ssmuБюллетень сибирской медициныBulletin of Siberian Medicine1682-03631819-3684Siberian State Medical University, the Ministry of Healthcare of the Russian Federation10.20538/1682-0363-2023-4-201-209ssmu-5436Research ArticleОБЗОРЫ И ЛЕКЦИИREVIEW AND LECTURESПроблемы диагностики патологий шейки маткиChallenges in the diagmosis of cervical pathologieshttps://orcid.org/0000-0002-1521-9668ЧерновД. Ю.ChernovD. Y.

Чернов Денис Юрьевич – ординатор, кафедра акушерства и гинекологии

634050, г. Томск, Московский тракт, 2

2, Moscow Trakt, Tomsk, 634050

denis.chrnv1@gmail.comhttps://orcid.org/0000-0003-4309-5831ТихоновскаяО. А.TikhonovskayaO. A.

Тихоновская Ольга Анатольевна – д-р мед. наук, профессор, кафедра акушерства и гинекологии

634050, г. Томск, Московский тракт, 2

2, Moscow Trakt, Tomsk, 634050

tikhonovskaya2012@mail.ruhttps://orcid.org/0000-0002-9876-6957ЛогвиновС. В.LogvinovS. V.

Логвинов Сергей Валентинович – д-р мед. наук, профессор, зав. кафедрой гистологии, эмбриологии и цитологии

634050, г. Томск, Московский тракт, 2

2, Moscow Trakt, Tomsk, 634050

s_Logvinov@mail.ruhttps://orcid.org/0000-0002-0697-3896ПетровИ. А.PetrovI. A.

Петров Илья Алексеевич – д-р мед. наук, профессор, кафедра акушерства и гинекологии

634050, г. Томск, Московский тракт, 2

2, Moscow Trakt, Tomsk, 634050

obgynsib@gmail.comhttps://orcid.org/0000-0002-1343-5471ЮрьевС. Ю.YurievY. S.

Юрьев Сергей Юрьевич – д-р мед. наук, профессор, кафедра акушерства и гинекологии

634050, г. Томск, Московский тракт, 2

2, Moscow Trakt, Tomsk, 634050

sergeiyuriev@gmail.comhttps://orcid.org/0000-0002-4954-7416ЖданкинаА. А.ZhdankinaA. A.

Жданкина Анна Александровна – д-р мед. наук, профессор, кафедра гистологии, эмбриологии и цитологии

634050, г. Томск, Московский тракт, 2

2, Moscow Trakt, Tomsk, 634050

annazhdank@yandex.ruhttps://orcid.org/0000-0002-8526-6187ГерасимовА. В.GerasimovA. V.

Герасимов Александр Владимирович – д-р мед. наук, доцент, профессор кафедры гистологии, эмбриологии и цитологии

634050, г. Томск, Московский тракт, 2

2, Moscow Trakt, Tomsk, 634050

av-gerasimov62@yandex.ruhttps://orcid.org/0009-0005-1508-2832ЗингалюкИ. В.ZingalyukI. V.

Зингалюк Илья Викторович – ординатор, кафедра акушерства и гинекологии

634050, г. Томск, Московский тракт, 2

2, Moscow Trakt, Tomsk, 634050

zingaliyk_27_07@mail.ruhttps://orcid.org/0000-0002-3869-1906МихеенкоГ. А.MikheenkoG. A.

Михеенко Галина Александровна – д-р мед. наук, доцент, профессор кафедры гистологии, эмбриологии и цитологии

634050, г. Томск, Московский тракт, 2

2, Moscow Trakt, Tomsk, 634050

mchnk@mail.ruСибирский государственный медицинский университет (СибГМУ)РоссияSiberian State Medical UniversityRussian Federation202324012024224201209Copyright © Чернов Д.Ю., Тихоновская О.А., Логвинов С.В., Петров И.А., Юрьев С.Ю., Жданкина А.А., Герасимов А.В., Зингалюк И.В., Михеенко Г.А., 20242024Чернов Д.Ю., Тихоновская О.А., Логвинов С.В., Петров И.А., Юрьев С.Ю., Жданкина А.А., Герасимов А.В., Зингалюк И.В., Михеенко Г.А.Chernov D.Y., Tikhonovskaya O.A., Logvinov S.V., Petrov I.A., Yuriev Y.S., Zhdankina A.A., Gerasimov A.V., Zingalyuk I.V., Mikheenko G.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://bulletin.ssmu.ru/jour/article/view/5436

Статья посвящена современному состоянию проблемы диагностики плоскоклеточных интраэпителиальных поражений шейки матки. Рассмотрены вопросы трансформации классификаций и терминологии патологий шейки матки. Обсуждается роль цитологических (жидкостная и традиционная цитология), молекулярно-биологических (Hybrid Capture Diegene Test), иммуногистохимических (p16INK4α, Ki-67) и гистологических методов в диагностике поражений шейки матки. Особое внимание уделено диагностике папилломавирусной инфекции, приведены показатели эффективности скрининговых программ, основанных на первичном определении ДНК вируса папилломы человека (ВПЧ) в сравнении с общепринятыми цитологическими методами. Рассмотрена тропность ВПЧ к различным отделам шейки матки, предрасполагающая к формированию глубоких мультифокальных поражений, а также влияние физического статуса ВПЧ на лечебную тактику и риски рецидивов.

This review deals with the current state of affairs in the diagnosis of cervical squamous intraepithelial lesions. Transformation of classifications of cervical pathologies is considered. The role of cytological (liquid-based and conventional cytology), molecular biological (Digene Hybrid Capture test), immunohistochemical (p16INK4α, Ki-67), and histologic methods in the diagnosis of cervical lesions is discussed. Particular attention is paid to the diagnosis of human papillomavirus infection. Performance indicators of screening programs based on primary determination of human papillomavirus (HPV) DNA in comparison with common cytological methods are presented. Tropism of HPV to various parts of the cervix, which predisposes to the formation of deep multifocal lesions, as well as the influence of the physical status of HPV on the treatment strategy and risks of relapse are considered.

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The authors declare that there are no conflicts of interest present.