEATURES OF HPV-ASSOCIATED LESIONS OF THE VULVA AND CERVIX
Keywords:
HPV infection, cervix, vulva, neoplasia, p16, Ki-67, pathogenesis, morphologyAbstract
The article presents current data on the pathogenesis and morphological characteristics of HPV-associated lesions of the vulva and cervix. The mechanisms of viral DNA integration and expression of oncogenic proteins E6 and E7, leading to dysregulation of the cell cycle and neoplastic transformation of the epithelium, are discussed. Morphological features of intraepithelial neoplasia (CIN, VIN) and the diagnostic value of immunohistochemical markers p16, Ki-67, p53, and E-cadherin are described. The importance of differentiating HPV-dependent and HPV-independent carcinogenic pathways is emphasized. An integrated approach to early diagnosis and prevention of HPV-induced neoplasms of the lower female genital tract is presented.
References
World Health Organization. Global strategy to accelerate the elimination of cervical cancer as a public health problem. Geneva: WHO, 2023.
IARC Monographs. Biological agents: Human Papillomaviruses. Vol. 100B, Lyon, 2020.
de Sanjosé S. et al. Human papillomavirus genotype attribution in invasive cervical cancer. Lancet Oncol. 2018;19(1):85–98.
Doorbar J. et al. The biology and life-cycle of human papillomaviruses. Vaccine. 2021;39 Suppl 1:A6–A13.
Bornstein J. et al. The 2022 ISSVD terminology of vulvar intraepithelial neoplasia. J Low Genit Tract Dis. 2022;26(2):101–108.
Crum C.P., Stoler M.H. Cervical and Vulvar Intraepithelial Neoplasia: Pathology and Pathogenesis. Mod Pathol. 2019;32(S1):S43–S57.
Moody C.A., Laimins L.A. Human papillomavirus oncogenes activate the ATM and ATR pathways to promote replication. J Virol. 2021;95(3):e02097-20.
Stoler M.H., Schiffman M. Interobserver reproducibility of cervical cytologic and histologic interpretations. JAMA. 2020;323(7):682–693.
Tornesello M.L. et al. Prognostic value of p16, Ki-67 and p53 expression in HPV-associated lesions. Pathol Oncol Res. 2019;25(3):1235–1243.
Kaldawy S. et al. Multifocal HPV-associated lower genital tract disease: Clinical and molecular correlations. Int J Gynecol Pathol. 2021;40(5):435–443.
Singh N. HPV-dependent and HPV-independent pathways in vulvar carcinogenesis. Histopathology. 2022;80(1):51–63.
WHO Technical Manual for HPV Testing, 2020.
Kjaer S.K. et al. Long-term effectiveness of HPV vaccination. N Engl J Med. 2021;385:2446–2456.
Shavkatovna, S. S., Amrilloev, A. Z., Nodir, R., & Talibova, N. A. (2023). Separate results of metronomic therapy with cyclophosphan and pazopanib in the palliative treatment of recurrent platinum-resistant ovarian cancer. Central Asian Journal of Medical and Natural Science, 4(4), 557–559.
Shakhanova, S. S., Abdurakhmonov, J. A., & Rakhimov, N. M. (2023). Targeted therapy in the palliative treatment of platinum-resistant recurrent ovarian cancer complicated by ascites. The American Journal of Medical Sciences and Pharmaceutical Research, 5(8).
Rizaev, J. A., Rahimov, N. M., & Kadirov, X. X. (2023). Oncoepidemiological assessment of the incidence and mortality of prostate cancer for the period 2015–2020 in the cross section of the Republic of Uzbekistan and individual regions. Open Access Repository, 4(3), 1108–1113.
