Objective: to identify informative markers of the progression of cervical intraepithelial lesions of low degree.Materials and methods: the dynamics of the results of the cytological study of cervical epithelium, genotyping of human papilloma viruses of high carcinogenic risk (HPV) with an assessment of the viral load, an immunocytochemical study of the expression of protein p16 (p16INK4α), serum folic acid in 90 HPV-positive patients of reproductive age was analyzed. 43 of the 90 patients (47.8%) who made up group I had regression of the disease. Group II included 30 of 90 patients (33.3%) with disease persistence - no significant changes in the results of laboratory and instrumental research methods. Group III was 17 out of 90 patients (18.9%) with disease progression. Statistical processing of the results was carried out using parametric and non-parametric analysis methods using IBM SPSS Statistics 28.0.1.1 (developed by IBM Corporation), STATISTICA 13.5.0.17 (developed by StatSoft.Inc) and MedCalc 20.027. Results: factors that significantly distinguish patients with persistence or progression of low grade cervical intraepithelial lesions from women with regression of the disease are: earlier age of sexual onset, detection of atypical changes in low grade cervical epithelium, clinically significant HPV viral load, detection of p16INK4a protein expression, serum folic acid below 3.1 ng/ml. Conclusions: deficiency of serum folic acid in HPV of positive patients should be considered as a pathogenetically significant risk factor for the implementation of infection into the clinical form of the disease, which is confirmed by its correlation with the cytological detection of LSIL, progressive increase in the copy of HPV, and p16INKα expression. The patient management strategy, which provides a personalized assessment of the risk of progression of cervical intraepithelial lesions, expands the monitoring of patients with cervical neoplasias associated with HPV.

Objective. The study aimed to compare the level of INF a2 immunoexpression in tissues obtained during medical abortion with the corresponding level of IFNa2 expression in a retained fetal egg tissues after the first missed abortion. The authors compared the anamnestic data on previous inflammatory diseases of the genital tract with the results of an extended morphological study of the material obtained during the evacuation of the contents of the uterine cavity during the first non-developing pregnancy in the first trimester.Materials and methods. The study included 15 patients with first-time missed abortions caused by a viral infection (6-8 weeks of pregnancy). All patients demonstrated either recurrent herpes simplex labialis/genitalis or PCR confirmed HSV, HPV, CMV. Exclusion criteria were recurrent miscarriage, blighted ovum, endocrinopathies, male factor infertility, and other causes of miscarriage. The comparison group included 20 women of the same age that chose to undergo a medical abortion.Results. In patients from the comparison group, the main producer of IFN a2 was syncytiotrophoblast as well as maternal decidual cells in the parietal endometrium and uteroplacental area. In the main group, manifested hematogenous infection (microabscesses, vasculitis, lymphocytic and macrophage infiltration) with dystrophy and necrosis of decidual maternal cells and secondary pathological changes in the placental villi were diagnosed, which led to a significant decrease in the IFN a2 immunoexpression in all the studied cells.Conclusion. The lack of anamnestic data on previous urogenital infections does not exclude the etiological role of the inflammatory component in the genesis of non-developing pregnancy. First-time occurred pregnancy loss requires adequate postoperative interferon therapy and a thorough examination of a couple.

Objective: To improve the management of mild cervical dysplasia by correcting serum folic acid as an epigenetic risk factor for disease progression.   Materials and methods: 90 patients with different outcomes of dynamic follow-up of LSIL associated with one type of HPV VCR were included in the study (16, 18, 33). Group I — 43 patients with regression of the disease; Group II — 30 patients with persistence of HPV infection and group III — 17 patients with LSIL progression. The effectiveness of the differentiated approach to the management of patients in the study groups was assessed based on the results of cytology of cervical smears and immunocytochemical reaction, the level of viral load, the results of colposcopic examination, and the dynamics of serum folic acid levels. Statistical processing of the results was performed using IBM SPSS Statistics 28.0.1.1, STATISTICA 13.5.0.17 and MedCalc 20.027.   Results: the prognostic significance of a number of anamnestic parameters and serum folate deficiency, the totality of which can be used as predictors of disease outcome progression, has been established; a computer program has been developed to calculate the individual risk of disease progression (IRD), which facilitates the use of the developed method for calculating progression in clinical practice.   Conclusions: The proposed method with a high degree of reliability and informativeness allows predicting the progression of LSIL without violating the algorithm of current clinical recommendations, timely forming among patients a high-risk group for the development of a more severe form of the disease (HSIL) and individually determining further treatment tactics.