Hakim Amy A, Lin Paul S, Wilczynski Sharon, Nguyen Kimhuynh, Lynes Billie, Wakabayashi Mark T
Department of Gynecologic Oncology, City of Hope, 1500 East Duarte Road, Duarte, CA 91010-3000, USA.
Curr Treat Options Oncol. 2007 Dec;8(6):393-401. doi: 10.1007/s11864-007-0050-0.
In the United States, there are 11,150 cases and 3670 deaths projected due to invasive cervical cancer for 2007. Approximately 500,000 new cases and 274,000 deaths will occur in women throughout the world. Human papillomavirus (HPV) has been designated by the World Health Organization (WHO) as a "necessary cause" of cervical cancer. There are 6.2 million new cases of HPV diagnosed each year. In addition to cervical cancer, the virus has also been implicated in vaginal, vulvar, penile, anal, and head and neck cancers. Current methods for prevention of cervical cancer include Pap smears, HPV testing, ablative procedures, cervical conization, and hysterectomy. These are costly as well as invasive. The HPV vaccine is the most recent breakthrough for the prevention of cervical cancer. The quadrivalent HPV vaccine (Gardasil) covers types 6, 11, 16, & 18. The bivalent vaccine (Cervarix) covers types 16 & 18, and is expected to come out in the early part of 2007. Approximately 70% of cervical cancer is caused by HPV types 16 & 18. HPV types 6 &11 are responsible for 90% of anogenital warts. Females of ages 11-12 and those prior to their sexual debut should be vaccinated, with all females in the age range of 9-26 also eligible. This vaccination strategy can prevent the above HPV infections, cervical dysplasia, and possibly cervical cancer.
在美国,预计2007年侵袭性宫颈癌病例有11150例,死亡3670例。全世界女性中约有50万新发病例,27.4万人死亡。人乳头瘤病毒(HPV)已被世界卫生组织(WHO)认定为宫颈癌的“必要病因”。每年有620万例HPV新诊断病例。除宫颈癌外,该病毒还与阴道癌、外阴癌、阴茎癌、肛门癌以及头颈癌有关。目前预防宫颈癌的方法包括巴氏涂片检查、HPV检测、消融手术、宫颈锥切术和子宫切除术。这些方法既昂贵又具有侵入性。HPV疫苗是预防宫颈癌的最新突破。四价HPV疫苗(佳达修)涵盖6、11、16和18型。二价疫苗(希瑞适)涵盖16和18型,并预计在2007年初上市。约70%的宫颈癌由16和18型HPV引起。6和11型HPV导致90%的肛门生殖器疣。11至12岁以及首次性行为前的女性应接种疫苗,9至26岁的所有女性也都符合接种条件。这种疫苗接种策略可以预防上述HPV感染、宫颈发育异常,并有可能预防宫颈癌。