Ассоциированные с инфекцией вируса папилломы человека маркеры возникновения и прогрессии цервикальных интраэпителиальных неоплазий: от научных разработок к клинической практике

Цервикальные интраэпителиальные неоплазии (ЦИН) – этапы развития рака шейки матки (РШМ) на фоне персистирующей инфекции, вызываемой вирусами папилломы человека (ВПЧ-инфекции), – заболевание, часто встречающееся у молодых женщин. Процесс канцерогенеза длится от 3–5 до 10–30 лет, в течение которых возможно своевременное выявление и органосохраняющее лечение поражений. Разработка маркеров персистенции ВПЧ-инфекции и перехода продуктивной фазы инфекции в трансформирующую (от ЦИН легкой степени тяжести к тяжелой) является основой современного подхода к скринингу ЦИН и РШМ и динамическому наблюдению больных. В обзорной статье представлены основные направления исследований по разработке маркеров, напрямую ассоциированных с ВПЧ-инфекцией (вирусная нагрузка НС2), типирование вируса, физический статус вируса, мРНК Е6 и Е7, соотношение Е2/Е6), а также опосредованных действием ее на клетки хозяина (p16INK4a, hTERT). Подробно рассмотрены патогенетическое действие ранних генов ВПЧ и связь их с экспрессией основных суррогатных маркеров. Большинство представленных маркеров активно внедряют в клиническую практику за рубежом.

вирусогенетические маркеры, цервикальная интраэпителиальная неоплазия, рак шейки матки, вирус папилломы человека, вирусная нагрузка, полуколичественный метод гибридного захвата, p16INK4a, теломеразная обратная транскриптаза, скрининг

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