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 VOLUME Vol.05 Issue03 2025 

PAGE NO. 7-10 

DOI 10.37547/ajbspi/Volume05Issue03-02 

 
 
 
 

The role of HPV in the development of cervical 

intraepithelial neoplasia and cervical cancer 
 

Abdusamieva Nargiza Khudratovna 

Assistant, Department of Medical Clinical Sciences, Termiz Economics service University, Uzbekistan 

 

Received: 03 January 2025; Accepted: 05 February 2025; Published: 07 March 2025 

 

Abstract: Despite impressive achievements in the field of molecular biology, which made it possible to reveal the 
main mechanisms and stages of carcinogenesis and to significantly improve the capabilities of instrumental 
diagnostics, every year there is a disappointing trend in the world towards an increase in the number of patients 
with oncological diseases. 

 

Keywords: Oncological diseases, stages of carcinogenesis. 

 

Introduction: Despite impressive achievements in the 
field of molecular biology, which made it possible to 
reveal the main mechanisms and stages of 
carcinogenesis and to significantly improve the 
capabilities of instrumental diagnostics, every year 
there is a disappointing trend in the world towards an 
increase in the number of patients with oncological 
diseases. 

According to the World Health Organization (WHO), the 
average annual increase in human papillomavirus 
infection exceeds 2.5-3 million, the frequency of 
asymptomatic virus carriage in the world is high and 
amounts to 15.5% in Russia; in the USA - 28.6%; in 
Europe - 2-12%. HPV-associated cervical cancer is the 
third most common cancer among women in the world, 
with -70% of cases due to infection with HPV types 16 
and 18. Compared to other gynecological diseases, 
cervical cancer is more common in young women, with 
an average age of about 49 years. Over the past 50 
years, the introduction of "... Pap smear testing and 
HPV vaccination in developed countries has reduced 
morbidity and mortality by 75% ...". Despite widely 
implemented prevention programs, the prevalence of 
cervical cancer continues to remain high. 

Cervical cancer is a dangerous disease, the second most 
common type of cancer among women in Uzbekistan. 
In 2021, 1,827 new cases were identified, 997 women 
died. Morbidity and mortality are steadily increasing, 
and cervical cancer is projected to cause 2,100 new 
cases and 1,300 deaths per year by 2030. [1]. 

In Karakalpakstan, the incidence of cervical cancer 
ranks second after breast cancer among the female 
population. A malignant tumor of the cervix in 2020 
claimed the life of 71 women in Karakalpakstan. 

Despite the widespread use in clinical practice of 
various destructive and excisional methods of 
treatment of cervical intraepithelial neoplasia (CIN) and 
carcinoma in situ, a number of patients subsequently 
revealed the persistence of human papillomavirus 
(HPV) of high carcinogenic risk, which contributes to 
the recurrence of the disease and repeated surgical 
interventions on the cervix [9; 10]. 

In order to accurately diagnose the severity of CIN, 
assess the prognosis of the course of small forms of 
cervical lesions, and select the most optimal 
management tactics for patients, it is necessary to 
search for effective biomarkers with high diagnostic 
and prognostic significance. 

Currently, the human genome and transcriptome are 
widely studied to search for biomarkers of CIN and PCM 
[2;3]. 

The purpose of the study 

To develop differentiated approaches to the 
management of patients with cervical intraepithelial 
neoplasia of varying severity based on the study of 
clinical, morphological methods. 

METHODS 

According to the inclusion and exclusion criteria, 110 
patients were recruited into a single-stage prospective 

 

https://doi.org/10.37547/ajbspi/Volume05Issue03-02
https://doi.org/10.37547/ajbspi/Volume05Issue03-02
https://doi.org/10.37547/ajbspi/Volume05Issue03-02
https://doi.org/10.37547/ajbspi/Volume05Issue03-02


American Journal of Applied Science and Technology 8 https://theusajournals.com/index.php/ajast 

American Journal of Applied Science and Technology (ISSN: 2771-2745) 
 

 

cohort study. Depending on the results of histological 
examination of cervical biopsies, 4 groups were 
formed: chronic cervicitis in combination with HPV 
infection (n=30), LSIL (n=30), HSIL (n=30) and  cervical 
cancer (n=20). 

Research methods 

Mandatory research methods: 

1. A clinical study that includes the collection of 
complaints, anamnesis, assessment of reproductive 
function and risk factors for HPV-associated cervical 

diseases, general examination and gynecological 
examination, calculation of body mass index (BMI), 
examination and palpation of the mammary glands. 

2. Cytological method (liquid cytology). 

3. Molecular genetic methods (genotyping of 21 HPV 
types with determination of viral load by real-time 
PCR). 

4. Advanced colposcopy. 

 

Table 1 

Classification of HPV depending on oncogenicity (IARC, 2003) 

The degree of oncogenicity of HPV 

Highly oncogenic 

Low-oncogenic 

Medium oncogenic 

Type of HPV 

Highly oncogenic 
16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68, 73, 

82 

Low-oncogenic 6, 11, 40, 42, 43, 44, 54, 61, 70, 72, 81 

Medium oncogenic 26, 53, 66 

In 2012, the IARC identified 3 groups of oncogenic HPV: 
group 1 - high carcinogenic risk, group 2 A - probable 
carcinogenic risk, group 2B - possible carcinogenic risk 
(Table 2). 

It is known that the human papillomavirus plays a key 
role in the development of breast cancer. In 2008, 

German physician and scientist Harald zur Hausen was 
awarded the Nobel Prize in Physiology or Medicine for 
his study of HPV and its role in the pathogenesis of 
breast cancer. 

 

Carcinogenic risk groups depending on the type of HPV (IARC, 2012) 

 Carcinogenic risk group 
Type of HPV  

1 
HPV 16, HPV 18, HPV 31, HPV 33, PO 35, HPV 39, HPV 45, HPV 51, 

HPV 52, HPV 56, HPV 58 and HPV 59 

2А HPV 68 

2В 
P 26, PCH 30, PCH 34, PCH 53, PCH 66, PCH 67, PCH 69, PCH 70, PCH 

73, PCH 82, HPV 85, HPV 97 

In August 2020, the World Health Assembly adopted 
the Global Strategy for cervical cancer elimination. The 
WHO has set up global 90-70-90 targets to be reached 
by 2030: 90% of girls fully vaccinated with the human 
papillomavirus (HPV) vaccine by age 15; 70% of women 
are screened by 35, and again by 45 years of age; and 
90% of women identified with cervical disease receive 
treatment. 

Cervical endometriosis (Figure 1) was detected in 12% 
of cases. Cervical endometriosis was most often found 
in patients who underwent knife conization, DEC and 
CO2 laser vaporization of the cervix - 23%. Less often, 
endometriosis was detected after the use of radio wave 
treatment (19%) and cryodestruction of the cervix 
(12%). 

The results of a retrospective analysis showed that in  

30% of women, after excision and/or destructive 
treatment of the cervix, pregnancy was complicated by 
ICN, in connection with which such patients had 
stitches on the cervix (67%), obstetric pessaries were  

also used (33%). An analysis of the obstetric history 
showed that premature birth was observed in 15% of 
pregnant women who underwent cervical surgery, and 
most often they were operative (cesarean section in 
60% of cases). A case of very early premature birth at 
the age of 27 weeks of pregnancy in a patient 4 years 
after cervical electroconization for HSIL deserves 
attention. As a result of this complication, the patient 
had a child with cerebral palsy (cerebral palsy). 

 



American Journal of Applied Science and Technology 9 https://theusajournals.com/index.php/ajast 

American Journal of Applied Science and Technology (ISSN: 2771-2745) 
 

 

 
Figure 1. Consequences of surgical treatment of the cervix: 

A) scarring of the cervix, B) endometriosis of the 
cervix, C) complete stenosis of the external pharynx of 
the cervix 

68% of excisional and destructive interventions on the 
cervix were performed outside the Republican 
Specialized Scientific and practical Medical Center of 
Oncology and Radiology. It should be noted that before 
surgical treatment of the cervix, as well as in the 
process of monitoring its condition after treatment 
outside the walls of the Republican Specialized 
Scientific and practical Medical Center of Oncology and 
RadiologyAGP, most patients were not typed for HPV, 
therefore it is not possible to assess the persistence of 
a certain type of HPV or reinfection with other types in 
these patients. According to the results of HPV testing, 
HPV infection was detected in almost half (48%) of the 

patients. Of these, HPV BP was detected in 96% of 
cases. The most common type of HPV was type 16 
(33%). Then we met 33 (7%), 52 (7%), 56 (7%), 59 (7%) 
types of HPV. 35 and 39 HPV types were detected with 
a frequency of 6% each. HPV 31, 44(55), 45, 51, 58 The 
types were identified with the same frequency - 4%. 
There were also 68 (3%) and 18 (3%) HPV types in 
patients with HPV infection. Type 82 HPV was detected 
in 1% of patients with HPV infection (Figure 10). From a 
cytological point of view, chronic cervicitis consists of 
cells of flat, cylindrical and metaplastic epithelium, 
elements of chronic inflammation (lymphocytes, 
histiocytes, cells of the plasma and fibroblastic series), 
non-specific signs such as acanthosis, hyper- and 
parakeratosis were often noted (Figure 2). 

 

 
 

Figure 2. Cytological picture of chronic cervicitis in combination with HPV infection 

The cytological picture in ASCUS was characterized by 
the presence of single squamous epithelial cells with 
signs of atypia, the interpretation of which caused 
difficulty. Coilocytes were often found - cells of the 
intermediate layer with enlarged nuclei, an uneven 
membrane and hyperchromia, with the presence of an 
extensive perinuclear zone of enlightenment, clearly 

delimited from the peripheral parts of the cytoplasm,  

which were stained more evenly and intensively. The 
perinuclear zone of enlightenment is the result of 
degenerative changes, necrosis of the cytoplasm, 
which begins with the nucleus with a gradual spread to  

the periphery. 



American Journal of Applied Science and Technology 10 https://theusajournals.com/index.php/ajast 

American Journal of Applied Science and Technology (ISSN: 2771-2745) 
 

 

 
 

Figure 3. The prevalence of various types of HPV in patients with a history of 

cervical surgery 

CONCLUSION 

Thus, the presence of relapses of SIL and breast cancer 
(22%) indicates the use of excessively gentle, non-
excisional HSIL treatment methods with the lack of 
adequate colposcopic control, as well as the 
subsequent persistence of HPV BP, the timely diagnosis 
of which was not given sufficient attention. The results 
of simultaneous HPV testing revealed a high incidence 
of HPV infection (48%), including HPV BP 96% in 
patients who had previously undergone destructive 
and excisional interventions on the cervix for 
precancerous and malignant diseases. Thus, HPV 
testing is advisable to use in addition to annual 
cytological screening in patients who have undergone 
cervical surgery to identify risk groups for the 
development of HSIL and breast cancer relapses. 

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