Clinical review for general practice

Aim. To investigate the potential of predicting the progression of precancerous cervical diseases based on proinflammatory and anti-inflammatory cytokines.

Materials and methods. The study included 131 women who were divided into three main groups: the first group consisted of 37 patients with low-grade squamous intraepithelial lesions (LSIL) who were negative for human papillomavirus (HPV); the second group included 41 women with LSIL who were HPV-positive; the third group comprised 53 patients with high-grade squamous intraepithelial lesions (HSIL) who were HPV-positive. The control group consisted of 26 practically healthy women. All participants underwent comprehensive examination, including cytological analysis (Pap test), extended colposcopy, and determination of HPV genotypes. Additionally, blood levels of proinflammatory (IL-6, TNF-α) and anti-inflammatory (IL-4, IL-10) interleukins were assessed. The severity of colposcopic and morphological changes was found to be significantly associated with HPV-positive status and the presence of high-risk HPV genotypes (types 16, 18, 31, 33, and 52). The identified imbalance in the cytokine profile, characterized by increased levels of IL-10, IL-4, and TNF-α, was most pronounced in patients with HSIL, indicating progression of the pathological process and impairment of immune response. The obtained results confirm the diagnostic and prognostic value of comprehensive assessment of clinical, colposcopic, virological, and immunological parameters for early detection and prediction of precancerous cervical diseases.

Results. Thus, the results of the study demonstrated that the identified parameters may be considered predictors and biomarkers of the development of precancerous cervical diseases. Monitoring and evaluation of proinflammatory and anti-inflammatory cytokine levels, as well as analysis of inflammatory response complications and clinical manifestations, have significant diagnostic and prognostic value. Observation of the dynamics of these indicators confirms the possibility of objective assessment of the severity of precancerous cervical diseases.

Keywords: precancerous cervical diseases, human papillomavirus, colposcopy, Pap test, interleukins, LSIL, HSIL.

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