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Chronic cervicitis: a gynecologist and cytologist’s view of the problem
https://doi.org/10.33667/2078-5631-2024-8-16-21
Abstract
Cervicitis is a clinical syndrome characterized by inflammation of the predominantly columnar epithelium located on the exocervix and/or inside the cervical canal. The cause of inflammation can be infections, including sexually transmitted infections (STIs), some systemic diseases, allergic reactions, chemical and mechanical irritants, and other factors. Chronic cervicitis is important from the point of view of oncological alertness, since it promotes deeper penetration of infectious agents into the tissue of the cervix, increases the risk of infection and persistence of the human papillomavirus (HPV). The article presents data on the diagnosis of cervicitis with an emphasis on cellular changes occurring in the cervical epithelium and patient management tactics.
About the Authors
A. V. Ledina
International Association of Gynecologists, Endocrinologists, Therapists; MD Medical Group; Lapino Clinical Hospital of the Mother and Child Group of Companies (Moscow region)
Russian Federation
Russian Federation
Ledina Antonina V., DM Sci (habil.), head of regional programs; physician,
Moscow.
S. I. Rogovskaya
All-Russian public organization «Russian Association for Genital Infections and Neoplasia (RAGIN)»
Russian Federation
Russian Federation
Rogovskaya Svetlana I., DM Sci (habil.), head of the ZhenProSvet project, honorary president,
Moscow
I. P. Shabalova
Russian Medical Academy of Continuing Professional Education (RMANPO)
Russian Federation
Russian Federation
Shabalova Irina P. DM Sci (habil.), professor at Dept of Clinical Laboratory Diagnostics with a course of laboratory immunology,
Moscow.
N. N. Bayandina
United Hospital with the Clinic of the Presidential Administration of the Russian Federation
Russian Federation
Russian Federation
Bayandina Natalya N., clinical laboratory diagnostics doctor (cytologist),
Moscow.
References
1. Iqbal U., Wills C. Cervicitis. 2022–5. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing.
2. Abudukelimu A., Barberis M., Redegeld F.A. et al. Predictable irreversible switching between acute and chronic inflammation. Frontiers in immunology. 2018; 9: 1596. DOI: 10.3389/fimmu.2018.01596
3. Sadri Nahand J, Moghoofei M, Salmaninejad A. et al. Pathogenic role of exosomes and microRNAs in HPV-mediated inflammation and cervical cancer: A review. Int J. Cancer. 2020; 146 (2): 305–320. DOI: 10.1002/ijc.32688
4. Polyanskaya I.B., Savelyeva I.V., Kochkina O.N., Pavilova I.N., Gimp M.V., Potyakina C.C., Grigorian R.A. Therapy optimization for chronic cervicitis associated with opportunistic pathogens. Vopr. ginekol. akus. perinatol. (Gynecology, Obstetrics and Perinatology). 2020; 19 (4): 22–27. (In Russ.). DOI: 10.20953/1726–1678–2020–4–22–27
5. Grueva E, Borisov I. The role of chlamydia trachomatis and some other associated microorganisms in endocervicitis. Akush Ginekol (Sofiia). 2006; 45 (5): 32–35. PMID: 17168494
6. Bebneva T.N., Orazov M.R., Kostin I.N. Cervicitis: an Unresolved Gynecological Problem. Doctor. Ru. 2018; 6 (150): 34–39. (In Russ.).
7. Lusk M.J., Konecny P. Cervicitis: a review. Curr. Opin. Infect. Dis. 2008; 21 (1): 49–55. DOI: 10.1097/QCO.0b013e3282f3d988
8. Tirskaya Yu.I., Rudakova E.B., Shakina I.A., Tsygankova O. Yu. The role of cervicitis in obstetric and gynecological pathology. Attending physician. 2009; 10: 63–66. (In Russ.).
9. Dehon PM, McGowin CL. Mycoplasma genitalium infection is associated with microscopic signs of cervical inflammation in liquid cytology specimens. J. Clin. Microbiol. 2014; 52 (7): 2398–2405. DOI: 10.1128/JCM.00159–14
10. Soares L.C., de Araújo A.R., Braz F.L.T. et al. Association of sexually transmitted diseases with cervical ectopy: a systematic review. Sex Transm. Dis. 2019; 46 (7): 452–457. DOI: 10.1136/bmj.g2646
11. Wilson JF. In the clinic. Vaginitis and cervicitis. Ann Intern. Med. 2009; 151 (5): ITC3–1-ITC3–15. DOI: 10.7326/0003–4819–151–5–200909010–01003
12. Ortiz-de la Tabla V, Gutiérrez F. Cervicitis: Etiology, diagnosis and treatment. Enferm. Infecc. Microbiol. Clin. (Engl Ed). 2019; 37 (10): 661–667. DOI: 10.1016/j.eimc.2018.12.004
13. Mattson S.K., Polk J.P., Nyirjesy P. Chronic Cervicitis: Presenting Features and Response to Therapy. J. Low. Genit. Tract. Dis. 2016; 20 (3): e30–3. DOI: 10.1097/LGT.0000000000000225
14. Unanyan A.L., Sidorova I.S., Arakelov S.E. et al. Chronic cervicitis and chronic endometritis: general aspects of pathogenesis and pathogenetic therapy. Medical advice. 2013; 4–2: 88–95. (In Russ.).
15. Moore A. et al. Recommendation on screening for chlamydia and gonorrhea in primary care for individuals not known to be at high risk. Cmaj. 2021; 193(16): E549–E559.
16. Pathology of the vagina and cervix / edited by V.I. Krasnopolsky. M.: Medicine, 1997. 272 p (In Russ.).
17. Stanley M., Pett M., Coleman N. HPV: from infection to cancer: 2007; 35 (Pt.6): 1456–1460. DOI: 10.1042/BST0351456
18. Sales K.J., Katz A.A. Inflammatory pathways in cervical cancer-the University of Cape Town’s contribution. SAMJ: South African Medical Journal. 2012;102: 493–496. DOI: 10.7196/samj.5532
19. Benign diseases of the cervix. In the book: Cervix, vagina, vulva. Physiology, pathology, colposcopy, aesthetic correction. Guide for practicing doctors / ed. S.I. Rogovskoy, E.V. Lipova. M.: Status Present, 2016. 829 p. (In Russ.).
20. Taylor SN. Cervicitis of unknown etiology. Curr. Infect. Dis. Rep. 2014; 16 (7):409. DOI: 10.1007/s11908–014–0409-x
21. Workowski K.A., Bolan G.A. Sexually transmitted diseases treatment guidelines, 2015. MMWR. Recommendations and reports: Morbidity and mortality weekly report. Recommendations and reports. 2015; 64(RR‑03): 1.
22. Lusk MJ, Garden FL, Rawlinson WD. et al. Cervicitis aetiology and case definition: a study in Australian women attending sexually transmitted infection clinics. Sex. Transm. Infect. 2016; 92 (3): 175–181. DOI: 10.1136/sextrans‑2015–052332
23. Ma J., Kan Y., Zhang A. et al. Female Sexual Dysfunction in Women with Non-Malignant Cervical Diseases: A Study from an Urban Chinese Sample. PLoS One. 2015; 10 (10): e0141004. DOI: 10.1371/journal.pone.0141004
24. Cekmez Y., Sanlikan F., Göcmen A. Is cryotherapy friend or foe for symptomatic cervical ectopy? Med. Princ. Pract. 2016; 25: 8–11. DOI: 10.1159/00044143
25. Bokach O.M. Risk factors and features of the development of squamous intraepithelial lesions of the cervix in women with chronic cervicitis. Dissertation Ph.D. SPb, 2022. 204 p. (In Russ.). https://disser.spbu.ru/files/2022/disser_bokach.pdf
26. Colposcopy. A comprehensive textbook (In Russ.).
27. Long T, Long L, Chen Y, Li Y, Tuo Y, Hu Y, Xie L, He G, Zhao W, Lu X, Lin Z. Severe cervical inflammation and high-grade squamous intraepithelial lesions: a cross-sectional study. Arch Gynecol Obstet. 2021 Feb; 303 (2): 547–556. DOI: 10.1007/s00404–020–05804-y. Epub 2020 Sep 26. PMID: 32980959.
28. Colposcopy to Diagnose Cervical Disease: Getting the Most Information to Practitioners About the Procedure. Bebneva T.N., Rogovskaya S.I., Podzolkova N.M. Doctor.ru. Special issue. 2014; 1 (5): 42–45. (In Russ.).
29. Castle P.E., Hillier S.L., Rabe L.K. et al. An association of cervical inflammation with high-grade cervical neoplasia in women infected with oncogenic human papillomavirus (HPV). Cancer Epidemiol Biomarkers Prev. 2001; 10 (10): 1021–1027. PMID: 11588127
30. Mirzaie-Kashani E, Bouzari M, Talebi A, Arbabzadeh-Zavareh F. Detection of Human Papillomavirus in Chronic Cervicitis, Cervical Adenocarcinoma, Intraepithelial Neoplasia and Squamous Cell Carcinoma// Jundishapur J. Microbiol. 2014; 7: 1–5. DOI: 10.5812/jjm.9930
31. Savicheva A.M., Shipitsyna E.V., Vorobyeva N. E. Vaginal infectious diseases and current approaches to their diagnosis and treatment. Akusherstvo i Ginekologiya. Obstetrics and Gynecology. 2016; 2: 120–126. (In Russ.).
32. Prilepskaya V.N., Abakarova P.R., Donnikov A.E. Vulvovaginitis of mixed etiology and real clinical practice. Gynecology. 2020; 22 (4): 82–87. (In Russ.). DOI: 10.26442/20795696.2020.4.200307
33. Borovikov I. O., Kutsenko I. I., Rubinina E. R. Experience of clinical management of mixed urogenital tract infections in women. Russian journal of Woman and Child Health. 2018; 1 (1): 26–32. (In Russ.).
34. State Register of Medicines of the Russian Federation (GRLS). Instructions for the medical use of the drug «Elgina» (in Russ.). https://grls.rosminzdrav.ru/Grls_View_v2.aspx?routingGuid=b800ff8c_6577_45cd_9e68_e466c2d2e209
35. Shatunova E.P., Dakhnyuk S.E. New opportunities in the treatment of vaginitis in patients with chronic salpingoophoritis. Obstetrics and Gynecology. 2017; 11: 129–133. (In Russ.). https://dx.doi.org/10.18565/aig.2017.11.129–133
36. The place of combination drugs in the treatment of vaginal infections. Effective pharmacotherapy. 2018; 37: 28–34. (In Russ.).
37. Dobrokhotova Yu.E., Borovkova E.I., Zaidieva Z.S., Romanovskaya V.V., Nugumanova O.R. Assessing the feasibility of preoperative preventive vaginal cleansing to prevent contamination of the uterine cavity with vaginal microflora. Akusherstvo i Ginekologiya. Obstetrics and Gynecology. 2022; 8: 132–134. (In Russ.) https://dx.doi.org/10.18565/aig.2022.8
38. Ministry of Health of the Russian Federation. Clinical Guidelines «Chlamydia infection». 2021. (In Russ.). https://cr.minzdrav.gov.ru/recomend/194_1
39. Ministry of Health of the Russian Federation. Clinical Guidelines «Urogenital diseases caused by Mycoplasma genitalium», 2021. (In Russ.). https://cr.minzdrav.gov.ru/recomend/216_1
40. Ministry of Health of the Russian Federation. Clinical Guidelines «Gonococcal infection», 2021. (In Russ.). https://cr.minzdrav.gov.ru/recomend/218_1
41. World Health Organization et al. WHO guidelines for the treatment of Neisseria gonorrhoeae.– World Health Organization, 2016.
42. Sahu B., Latheef R., Aboel Magd S. Prevalence of pathology in women attending colposcopy for postcoital bleeding with negative cytology// Arch Gynecol Obstet. 2007; 276: 471–473, DOI: 10.1007/s00404–007–0362–0
43. Shargorodskaya A.V., Bebneva T.N. Cervicitis associated with papillomavirus infection: prediction and management strategychoice. Russian Journal of Woman and Child Health. 2019; 2 (2): 143–147. (In Russ.).
44. Dhakal R, Makaju R, Sharma S, et al. Correlation of Cervical Pap Smear with Biopsy in the Lesion of Cervix. Kathmandu Univ. Med. J. (KUMJ).2016; 14 (55): 254–257.
45. Ministry of Health of the Russian Federation. Clinical Guidelines «Cervical intraepithelial neoplasia», 2020. (In Russ.). https://cr.minzdrav.gov.ru/recomend/597_1
46. Dhakal R. et al. Correlation of cervical pap smear with biopsy in the lesion of cervix. Kathmandu Univ. Med. J. 2016; 14 (55): 254–7, PMID: 28814689
47. Hakverdi A.U., Gül T., Taner C.E, et al. Treatment of chronic cervicitis: the loop electrosurgical excision procedure. Zentralbl. Gynakol. 1997; 119 (1): 16–20. PMID: 9050198
48. Aminodova I.P. et. al. Therapeutic efficiency due to local exposures to cavitated (insonified) Panavir solution in patients with HPV-associated cervicitis. Russian Bulletin of Obstetrician-Gynecologist. 2016; 16 (6).
49. Sobel J.D., Reichman O., Misra D. Prognosis and treatment of desquamative inflammatory vaginitis. Obstet. Gynecol. 2011; 117: 850–855. DOI: 10.1097/AOG.0b013e3182117c9e
50. Nyirjesy P. Nongonococcal and nonchlamydial cervicitis //Current Infectious Disease Reports. 2001; 3 (6): 540–545.
51. Taylor S.N., Lensing S., Schwebke J. et al. Prevalence and treatment outcome of cervicitis of unknown etiology. Sex Transm. Dis. 2013; 40 (5): 379–385.
Review
For citations:
Ledina A.V., Rogovskaya S.I., Shabalova I.P., Bayandina N.N. Chronic cervicitis: a gynecologist and cytologist’s view of the problem. Medical alphabet. 2024;(8):16-21. (In Russ.) https://doi.org/10.33667/2078-5631-2024-8-16-21
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