二氧化硅,亚硒酸钠和柠檬酸阴道凝胶,HPV感染和宫颈浸润前疾病:叙述回顾。

IF 4.7 2区 医学 Q1 OBSTETRICS & GYNECOLOGY
Emmanuel Sánchez Díaz, Gabriel Levin, Beatriz Aristizabal, Andreína Fernandes, Florencia Noll, David Cantú, Fernando Heredia, Helena M Obermair, Rene Pareja
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引用次数: 0

摘要

子宫颈癌仍然是一个主要的公共卫生问题,特别是在低收入和中等收入国家。它主要是由持续感染人乳头瘤病毒(HPV)引起的。筛查一直是降低死亡率的最有效策略,但在过去二十年中,疫苗接种已成为一种重要的辅助手段,有助于降低发病率和死亡率。考虑到HPV感染的自然史,大多数低级别病变会随着时间的推移自发消退;因此,观察是低级别鳞状上皮内病变的首选方法。一些作者认为,这段没有干预的时期可能会引起患者和医生的焦虑。一种阴道凝胶每剂含有10.0毫克二氧化硅、24.8毫克柠檬酸和0.25毫克硒,以DeflaGyn、Deflamin或Deflamed上市,已在欧洲、阿拉伯联合酋长国、乌兹别克斯坦和哥伦比亚获得批准。进行文献检索以确定所有已发表的关于DeflaGyn的临床试验。截至2025年1月,已发表6项研究:1项回顾性研究,1项随机临床试验(RCT), 2项事后分析,1项前瞻性非随机试验,1项体外研究。进行了方法学上的偏倚风险评估,揭示了RCT及其事后分析中存在高或未知偏倚风险的一些领域。本综述旨在总结现有证据,并对研究进行批判性分析。目前的证据不足以支持其用于治疗HPV感染或发育不良。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Silicon dioxide, sodium selenite and citric acid vaginal gel, HPV infection, and cervical preinvasive disease: a narrative review.

Cervical cancer continues to be a major public health concern, particularly in low- and middle-income countries. It is mainly caused by persistent infection with human papillomavirus (HPV). Screening has been the most effective strategy to reduce mortality, but over the last 2 decades, vaccination has emerged as an important adjunct, helping to decrease incidence and mortality. Given the natural history of HPV infection, most low-grade lesions will spontaneously resolve over time; therefore, observation is the preferred approach for low-grade squamous intraepithelial lesions. Some authors have suggested that this period without intervention may cause anxiety among patients and physicians. A vaginal gel containing 10.0 mg of silicon dioxide, 24.8 mg citric acid, and 0.25 mg selenium per dose, marketed as DeflaGyn, Deflamin, or Deflamed, has been approved in Europe, the United Arab Emirates, Uzbekistan, and Colombia. A literature search was conducted to identify all published clinical trials on DeflaGyn. As of January 2025, 6 studies have been published: 1 retrospective study, 1 randomized clinical trial (RCT) with 2 post hoc analyses, 1 prospective non-randomized trial, and 1 in vitro study. A methodological risk-of-bias assessment was performed, revealing a number of domains with high or unknown risk of bias in the RCT and its post hoc analyses. This review aims to summarize the available evidence and perform a critical analysis of the research. Current evidence is insufficient to support its use for treating HPV infection or dysplasia.

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来源期刊
CiteScore
6.60
自引率
10.40%
发文量
280
审稿时长
3-6 weeks
期刊介绍: The International Journal of Gynecological Cancer, the official journal of the International Gynecologic Cancer Society and the European Society of Gynaecological Oncology, is the primary educational and informational publication for topics relevant to detection, prevention, diagnosis, and treatment of gynecologic malignancies. IJGC emphasizes a multidisciplinary approach, and includes original research, reviews, and video articles. The audience consists of gynecologists, medical oncologists, radiation oncologists, radiologists, pathologists, and research scientists with a special interest in gynecological oncology.
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