medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2018-13-10-15medsovet-2595Research ArticleАктуальная проблемаActual problemАногенитальные кондиломы, ассоциированные с ВПЧ: клинико-морфологические аспекты и принципы терапииHPV-associated anogenital condylomas: clinical-morphological aspects and therapy principlesНазароваН. М.NazarovaN. M.

д.м.н., ведущий научный сотрудник

Moscow

НекрасоваМ. Е.NekrasovaM. E.

аспирант

Moscow

ПрилепскаяВ. Н.PrilepskayaV. N.

д.м.н., профессор, заместитель директора

Moscow

ГусаковК. И.GusakovK. I.

аспирант

Moscow

ТрофимовД. Ю.TrofimovD. Yu.

д.биол.н., заведующий лабораторией молекулярно-генетических методов

Moscow

ФГБУ «Национальный медицинский исследовательский центр акушерства, гинекологии и перинатологии имени академика В.И. Кулакова» Министерства здравоохранения РФРоссияV.I. Kulakov National Medical Research Centre for Obstetrics, Gynaecology and Perinatology of the Ministry of Health of RussiaRussian Federation2018210920180131015Copyright © Назарова Н.М., Некрасова М.Е., Прилепская В.Н., Гусаков К.И., Трофимов Д.Ю., 20182018Назарова Н.М., Некрасова М.Е., Прилепская В.Н., Гусаков К.И., Трофимов Д.Ю.Nazarova N.M., Nekrasova M.E., Prilepskaya V.N., Gusakov K.I., Trofimov D.Y.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/2595

ВПЧ обладает тропностью к эпителиальным тканям вне зависимости от их локализации и проникает в ткани через микроскопические трещины. Клинические проявления заболеваний, ассоциированных с ВПЧ, многообразны и одинаково актуальны для женщин и мужчин. Несмотря на то что экзофитные кондиломы расценивают как доброкачественное заболевание и их диагностика не вызывает трудностей, у клинициста всегда должна присутствовать онкологическая настороженность, особенно в отношении диффузного, длительно протекающего кондиломатоза.

HPV infects epithelial tissues regardless of their location and penetrates into the cell through microscopic cuts. The clinical manifestations of HPV-associated diseases are diverse and equally relevant for women and men. Despite the fact that exophytic condylomas are regarded as a benign disease and establishing diagnosis does not cause difficulties, a clinician should always have oncological alertness, especially with regard to diffuse, long-lasting condylomatosis.

вирус папилломы человекааногенитальные бородавкиэкзофитные кондиломыhuman papillomavirusanogenital wartsexophytic condylomasReferencesDoorbar J, Quint W, Banks L, Bravo IG, Stoler M, Broker TR et al. The biology and life-cycle of human papillomaviruses. Vaccine, 2012 Nov 20, 30(Suppl 5): F55-70. doi: 10.1016/j.vaccine.2012.06.083.Doorbar J, Quint W, Banks L, Bravo IG, Stoler M, Broker TR et al. The biology and life-cycle of human papillomaviruses. Vaccine, 2012 Nov 20, 30(Suppl 5): F55-70. doi: 10.1016/j.vaccine.2012.06.083.Serour Y, Bendahmane M, Abbou Baker F, Medles M, Moueddene B, Kraiba R. HPV test by Hybrid Capture II for the diagnosis of HR-HPV persistent infection. Med Mal Infect, 2017, 47(7): 484- 489.Serour Y, Bendahmane M, Abbou Baker F, Medles M, Moueddene B, Kraiba R. HPV test by Hybrid Capture II for the diagnosis of HR-HPV persistent infection. Med Mal Infect, 2017, 47(7): 484- 489.Luo ZY, Chen Q, Yang H, Lin M, Chen CY, Yang C et al. The Prevalence and Genotype of Human Papillomavirus from patients with Genital Warts in Eastern Guangdong Province. Asian Pac J Cancer Prev, 2015, 16(14): 5675-5679.Luo ZY, Chen Q, Yang H, Lin M, Chen CY, Yang C et al. The Prevalence and Genotype of Human Papillomavirus from patients with Genital Warts in Eastern Guangdong Province. Asian Pac J Cancer Prev, 2015, 16(14): 5675-5679.Krueger H et al. HPV and Other Infectious Agents in Cancer. Oxford University Press. 2010, p. 540. 5. Javier RT. Cell polarity proteins: common targets for tumorigenic human viruses. Oncogene, 2008 Nov 24, 27(55): 7031-7046.Krueger H et al. HPV and Other Infectious Agents in Cancer. Oxford University Press. 2010, p. 540.Kranjec C, Banks L. A systematic analysis of human papillomavirus (HPV) E6 PDZ substrates identifies MAGI-1 as a major target of HPV type 16 (HPV-16) and HPV-18 whose loss accompanies disruption of tight junctions. J Virol, 2011 Feb, 85(4): 1757-1764.Javier RT. Cell polarity proteins: common targets for tumorigenic human viruses. Oncogene, 2008 Nov 24, 27(55): 7031-7046.Massimi P, Narayan N, Thomas M, Gammoh N, Strand S, Strand D et al. Regulation of the hDlg/hScrib/Hugl-1 tumour suppressor complex. Exp Cell Res, 2008 Nov 1, 314(18): 3306- 3317.Kranjec C, Banks L. A systematic analysis of human papillomavirus (HPV) E6 PDZ substrates identifies MAGI-1 as a major target of HPV type 16 (HPV-16) and HPV-18 whose loss accompanies disruption of tight junctions. J Virol, 2011 Feb, 85(4): 1757-1764.Pim D, Bergant M, Boon SS, Ganti K, Kranjec C, Massimi P et al. Human papillomaviruses and the specificity of PDZ domain targeting. FEBS J, 2012 Oct, 279(19): 3530-3537.Massimi P, Narayan N, Thomas M, Gammoh N, Strand S, Strand D et al. Regulation of the hDlg/hScrib/Hugl-1 tumour suppressor complex. Exp Cell Res, 2008 Nov 1, 314(18): 3306- 3317.Thomas M, Dasgupta J, Zhang Y, Chen X, Banks L. Analysis of specificity determinants in the interactions of different HPV E6 proteins with their PDZ domain-containing substrates. Virology, 2008 Jul 5, 376 (2): 371-378.Pim D, Bergant M, Boon SS, Ganti K, Kranjec C, Massimi P et al. Human papillomaviruses and the specificity of PDZ domain targeting. FEBS J, 2012 Oct, 279(19): 3530-3537.Fu L, Van Doorslaer K, Chen Z, Ristriani T, Masson M, Travé G et al. Degradation of p53 by human Alphapapillomavirus E6 proteins shows a stronger correlation with phylogeny than oncogenicity. PLoS One, 2010 Sep 17, 5(9).Thomas M, Dasgupta J, Zhang Y, Chen X, Banks L. Analysis of specificity determinants in the interactions of different HPV E6 proteins with their PDZ domain-containing substrates. Virology, 2008 Jul 5, 376 (2): 371-378.Zanier K, ould M’hamed ould Sidi A, BouladeLadame C, Rybin V, Chappelle A, Atkinson A et al. Solution structure analysis of the HPV16 E6 oncoprotein reveals a self-association mechanism required for E6-mediated degradation of p53. Structure, 2012 Apr 4, 20(4): 604-617.Fu L, Van Doorslaer K, Chen Z, Ristriani T, Masson M, Travé G et al. Degradation of p53 by human Alphapapillomavirus E6 proteins shows a stronger correlation with phylogeny than oncogenicity. PLoS One, 2010 Sep 17, 5(9).Pim D, Banks L. Interaction of viral oncoproteins with cellular target molecules: infection with high-risk vs low-risk human papillomaviruses. APMIS, 2010 Jun, 118(6-7): 471-493.Zanier K, ould M’hamed ould Sidi A, BouladeLadame C, Rybin V, Chappelle A, Atkinson A et al. Solution structure analysis of the HPV16 E6 oncoprotein reveals a self-association mechanism required for E6-mediated degradation of p53. Structure, 2012 Apr 4, 20(4): 604-617.PaVE: Papillomavirus Episteme (accessed on 11 July 2015). http://pave.niaid.nih.Pim D, Banks L. Interaction of viral oncoproteins with cellular target molecules: infection with high-risk vs low-risk human papillomaviruses. APMIS, 2010 Jun, 118(6-7): 471-493.Zheng ZM, Baker CC. Papillomavirus genome structure, expression, and post-transcriptional regulation. Front Biosci, 2006 Sep 1, 11: 2286- 2302.PaVE: Papillomavirus Episteme (accessed on 11 July 2015). http: //pave.niaid.nih.Сабдулаева Э.Х., Трофимов Д.Ю., Коган Е.А. и др. Новые технологии в диагностике папилломавирусной инфекции. Мать и Дитя в Кузбассе. Спецвыпуск, 2011, 1: 28-30.Zheng ZM, Baker CC. Papillomavirus genome structure, expression, and post-transcriptional regulation. Front Biosci, 2006 Sep 1, 11: 2286- 2302.Fleider LA, Tatti SA, Suzuki AV, Maldonado VA, Díaz LB, Chiesa IJ et al. Human Papillomavirus Types Involved in External Genital Warts in a Group of Argentinian Women in Buenos Aires. Journal of Lower Genital Tract Disease, 2016, 20(4): 365-366.Sabdulaeva EKh, Trofimov DYu, Kogan EA. New technologies in the diagnosis of papillomavirus infection. Mat i Ditja v Kuzbasse. Specvypusk, 2011, 1: 28-30.Wiley DJ, Douglas J, Beutner K, Cox T, Fife K, Moscicki AB et al. External genital warts: diagnosis, treatment, and prevention. Clin Infect Dis, 2002 Oct 15, 35(Suppl 2): 210-224.Fleider LA, Tatti SA, Suzuki AV, Maldonado VA, Díaz LB, Chiesa IJ et al. Human Papillomavirus Types Involved in External Genital Warts in a Group of Argentinian Women in Buenos Aires. Journal of Lower Genital Tract Disease, 2016, 20(4): 365-366.Jansen KU, Shaw AR. Human papillomavirus vaccines and prevention of cervical cancer. Annu Rev Med, 2004, 55: 319-331.Wiley DJ, Douglas J, Beutner K, Cox T, Fife K, Moscicki AB et al. External genital warts: diagnosis, treatment, and prevention. Clin Infect Dis, 2002 Oct 15, 35(Suppl 2): 210-224.Trottier H, Franco EL. The epidemiology of genital human papillomavirus infection. Vaccine, 2006, 24(suppl 1): 1-15.Jansen KU, Shaw AR. Human papillomavirus vaccines and prevention of cervical cancer. Annu Rev Med, 2004, 55: 319-331.Lacey CJN, Woodhall SC, Wikstrom A, Ross J. European guideline for the management of anogenital warts. J Eur Acad Dermatol Venereol, 2013, 27(3): e263-270.Trottier H, Franco EL. The epidemiology of genital human papillomavirus infection. Vaccine, 2006, 24(suppl 1): 1-15.Wang H, Qiao YL. Human papillomavirus typedistribution in condylomata acuminata of mainland China: a meta-analysis. Int J STD AIDS, 2008, 19(10): 680-684.Lacey CJN, Woodhall SC, Wikstrom A, Ross J. European guideline for the management of anogenital warts. J Eur Acad Dermatol Venereol, 2013, 27(3): e263-270.Назарова Н.М., Бурменская О.В., Суламанидзе Л.А., Прилепская В.Н., Павлович С.В., Трофимов Д.Ю. Распространенность типов вируса папилломы человека аногенитальной области у пациенток с ВПЧ-ассоциированными заболеваниями шейки матки. Акушерство и гинекология, 2015, 12.Wang H, Qiao YL. Human papillomavirus typedistribution in condylomata acuminata of mainland China: a meta-analysis. Int J STD AIDS, 2008, 19(10): 680-684.www.issvd.org.Nazarova NM, Burmenskaya OV, Sulamanidze LA, Prilepskaya VN, Pavlovich SV, Trofimov DYu. The prevalence of anogenital types of human papillomavirus in patients with HPV-associated cervical disease. Akusherstvo i Ginekologija, 2015, 12.www.ragin-std.ru.www.issvd.org.Araújo PSR, Padilha CEG, Soares MF. BuschkeLowenstein tumor in a woman living with HIV/ AIDS. Rev Soc Bras Med Trop,. 2017, 50(4): 577.www.ragin-std.ru.Campaner AB, Cardoso FA, Fernandes GL, Veasey JV. Verrucous carcinoma of the vulva: diagnosis and treatment. An Bras Dermatol, 2017, 92(2): 243-245.Araújo PSR, Padilha CEG, Soares MF. BuschkeLowenstein tumor in a woman living with HIV/ AIDS. Rev Soc Bras Med Trop,. 2017, 50(4): 577.Erman-Vlahovic M, Vlahovic J, Mrcela M, Hrgovic Z. Coexistence of Condylomata Acuminata with Warty Squamous Cell Carcinoma and Squamous Cell Carcinoma. Med Arch, 2017, 71(1): 72-75.Campaner AB, Cardoso FA, Fernandes GL, Veasey JV. Verrucous carcinoma of the vulva: diagnosis and treatment. An Bras Dermatol, 2017, 92(2): 243-245.Koukoura O, Klados G, Strataki M, Daponte A. A rapidly growing vulvar condyloma acuminatum in a young patient. BMJ Case Rep, 2015 Jun 24.Erman-Vlahovic M, Vlahovic J, Mrcela M, Hrgovic Z. Coexistence of Condylomata Acuminata with Warty Squamous Cell Carcinoma and Squamous Cell Carcinoma. Med Arch, 2017, 71(1): 72-75.Masuda M, Abiko K, Minamiguchi S, Murakami R, Baba T and Konishi I. Case of rapidly progressing condylomatous squamous cell carcinoma of the uterine cervix associated with low-risk human papillomavirus type 6. J. Obstet. Gynaecol. Res., 2017. doi: 10.1111/jog.13553.Koukoura O, Klados G, Strataki M, Daponte A. A rapidly growing vulvar condyloma acuminatum in a young patient. BMJ Case Rep, 2015 Jun 24.Федеральные клинические рекомендации по ведению больных аногенитальными (венерическими) бородавками. Под ред. Перламутрова Ю.Н., Рахматулиной М.Р., Соколовского Е.В., Черновой Н.И. М., 2013.Masuda M, Abiko K, Minamiguchi S, Murakami R, Baba T and Konishi I. Case of rapidly progressing condylomatous squamous cell carcinoma of the uterine cervix associated with low-risk human papillomavirus type 6. J. Obstet. Gynaecol. Res., 2017. doi: 10.1111/jog.13553.Приказ Министерства здравоохранения РФ от 1 ноября 2012 г. №572н «Об утверждении Порядка оказания медицинской помощи по профилю «акушерство и гинекология (за исключением использования вспомогательных репродуктивных технологий)»Federal clinical guidelines for managing patients with anogenital (venereal) warts. Ed. Perlamutrova YuN, Rakhmatulina MR, Sokolovsky EV, Chernova NI. M., 2013.Bertolotti A, Dupin N, Bouscarat F, Milpied B, Derancourt C. Cryotherapy to treat anogenital warts in nonimmunocompromised adults: Systematic review and meta-analysis. J Am Acad Dermatol, 2017, 77(3): 518-526.Order of the Ministry of Health of the Russian Federation No. 572n «On the Approval of the Procedure for Rendering Medical Assistance in Obstetrics and Gynecology (excluding the assisted reproductive technologies)» of November 1, 2012Grillo-Ardila CF, Angel-Müller E, Salazar-Díaz LC, Gaitán HG, Ruiz-Parra AI, Lethaby A. Imiquimod for anogenital warts in non-immunocompromised adults. Cochrane Database Syst Rev, 2014, 11: CD010389.Bertolotti A, Dupin N, Bouscarat F, Milpied B, Derancourt C. Cryotherapy to treat anogenital warts in nonimmunocompromised adults: Systematic review and meta-analysis. J Am Acad Dermatol, 2017, 77(3): 518-526.Sharma N, Sharma S, Singhal C. A Comparative Study of Liquid Nitrogen Cryotherapy as Monotherapy versus in Combination with Podophyllin in the Treatment of Condyloma Acuminata. J Clin Diagn Res, 2017, 11(3): WC01-WC05.Grillo-Ardila CF, Angel-Müller E, Salazar-Díaz LC, Gaitán HG, Ruiz-Parra AI, Lethaby A. Imiquimod for anogenital warts in non-immunocompromised adults. Cochrane Database Syst Rev, 2014, 11: CD010389.Yang LJ, Zhu DN, Dang YL, Zhao X. Treatment of condyloma acuminata in pregnant women with cryotherapy combined with proanthocyanidins: Outcome and safety. Exp Ther Med, 2016, 11(6): 2391-2394.Sharma N, Sharma S, Singhal C. A Comparative Study of Liquid Nitrogen Cryotherapy as Monotherapy versus in Combination with Podophyllin in the Treatment of Condyloma Acuminata. J Clin Diagn Res, 2017, 11(3): WC01-WC05.Malgouyat J. A new approach to the treatment of genital condyloma in women. Gynaecol, 1983, 34: 415-7.Yang LJ, Zhu DN, Dang YL, Zhao X. Treatment of condyloma acuminata in pregnant women with cryotherapy combined with proanthocyanidins: Outcome and safety. Exp Ther Med, 2016, 11(6): 2391-2394.Шварц Г.Я., Прилепская В.Н., Мынбаев О.А. Изопринозин в лечении папилломавирусной инфекции в гинекологической практике. М., 2011. 83 с.Malgouyat J. A new approach to the treatment of genital condyloma in women. Gynaecol, 1983, 34: 415-7.Изопринозин (Isoprinosine). Инструкция по применению.Shvarts GYa, Prilepskaya VN, Mynbayev OA. Isoprinosine for the treatment of papillomavirus infection in gynecological practice. M., 2011. 83 p.Изопринозин (Isoprinosine). Инструкция по применению./ Isoprinosine. Instructions for use.Изопринозин (Isoprinosine). Инструкция по применению./ Isoprinosine. Instructions for use.

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