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[人乳头瘤病毒感染在子宫颈癌病因学中的作用]

[HPV infection in etiology of uterine cervix cancer].

作者信息

Olejek Anita

机构信息

Katedra i Oddział Kliniczny Ginekologii, Połoznictwa i Ginekologii Onkologicznej w Bytomiu.

出版信息

Ginekol Pol. 2008 Feb;79(2):126-32.

Abstract

Uterine cervical cancer may be the direct result of persistent HPV infection. The DNA analysis shows over 200 HPV types. The natural history of uterine cervix cancer is a constantly progressing process, from low pathology changes, through medium to major pathology changes, including microinvasion and invasive carcinoma. The population studies show that over 20% of women at the moment of examination is infected with HPV. The study of cervical cancer tissue revealed the HPV in the DNA, whereas the serological study revealed the presence of specific antibodies to HPV capsid antigens in most women (in USA the number amounts up to 70%). The serological conversion after HPV infection is not a common process. Therefore, the naturally infected women, still do not have enough antibodies and they are at the risk of infection, just as seronegative women. The vaccination of women between the ages of 15 and 25, causes the increase of the number of antibodies, several times higher than in the case of naturally acquired ones. The positive results of HPV examination is not a contraindication to vaccination. However, in case of vaccinated women, the negative test for 14 oncogenic HPV types has an overwhelmingly negative predictive value. Independent of the presence or absence of HPV infection, it is essential to continue cytological. The vaccination does not protect patients from all oncogenic HPV types. Cytological screening enables doctors to recognize cervical pathology at the early stage and introduce a proper treatment.

摘要

子宫颈癌可能是持续性人乳头瘤病毒(HPV)感染的直接结果。DNA分析显示有200多种HPV类型。子宫颈癌的自然史是一个不断进展的过程,从低度病理变化,经过中度到重度病理变化,包括微浸润和浸润性癌。人群研究表明,超过20%的女性在检查时感染了HPV。对宫颈癌组织的研究在DNA中发现了HPV,而血清学研究表明大多数女性体内存在针对HPV衣壳抗原的特异性抗体(在美国这一比例高达70%)。HPV感染后的血清学转换并不常见。因此,自然感染的女性体内仍然没有足够的抗体,她们与血清学阴性的女性一样有感染风险。对15至25岁的女性进行疫苗接种会使抗体数量增加,比自然获得抗体的情况高出几倍。HPV检测呈阳性结果并非疫苗接种的禁忌证。然而,对于接种过疫苗的女性,14种致癌性HPV类型检测呈阴性具有极高的阴性预测价值。无论是否存在HPV感染,持续进行细胞学检查至关重要。疫苗接种并不能保护患者免受所有致癌性HPV类型的侵害。细胞学筛查使医生能够在早期识别宫颈病变并进行适当治疗。

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