Role of the medication treatment for the low risk cervical preinvasive lesions

The most common cervical precancerous disease is low-risk intraepithelial neoplasia or CIN 1. These lesions spontaneously regresses in 57%, persists in 32%, progresses in 12%. Pharmacological treatment with glycyrrhizinic acid could reduce persistent HPV infection, the incidence of CIN 1, and the use of more aggressive therapies. The aim of the study is to investigate efficiency of medication treatment for CIN 1 lesions. A prospective study is ongoing in Riga East Clinical University Hospital. Women with histologically confirmed CIN 1 in cervical biopsies are included in the study. Participants of the study group members use glycyrrhizinic acid spray (Epigen spray) topically for 6 months. Women of the control group have no any treatment. During two follow-up visits 6 months apart cytological, colposcopic and histological examination is done. All patients are screened for human papillomavirus before enrollment and during the 1st follow-up visit. There are currently 45 patients of the Epigen and 44 patients of the control group involved in the study, 64 of them have completed the study. No statistically significant different incidence of improvement or deterioration in cytological and colposcopic findings at either the first or second control visit is found. Though participants of the Epigen’s group progression to CIN 2/3 in histological findings at first control visit is less common (in Epigen’s group lesions progress in 4.8 % vs 35.3 % in control group p=0.01). No such relationship is found during the second control visit. Most commonly detected HPV types among the enrolled women are 16, 31, 33, 44 and 56. There is no statistically significant difference in distribution and changes of virus concentration over the time between groups. Currently data on medication treatment efficiency for low risk cervical preinvasive lesions are inconclusive. The study needs to be continued.