Introduction. The leading role of the human papillomavirus in the etiopathogenesis of malignant neoplasms of some localizations is generally recognized. Vaccines that are used in the world and in Russia for the prevention of papillomavirus infection create the basis for the elimination of diseases associated with the human papillomavirus in the future. The aim of the study is to determine the regional, gender and age-specific features of cancers associated with the human papillomavirus to substantiate the development of a unified system of epidemiological surveillance and vaccination. Materials and methods. The retrospective epidemiological analysis of the incidence of cancers associated with the human papillomavirus and mortality due to these neoplasms in the regions of the North-Western Federal District of Russia in 20112020 was carried out based on data from Statistic Form 7 "Information on malignant neoplasms" and the Population cancer Registers of St. Petersburg (13,117 cases), Leningrad region (3204 cases) and the Kaliningrad region (2898 cases). Results. In the structure of cancers associated with the human papillomavirus in St. Petersburg, Leningrad and Kaliningrad regions, more than 90% of men had tumors of the oral cavity, oropharynx and larynx, more than 60% of women had cervical cancer. Regional and age-specific features of the incidence of cervical cancer and mortality from this pathology have been established. Statistically significant differences in the incidence of cancer of the head and neck, anus and anal canal in different age groups of the male and female population were revealed. Conclusion. As a result of the study, regional, gender and age-specific features of the incidence of human papillomavirus-associated malignant neoplasms in the North-West of Russia were established. These data should be used to develop a system of epidemiological surveillance of papillomavirus infection and vaccination program.

Международное агентство по изучению рака относит к злокачественным новообразованиям, ассоциированным с вирусом папилломы человека (ВПЧ), рак полости рта, миндалин, ротоглотки, гортани, анального канала, вульвы, влагалища, шейки матки и полового члена. Различные формы физического статуса ДНК вируса могут играть роль в процессе вирусного канцерогенеза. Цель: оценить тяжесть заболевания у пациентов с предраковыми и злокачественными новообразованиями, ассоциированными с ВПЧ, в зависимости от вирусной нагрузки и статуса ДНК вируса. Ключевые слова: злокачественные новообразования, вирус папилломы человека, вирусная нагрузка, физический статус, рак орофарингеальной области, анальный рак, рак шейки матки. Материалы и методы: исследовано 80 образцов опухолевой ткани пациентов с раком полости рта, миндалин, ротоглотки, вульвы, влагалища, шейки матки анального канала, тяжелой дисплазией шейки матки. Выявление, генотипирование, определение вирусной нагрузки и физического статуса ДНК ВПЧ проводили методом ПЦР в режиме реального времени на приборе RotorGene 6000 с использованием комплектов реагентов фирмы «Amplisens®». В результате исследования в 89,7% случаях обнаружен ВПЧ. Высокая вирусная нагрузка выявлена в 60,7%, низкая – в 39,3% случаях; эписомальная форма ДНК вируса не выявлена, «смешанная» обнаружена в 86,4%, интегрированная – в 13,4% случаев. В образцах опухолей с высокой вирусной нагрузкой в более 90% случаев ДНК ВПЧ выявлена в смешанной форме. Уровень вирусной нагрузки ВПЧ при орофарингеальном раке варьировал от 1,97 до 6,59 lg, при раке анального канала и шейки матки составил более 5,8 lg ДНК ВПЧ/105 клеток. В большинстве образцов опухолевой ткани при раке анального канала и шейки матки на III-IV стадии заболевания выявлена смешанная форма ДНК ВПЧ. Заключение: в образцах опухолевой ткани больных раком анального канала и шейки матки с III-IV стадией превалировали смешанные формы ДНК ВПЧ с высокой вирусной нагрузкой, что может служить потенциальным биомаркером более тяжелого клинического течения опухолевого процесса.

Objective.To study the peculiarities of morbidity and mortality from malignant neoplasms associated with the human papillomavirus among male and female population in a megalopolis. The International Agency for Research on Cancer relates cancer of the oral cavity, tonsils and oropharynx, larynx, anal canal and skin of the perianal region, vulva, vagina, cervix and penis to malignant neoplasms associated with the human papillomavirus. Material and methods. The analysis of morbidity and mortality was carried out according to the Population Cancer Registry of St. Petersburg for the period 20112020. The structure of the localization of the tumor process, trends and levels of morbidity and mortality from neoplasia associated with papillomavirus infection were studied. The study included information on 13,117 cases of the disease and 7,257 deaths. Research methods: epidemiological, clinical, statistical methods. Results. Among all the malignant neoplasms, the proportion of HPV-associated neoplasias was 5.1 % in men and 5.8 % in women (p 0.05). In the structure of morbidity and mortality from HPV-associated tumors, cancer of the oral cavity and larynx occupies the largest share among men, and cervical cancer among women. The incidence of oropharyngeal cancer among the male population is higher compared to the female, the incidence of anal cancer among women is 2.9 times higher and there is an upward trend with higher growth rates (p 0.05). Conclusions. The established gender differences of HPV-associated malignant neoplasms should be taken into account when justifying the directions for improving dispensary monitoring of patients and vaccination of papillomavirus infection.

Molecular genetic studies have revealed the involvement of different genotypes of human papillomavirus (HPV) in the carcinogenesis of cervical cancer and malignant lesions of other localizations. It is reported that patients with HPV-positive cancer have a better prognosis of the disease and survival than patients with unconfirmed HPV infection or with a low viral load. The objective was to identify the detectability, viral load, genotypes of human papillomavirus in HPV-associated precancerous and malignant neoplasia of various localization and to determine risk factors for their occurrence in the metropolis of St. Petersburg at the present time. Materials and methods. A total of 80 samples taken from morphologically confirmed tissues of oropharyngeal and anal cancer, malignant tumors of vulva, vagina, cervix and cervical intraepithelial neoplasia were studied in St. Petersburg Clinical Oncologic Center. Detection, quantification and genotyping of HPV DNA were carried out by real-time PCR at the St. Petersburg Pasteur Institute. Results. HPV was detected in 89.7% (61/68) of patients with malignant tumors and 83.3% (10/12) with severe cervical dysplasia. The vast majority (85.9%) of HPV-positive patients were infected with HPV genotype 16; papillomavirus mixed infection (genotypes 16, 18, 31, 33, 35, 39, 45) was detected in anal cancer, cancer and severe cervical dysplasia. The average viral load in stages IIIIV of anal cancer, cervical cancer and severe cervical dysplasia exceeded 5.7 lg HPV DNA/105 cells. Among patients with oropharyngeal cancer, men predominated (85.7%); anal cancer was detected in women (90.0%). No statistically significant risk factors (smoking and alcohol consumption) for the occurrence of HPV-associated malignancies were identified. Conclusions. The detection of HPV, mainly of genotype 16, varied depending on the location of the neoplasia: anal cancer 100%, cancer of the female genitalia 94% (in case of cancer of the vagina and cervix 100.0%), head and neck cancer 76.2%. The highest HPV DNA load in the tumor tissue was found in IIIIV stages of the cervical and anal cancer.

Introduction: The etiological role of human papillomavirus has been proven in the development of cervical cancer and other tumors of the anogenital tract and oropharyngeal region. Vaccination against papillomavirus infection is carried out in most countries of the world, including Russia, to reduce cancer incidence rates. Objective: To study clinical and epidemiological features of malignant neoplasms associated with the human papillomavirus (HPV) in order to improve vaccine prevention in the North-West of Russia. Materials and methods: We analyzed morbidity, distribution by stages of the tumor process and mortality from cancer of the cervix, oral cavity, tonsils, oropharynx, larynx, anus and anal canal, vulva, vagina, and penis based on data collected by Form 7 “Data on Malignant Neoplasms” and population cancer registries of St. Petersburg and the Kaliningrad Region for the years 2011–2020. The number of incident cases of those neoplasms in St. Petersburg, the Leningrad and Kaliningrad Regions was 13,117, 3,204, and 2,898 cases, respectively. In 2018–2021, the total number of people vaccinated against papillomavirus infection was 9,603. We applied methods of retrospective epidemiological analysis, while statistical processing of the collected data was carried out using Statistica 12 and WinPepi software. Results: In 2011–2019, the incidence of cervical cancer increased in the city of St. Petersburg and the Kaliningrad Region. The incidence of laryngeal cancer among the male population of the Northwestern regions of Russia did not change significantly. The proportion of patients with oropharyngeal cancer of stages 3 and 4 was more than 60 %, those with cervical cancer – about 50 % of cases. An increase in mortality from oropharyngeal cancer was detected in the age group of 60–69 years. We also revealed low coverage with vaccination against HPV in the Northwestern Federal District. Conclusion: To reduce morbidity and mortality from HPV-associated malignant neoplasms in the North-West of Russia, it is necessary to develop a system of epidemiological surveillance and vaccine prevention of human papillomavirus infection.