Документ взят из кэша поисковой машины. Адрес оригинального документа : http://chem.msu.ru/rus/teaching/carcinogenesis/5.pdf Дата изменения: Wed Feb 27 13:28:03 2013 Дата индексирования: Sun Apr 10 17:18:42 2016 Кодировка:

CIN



~1




2­5


4­5 CIN 1 CIN 2/3

9­15

2



1. Adapted from Pagliusi SR, Aguado MT. Vaccine. 2004;23:569­578.



14.6

16 18 45
25.7

69.7

/

31 33 52 58

17

52.5

67.6 12.6



57



/
1. MuЯoz N, Bosch FX, CastellsaguИ X, et al. Int J Cancer. 2004;111:278­285.


CIN
:
CO2 , , , () ~90%

:
CO2 , , LEEP/LLETZ

1,2

LEEP = loop electrosurgical excision procedure; LLETZ = large loop excision of the transformation zone
1. Martin-Hirsch PL, Paraskevaidis E, Kitchener H. Cochrane Database Syst Rev, CD001318. In: The Cochrane Library, Issue 4, 2005. Chichester, John Wiley & Sons, Ltd. 2. American College of Obstetrics and Gynecology. Obstet Gynecol. 2005;106:645­664.


TM
L1 VLP ( 6, 11, 16, 18)


(6, 11, 16, 18) L1
VLPs Saccharomyces cerevisiae 225 3- - 0,5 0, 2, 6

6/11


90% 25% CIN I 25% CIN 1 70% CIN 2/3


90% ( ) 70% AIN 2/3 70% of Anal Cancer , ,

16/18

70% 70% , ,


:
II 16 16­23 II 16­23

5 - booster dose

~29,000 33


III 16­23
III . 915



2003

2004

2005

2006

2007

2008

2009

2010


GARDASILTM: ( 6, 11, 16, and 18) L1 VLP

:






.

CIN* 2/3

Cervical Cancer

CIN* 1



*CIN

= cervical intraepithelial neoplasia



-



Per-Protocol *

6/11/16/18 ­ CIN 2/3 or AIS VIN, VaIN 2/3 Genital warts



- (%) 100 100 99

n 8487 8487 7897



n 8460 8460 7899



95% CI (93­100) (89­100) (93­100)

P < 0.001

0 0 1

53 24 91

* ­ 3 1 ; 6/11/16/18 (-) 1 6/11/16/18 (-) 1 ­ 7


, ?

, 1 , , , , /


GARDASILTM: ( 6, 11, 16, and 18) L1 VLP

:



( III): (7- )
(P<0.001)*
10­15 % (95% CI) (n=506) 10-15 % (95% CI) (n=508) 16-23 % (95% CI) (n=511) 100 (98.9%,100%) 100 (98.9%,100%) 100 (98.8%,100%)

Anti-HPV 6 Anti-HPV 11 Anti-HPV 16 Anti-HPV 18

100 (99.1%,100%) 100 (99.1%,100%) 100 (99.1%,100%) 100 (99.1%,100%) 100 (99.1%,100%) 100 (99.1%,100%)

100 (99.1%,100%) 99.8 (98.7%,100%) 99.1(97.4%,99.8%)

* P <0.025 , - 10-15- , 16-23-


( III) : - GMT* (7- )

1500 1000 500 0 Anti-HPV 6 (HPV 6 mMU/mL) 8000 6000 4000 2000 0 Anti-HPV 16 (HPV 16 mMU/mL)
10­15

1500 1000 500 0 Anti-HPV 11 (HPV 11 mMU/mL)

1500 1000 500 0 Anti-HPV 18 (HPV 18 mMU/mL)
16­23

10­15

*GMT =



10,000 1,000 100 10 1 0 5 10 15 20 25 30 35 40 45 50 55

HPV 6
Naturally Infected Vaccinated Serostatus Cutoff

10,000

HPV 16

1,000

100

10

GMT

1 0 5 10 15 20 25 30 35 40 45 50 55

10,000

HPV 11

10,000

HPV 18

1,000

1,000

100

100

10

10

1 0 5 10 15 20 25 30 35 40 45 50 55

1 0 5 10 15 20 25 30 35 40 45 50 55






?
5


GARDASILTM: ( 6, 11, 16, and 18) L1 VLP

:



:
( 84%, 25%, 25%, 3% vs. 75%, 18%, 16%, 3% ) (10% vs. 9%) ( , , ): 0,020,03% vs. 0,01-0,02% 4- 9 11813 3 9701 (n=1115) (n=1151)


?
-
18 26 9 17



-



+
­ ­