urmjУральский медицинский журналUral Medical Journal2949-4389Ural State Medical University10.52420/umj.23.2.33IAFZPTurmj-1494Research ArticleОригинальные статьи | Original articlesOriginal articlesПредикторы предраковых заболеваний шейки маткиPredictors of Precancerous Diseases of the Cervixhttps://orcid.org/0000-0003-1303-3955РосюкЕ. А.RosyukE. A.

Елена Александровна Росюк — кандидат медицинских наук, доцент кафедры акушерства и гинекологии с курсом медицинской генетики

Екатеринбург

Elena A. Rosyuk — Candidate of Sciences (Medicine), Associate Professor of the Department of Obstetrics and Gynecology with Medical Genetics Course

Ekaterinburg

elenakdc@yandex.ruhttps://orcid.org/0000-0003-0711-7896ОбоскаловаТ. А.OboskalovaT. A.

Татьяна Анатольевна Обоскалова — доктор медицинских наук, профессор, заведующий кафедрой акушерства и гинекологии с курсом медицинской генетики

Екатеринбург

Tatiana A. Oboskalova — Doctor of Sciences (Medicine), Professor, Head of the Department of Obstetrics and Gynecology with Medical Genetics Course

Ekaterinburg

oboskalova.tat@yandex.ruАскероваМ. Г.AskerovaM. G.

Марина Геннадьевна Аскерова — кандидат медицинских наук, доцент кафедры акушерства и гинекологии с курсом медицинской генетики

Екатеринбург

Marina G. Askerova — Candidate of Sciences (Medicine), Associate Professor of the Department of Obstetrics and Gynecology with Medical Genetics Course

Ekaterinburg

mg.askerova@gmail.comБакуринскихА. Б.BakurinskikhA. B.

Алексей Борисович Бакуринских — кандидат медицинских наук, доцент кафедры акушерства и гинекологии с курсом медицинской генетики

Екатеринбург

Alexey B. Bakurinskikh — Candidate of Sciences (Medicine), Associate Professor of the Department of Obstetrics and Gynecology with Medical Genetics Course

Ekaterinburg

a.bakurinskikh-farma@yandex.ruЯкушевА. М.YakushevA. M.

Александр Михайлович Якушев — кандидат медицинских наук, доцент кафедры акушерства и гинекологии с курсом медицинской генетики

Екатеринбург

Alexander M. Yakushev — Candidate of Sciences (Medicine), Associate Professor of the Department of Obstetrics and Gynecology with Medical Genetics Course

Ekaterinburg

ayakushev55@mail.ruКиселёваМ. К.KiselevaM. K.

Марина Кесаревна Киселёва — кандидат медицинских наук, доцент кафедры акушерства и гинекологии с курсом медицинской генетики

Екатеринбург

Marina K. Kiseleva — Candidate of Sciences (Medicine), Associate Professor of the Department of Obstetrics and Gynecology with Medical Genetics Course

Ekaterinburg

kmk61@yandex.ruhttps://orcid.org/0000-0002-0828-0479СевостьяноваО. Ю.SevostyanovaO. Yu.

Ольга Юрьевна Севостьянова — доктор медицинских наук, профессор кафедры акушерства и гинекологии с курсом медицинской генетики

Екатеринбург

Olga Yu. Sevostyanova — Doctor of Sciences (Medicine), Professor of the Department of Obstetrics and Gynecology with Medical Genetics Course

Ekaterinburg

olsyava@gmail.comКоноваловВ. И.KonovalovV. I.

Вячеслав Иосифович Коновалов — доктор медицинских наук, независимый исследователь

Екатеринбург

Vyacheslav I. Konovalov — Doctor of Sciences (Medicine), Independent Researcher

Ekaterinburg

konovalov-vi@mail.ruУральский государственный медицинский университетРоссияUral State Medical UniversityRussian Federation2024080520242323340Copyright © Росюк Е.А., Обоскалова Т.А., Аскерова М.Г., Бакуринских А.Б., Якушев А.М., Киселёва М.К., Севостьянова О.Ю., Коновалов В.И., 20242024Росюк Е.А., Обоскалова Т.А., Аскерова М.Г., Бакуринских А.Б., Якушев А.М., Киселёва М.К., Севостьянова О.Ю., Коновалов В.И.Rosyuk E.A., Oboskalova T.A., Askerova M.G., Bakurinskikh A.B., Yakushev A.M., Kiseleva M.K., Sevostyanova O.Y., Konovalov V.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.umjusmu.ru/jour/article/view/1494Введение

Введение. Заболеваемость населения злокачественными новообразованиями выросла за последние 15 лет в 1,66 раза, а заболеваемость раком шейки и тела матки, плаценты — в 1,3 раза.

Цель работы — выявить предикторы предраковых заболеваний шейки матки.

Материалы и методы

Материалы и методы. Проведен ретроспективный анализ историй болезни пациенток, которые наблюдались в кабинете патологии шейки матки Екатеринбургского клинического перинатального центра (ЕКПЦ). Методом сплошной выборки сформированы 2группы: 30женщин сдиагнозом цервикальная интраэпителиальная неоплазия (англ. CervicalIntraepithelial Neoplasia, CIN) и30женщин без диагноза CIN, которые составили контрольную группу.

Результаты

Результаты. К факторам риска предраковых заболеваний шейки матки можно отнести наличие сердечно-сосудистых заболеваний в анамнезе (р = 0,043), оперативные вмешательства (р = 0,039), инфекции, передающиеся половым путем (ИППП) (р = 0,023), большое число беременностей (вне зависимости от исхода) (р = 0,013), наличие абортов (р = 0,04), большое число половых партнеров в течение жизни (р = 0,022).

Обсуждение

Обсуждение. Частая смена половых партнеров, и, как следствие, высокий риск присоединения ИППП также относятся к общеизвестным факторам риска рака и предрака шейки матки, в этих условиях вирус папилломы человека (ВПЧ) быстрее переходит из свободной в эписомальную форму и запускает процесс трансформации клеток эпителия шейки матки.

Заключение

Заключение. Особенностями анамнеза женщин с предраковыми заболеваниями шейки матки являются высокий паритет и наличие абортов, ИППП, носительство ВПЧ высокоонкогенного типа, сердечно-сосудистые заболевания и оперативные вмешательства в анамнезе, большое число половых партнеров в жизни, низкая приверженность к использованию комбинированных оральных контрацептивов (КОК).

Introduction

Introduction. The incidence of malignant neoplasms in the population has increased by 1.66 times over the past 15 years, and the incidence of cancer of the cervix and body of the uterus, placenta — by 1.3 times.

Materials and methods

Materials and methods. 2 groups were formed by the continuous sampling method: 30 women with a diagnosis of cervical intraepithelial neoplasia (CIN) and 30 women without a diagnosis of CIN, who made up the control group. Statistical analysis was carried out using the StatTech 3.1.7 program (Stattech LLC, Russia).

Results

Results. Risk factors for precancerous diseases of the cervix include the presence of a history of cardiovascular diseases

(p = 0

(p = 0.043), surgical interventions (p = 0.039), sexually transmitted infections (p = 0.023), a large number of pregnancies (regardless of the outcome) (p = 0.013), the presence of abortions (p = 0.04), a large number of sexual partners during life (p = 0.022).

Discussion

Discussion. Frequent change of sexual partners, and as a consequence — a high risk of STIs are also well-known risk factors for cancer and precancerous cervix, in these conditions HPV passes from free to episomal form faster and starts the process of transformation of cervical epithelial cells.

Conclusion

Conclusion. The features of the anamnesis of women with precancerous diseases of the cervix are high parity and the presence of abortions, STIs, cardiovascular diseases and surgical interventions in the anamnesis, a large number of sexual partners in life, low adherence to the use of combined oral contraceptives (COCs).

факторы рискацервикальная интраэпителиальная неоплазиядисплазия шейки маткивирус папилломы человекаrisk factorscervical intraepithelial neoplasiacervical dysplasiahuman papillomavirusReferencesKononova IN, Kareva EN, Dobrokhotova YuE. Antiviral drug alloferon in the treatment of patients with cervical intraepithelial neoplasia: A review analysis of studies. Women’s Health and Reproduction. 2023; (2):19–31. (In Russ.). EDN: https://elibrary.ru/gidhad.Kononova IN, Kareva EN, Dobrokhotova YuE. Antiviral drug alloferon in the treatment of patients with cervical intraepithelial neoplasia: A review analysis of studies. Women’s Health and Reproduction. 2023; (2):19–31. (In Russ.). EDN: https://elibrary.ru/gidhad.Bril YuA, Raevskaya OA. “Higgs bosons” of cervical neoplasia. StatusPraesens. Gynecology, Obstetrics, Infertile Marriage. 2019;(3):74–81. (In Russ.). EDN: https://elibrary.ru/ixnqoi.Bril YuA, Raevskaya OA. “Higgs bosons” of cervical neoplasia. StatusPraesens. Gynecology, Obstetrics, Infertile Marriage. 2019;(3):74–81. (In Russ.). EDN: https://elibrary.ru/ixnqoi.Kalandarova AN. Modern understanding of cervical intraepithelial neoplasia. A New Day in Medicine. 2019;(2):178–182. (In Russ.). EDN: https://elibrary.ru/pungkf.Kalandarova AN. Modern understanding of cervical intraepithelial neoplasia. A New Day in Medicine. 2019;(2):178–182. (In Russ.). EDN: https://elibrary.ru/pungkf.Hajieva KA, Alieva KA. Human papillomavirus as the main risk factor for cervical cancer (Literature review). Spirit Time. 2019;(1):6–9. (In Russ.). EDN: https://elibrary.ru/yzanfz.Hajieva KA, Alieva KA. Human papillomavirus as the main risk factor for cervical cancer (Literature review). Spirit Time. 2019;(1):6–9. (In Russ.). EDN: https://elibrary.ru/yzanfz.Bukharova DA, Dmitrishina EM. Risk factors for cervical cancer and clinical and morphological assessment of precancerous conditions. News of the Russian Military Medical Academy. 2019;38(S1-1):73–76. (In Russ.). EDN: https://elibrary.ru/rnubzs.Bukharova DA, Dmitrishina EM. Risk factors for cervical cancer and clinical and morphological assessment of precancerous conditions. News of the Russian Military Medical Academy. 2019;38(S1-1):73–76. (In Russ.). EDN: https://elibrary.ru/rnubzs.Zvychanyy MA, Kiseleva MK, Bakurinskikh AB, Askerova M, Volkova L. Determination of risk factors for aggressive course of squamous cell carcinoma of the cervix. Znanstvena Misel. 2019;37-1:35–37. (In Russ.). EDN: https://elibrary.ru/hflqoc.Zvychanyy MA, Kiseleva MK, Bakurinskikh AB, Askerova M, Volkova L. Determination of risk factors for aggressive course of squamous cell carcinoma of the cervix. Znanstvena Misel. 2019;37-1:35–37. (In Russ.). EDN: https://elibrary.ru/hflqoc.Blesmanovich AE, Petrov YuA, Alyokhina AG. Risk factors and preventive diagnosis of cervical cancer. Journal of Scientific Articles Health and Education in the XXI Century. 2019;21(1):25–30. (In Russ.). EDN: https://elibrary.ru/tobeku.Blesmanovich AE, Petrov YuA, Alyokhina AG. Risk factors and preventive diagnosis of cervical cancer. Journal of Scientific Articles Health and Education in the XXI Century. 2019;21(1):25–30. (In Russ.). EDN: https://elibrary.ru/tobeku.Belotserkovtseva LD, Mayer YuI, Kovalenko LV. Reproductive behavior of adolescents and experience in the prevention of HPV-associated diseases in the Khanty-Mansi Autonomous Okrug — Yugra. Questions of Gynecology, Obstetrics and Perinatology. 2018;17(1):92–100. (In Russ.). DOI: https://doi.org/10.20953/1726-1678-2018-1-92-100.Belotserkovtseva LD, Mayer YuI, Kovalenko LV. Reproductive behavior of adolescents and experience in the prevention of HPV-associated diseases in the Khanty-Mansi Autonomous Okrug — Yugra. Questions of Gynecology, Obstetrics and Perinatology. 2018;17(1):92–100. (In Russ.). DOI: https://doi.org/10.20953/1726-1678-2018-1-92-100.Struin NL, Struina NN, Ufimtseva MA, Andreev JJ, Gurkovskaya EP. Using foresight technology to limit the spread of sexually transmitted infections in the population. Ural Medical Journal. 2022;21(3):21–29. (In Russ.). DOI: https://doi.org/10.52420/2071-5943-2022-21-3-21-29.Struin NL, Struina NN, Ufimtseva MA, Andreev JJ, Gurkovskaya EP. Using foresight technology to limit the spread of sexually transmitted infections in the population. Ural Medical Journal. 2022;21(3):21–29. (In Russ.). DOI: https://doi.org/10.52420/2071-5943-2022-21-3-21-29.Garelik TM, Naumov IA. Identification of medical and social risk factors for cervical cancer and deterioration of reproductive health. Modern Problems of Hygiene, Radiation and Environmental Medicine. 2020;10:69–82. (In Russ.). EDN: https://elibrary.ru/uvgxui.Garelik TM, Naumov IA. Identification of medical and social risk factors for cervical cancer and deterioration of reproductive health. Modern Problems of Hygiene, Radiation and Environmental Medicine. 2020;10:69–82. (In Russ.). EDN: https://elibrary.ru/uvgxui.Radkevich LA, Nikolaeva IS, Radkevich DA. The role of environmental factors (latitude and longitude) in predicting the risk of breast cancer, cervical and uterine body cancer, ovarian cancer in women in different populations of the world. Norwegian Journal of Development of the International Science. 2018;8-2:5–13. (In Russ.). EDN: https://elibrary.ru/hsjwqg.Radkevich LA, Nikolaeva IS, Radkevich DA. The role of environmental factors (latitude and longitude) in predicting the risk of breast cancer, cervical and uterine body cancer, ovarian cancer in women in different populations of the world. Norwegian Journal of Development of the International Science. 2018;8-2:5–13. (In Russ.). EDN: https://elibrary.ru/hsjwqg.Naigovzina NB, Son M, Zimina EV. Approaches to assessing the number of managerial personnel in health-care. Modern Problems of Healthcare and Medical Statistics. 2022;4:537–558. (In Russ.). DOI: https://doi.org/10.24412/2312-2935-2022-4-537-558.Naigovzina NB, Son M, Zimina EV. Approaches to assessing the number of managerial personnel in health-care. Modern Problems of Healthcare and Medical Statistics. 2022;4:537–558. (In Russ.). DOI: https://doi.org/10.24412/2312-2935-2022-4-537-558.Cervical intraepithelial neoplasia, erosion and ectropion of the cervix [clinical recommendations]. 2020. 57p. (In Russ.). Available: https://clck.ru/39Wcie [Accessed 23 September 2023].Cervical intraepithelial neoplasia, erosion and ectropion of the cervix [clinical recommendations]. 2020. 57p. (In Russ.). Available: https://clck.ru/39Wcie [Accessed 23 September 2023].Sevostyanova OYu, Oboskalova TA, Chumarnaya TV, Rosyuk EA, Belomestnov SR, Sevostyanova NE. Epidemiological features of the incidence of cervical intraepithelial neoplasia in the modern megapolis. Tumors of Female Reproductive System. 2023;19(1):112–119. (In Russ.). DOI: https://doi.org/10.17650/1994-4098-2023-19-1-112–119.Sevostyanova OYu, Oboskalova TA, Chumarnaya TV, Rosyuk EA, Belomestnov SR, Sevostyanova NE. Epidemiological features of the incidence of cervical intraepithelial neoplasia in the modern megapolis. Tumors of Female Reproductive System. 2023;19(1):112–119. (In Russ.). DOI: https://doi.org/10.17650/1994-4098-2023-19-1-112–119.Rosyuk EA, Oboskalova TA, Korotovskikh LI, Glukhov EYu. Experience of interaction with an industrial partner: Results and prospects. Bulletin of USMU. 2023;(1):74–84. (In Russ.). EDN: https://elibrary.ru/zxovol.Rosyuk EA, Oboskalova TA, Korotovskikh LI, Glukhov EYu. Experience of interaction with an industrial partner: Results and prospects. Bulletin of USMU. 2023;(1):74–84. (In Russ.). EDN: https://elibrary.ru/zxovol.Bulanov NM, Suvorov AYu, Blyuss OB, Munblit DB, Butnaru DV, Nadinskaia MYu, et al. Basic principles of descriptive statistics in medical research. Sechenov Medical Journal. 2021;12(3):4–16. (In Russ.). DOI: https://doi.org/10.47093/2218-7332.2021.12.3.4-16.Bulanov NM, Suvorov AYu, Blyuss OB, Munblit DB, Butnaru DV, Nadinskaia MYu, et al. Basic principles of descriptive statistics in medical research. Sechenov Medical Journal. 2021;12(3):4–16. (In Russ.). DOI: https://doi.org/10.47093/2218-7332.2021.12.3.4-16.Kim JH, Kim J, Kim K, No JH, Kim YB, Suh DH. Risk factor and treatment of vaginal intraepithelial neoplasia aſter hysterectomy for cervical intraepithelial neoplasia. Journal of Lower Genital Tract Disease. 2022;26 (2):147–151. DOI: https://doi.org/10.1097/LGT.0000000000000664.Kim JH, Kim J, Kim K, No JH, Kim YB, Suh DH. Risk factor and treatment of vaginal intraepithelial neoplasia aſter hysterectomy for cervical intraepithelial neoplasia. Journal of Lower Genital Tract Disease. 2022;26 (2):147–151. DOI: https://doi.org/10.1097/LGT.0000000000000664.Paparazzi F, La Vecchia C, Negri E, Cecchetti G, Fedele L. Reproductive factors and the risk of invasive and intraepithelial cervical neoplasia. British Journal of Cancer. 1989;59:805–809. DOI: https://doi.org/10.1038/bjc.1989.168.Paparazzi F, La Vecchia C, Negri E, Cecchetti G, Fedele L. Reproductive factors and the risk of invasive and intraepithelial cervical neoplasia. British Journal of Cancer. 1989;59:805–809. DOI: https://doi.org/10.1038/bjc.1989.168.Mirghani H, Sturgis EM, Aupérin A, Monsonego J, Blanchard P. Is there an increased risk of cancer among spouses of patients with an HPV-related cancer: A systematic review. Oral Oncology. 2017;67:138–145. DOI: https://doi.org/10.1016/j.oraloncology.2017.02.024.Mirghani H, Sturgis EM, Aupérin A, Monsonego J, Blanchard P. Is there an increased risk of cancer among spouses of patients with an HPV-related cancer: A systematic review. Oral Oncology. 2017;67:138–145. DOI: https://doi.org/10.1016/j.oraloncology.2017.02.024.Su Y, Tang Y, Zhang T, Xu Y, Zhang Y, Shen Y, et al. Methylated ZNF582 as a triage marker for occult cervical cancer and advanced cervical intraepithelial neoplasia. Future Oncology. 2022;18(23):2583–2592. DOI: https://doi.org/10.2217/fon-2021-1625.Su Y, Tang Y, Zhang T, Xu Y, Zhang Y, Shen Y, et al. Methylated ZNF582 as a triage marker for occult cervical cancer and advanced cervical intraepithelial neoplasia. Future Oncology. 2022;18(23):2583–2592. DOI: https://doi.org/10.2217/fon-2021-1625.Reis Campos LM, Luz Dias Fd, Antunes LM, Murta EF. Prevalence of micronuclei in exfoliated uterine cervical cells from patients with risk factors for cervical cancer. Sao Paulo Medical Journal. 2008;126(6):323– 328. DOI: https://doi.org/10.1590/S1516-31802008000600006.Reis Campos LM, Luz Dias Fd, Antunes LM, Murta EF. Prevalence of micronuclei in exfoliated uterine cervical cells from patients with risk factors for cervical cancer. Sao Paulo Medical Journal. 2008;126(6):323– 328. DOI: https://doi.org/10.1590/S1516-31802008000600006.He YH, Su RJ, Zheng J. Detection of DKK-1 gene methylation in exfoliated cells of cervical squamous cell carcinoma and its relationship with high risk HPV infection. Archives of Gynecology and Obstetrics. 2021;304(3):743–750. DOI: https://doi.org/10.1007/s00404-021-05982-3.He YH, Su RJ, Zheng J. Detection of DKK-1 gene methylation in exfoliated cells of cervical squamous cell carcinoma and its relationship with high risk HPV infection. Archives of Gynecology and Obstetrics. 2021;304(3):743–750. DOI: https://doi.org/10.1007/s00404-021-05982-3.Derbie A, Amare B, Misgan E, Nibret E, Maier M, Woldeamanuel Y, et al. Histopathological profile of cervical punch biopsies and risk factors associated with high-grade cervical precancerous lesions and cancerin northwest Ethiopia. PLoS One. 2022;17(9):e0274466. DOI: https://doi.org/10.1371/journal.pone.0274466.Derbie A, Amare B, Misgan E, Nibret E, Maier M, Woldeamanuel Y, et al. Histopathological profile of cervical punch biopsies and risk factors associated with high-grade cervical precancerous lesions and cancerin northwest Ethiopia. PLoS One. 2022;17(9):e0274466. DOI: https://doi.org/10.1371/journal.pone.0274466.Wang W, Liu Y, Pu Y, Li C, Zhou H, Wang Z. Effectiveness of focused ultrasound for high risk human papillomavirus infection-related cervical lesions. International Journal of Hyperthermia. 2021;38(2):96–102. DOI: https://doi.org/10.1080/02656736.2021.1910736.Wang W, Liu Y, Pu Y, Li C, Zhou H, Wang Z. Effectiveness of focused ultrasound for high risk human papillomavirus infection-related cervical lesions. International Journal of Hyperthermia. 2021;38(2):96–102. DOI: https://doi.org/10.1080/02656736.2021.1910736.He Y, Zhao Q, Geng YN, Yang SL, Yin CH, Wu YM. Clinical analysis of cervical intraepithelial neoplasia with vaginal intraepithelial neoplasia. Medicine. 2017;96(17):e6700. DOI: https://doi.org/10.1097/MD.0000000000006700.He Y, Zhao Q, Geng YN, Yang SL, Yin CH, Wu YM. Clinical analysis of cervical intraepithelial neoplasia with vaginal intraepithelial neoplasia. Medicine. 2017;96(17):e6700. DOI: https://doi.org/10.1097/MD.0000000000006700.Kanyina EW, Kamau L, Muturi M. Cervical precancerous changes and selected cervical microbial infections, Kiambu County, Kenya, 2014: A cross sectional study. BMC Infectious Diseases. 2017;17:647. DOI: https://doi.org/10.1186/s12879-017-2747-4.Kanyina EW, Kamau L, Muturi M. Cervical precancerous changes and selected cervical microbial infections, Kiambu County, Kenya, 2014: A cross sectional study. BMC Infectious Diseases. 2017;17:647. DOI: https://doi.org/10.1186/s12879-017-2747-4.Holubekova V, Mersakova S, Grendar M, Snahnicanova Z, Kudela E, Kalman M, et al. The role of CADM1 and MAL promoter methylation in inflammation and cervical intraepithelial neoplasia. Genetic Testing and Molecular Biomarkers. 2020;24(5):256–263. DOI: https://doi.org/10.1089/gtmb.2019.0188.Holubekova V, Mersakova S, Grendar M, Snahnicanova Z, Kudela E, Kalman M, et al. The role of CADM1 and MAL promoter methylation in inflammation and cervical intraepithelial neoplasia. Genetic Testing and Molecular Biomarkers. 2020;24(5):256–263. DOI: https://doi.org/10.1089/gtmb.2019.0188.Ki EY, Park JS, Lee A, Kim TJ, Jin HT, Seo YB, et al. Utility of human papillomavirus L1 capsid protein and HPV test as prognostic markers for cervical intraepithelial neoplasia 2+ in women with persistent ASCUS/LSIL cervical cytology. International Journal of Medical Sciences. 2019;6;16(8):1096–1101. DOI: https://doi.org/10.7150/ijms.31163.Ki EY, Park JS, Lee A, Kim TJ, Jin HT, Seo YB, et al. Utility of human papillomavirus L1 capsid protein and HPV test as prognostic markers for cervical intraepithelial neoplasia 2+ in women with persistent ASCUS/LSIL cervical cytology. International Journal of Medical Sciences. 2019;6;16(8):1096–1101. DOI: https://doi.org/10.7150/ijms.31163.Xu J, Zhao J, Dong Y, Zhao X, Chen R, Shi Y, et al. Photodetection and safety of 5-aminolevulinic acid-induced porphyrin in patients with cervical intraepithelial neoplasia. Lasers in Surgery and Medicine. 2021;53(5):654–663. DOI: https://doi.org/10.1002/lsm.23338.Xu J, Zhao J, Dong Y, Zhao X, Chen R, Shi Y, et al. Photodetection and safety of 5-aminolevulinic acid-induced porphyrin in patients with cervical intraepithelial neoplasia. Lasers in Surgery and Medicine. 2021;53(5):654–663. DOI: https://doi.org/10.1002/lsm.23338.Dayal U, Gupta B, Hariprasad R, Shriya R, Rajaram S, Prasad B, et al. Comparison of the AV Magnivisualizer device with colposcopy to detect cervical intraepithelial neoplasia using the Swede scoring system. International Journal of Gynecology & Obstetrics. 2019;147(2):219–224. DOI: https://doi.org/10.1002/ijgo.12931.Dayal U, Gupta B, Hariprasad R, Shriya R, Rajaram S, Prasad B, et al. Comparison of the AV Magnivisualizer device with colposcopy to detect cervical intraepithelial neoplasia using the Swede scoring system. International Journal of Gynecology & Obstetrics. 2019;147(2):219–224. DOI: https://doi.org/10.1002/ijgo.12931.Silva NNT, Sabino AP, Tafuri A, Lima AA. Lack of association between methylenetetrahydrofolate reductase C677T polymorphism, HPV infection and cervical intraepithelial neoplasia in Brazilian women. BMC Medical Genetics. 2019;20(1):100. DOI: https://doi.org/10.1186/s12881-019-0831-x.Silva NNT, Sabino AP, Tafuri A, Lima AA. Lack of association between methylenetetrahydrofolate reductase C677T polymorphism, HPV infection and cervical intraepithelial neoplasia in Brazilian women. BMC Medical Genetics. 2019;20(1):100. DOI: https://doi.org/10.1186/s12881-019-0831-x.

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