致癌性人乳头瘤病毒的不断演变的定义。

The evolving definition of carcinogenic human papillomavirus.

作者信息

Castle Philip E

机构信息

Division of Cancer Epidemiology and Genetics, National Cancer Institute, 6120 Executive Blvd, Room 5004, MSC 7234, Bethesda, MD 20892-7234, USA.

出版信息

Infect Agent Cancer. 2009 May 11;4:7. doi: 10.1186/1750-9378-4-7.

Abstract

Thirteen human papillomavirus (HPV) genotypes have been judged to be carcinogenic or probably carcinogenic, and the cause of virtually all cervical cancer worldwide. Other HPV genotypes could possibly be involved. Although the inclusion of possibly carcinogenic HPV genotypes may hurt test specificity, it may indirectly increase the reassurance following a negative HPV test (i.e. the negative predictive value of an HPV test for cervical precancer and cancer). The future of cervical cancer screening in low-resource setting, however, may include once-in-a-lifetime, low-cost and rapid HPV testing. However, the tradeoff of more false positives for greater reassurance may not be acceptable if the local infrastructure cannot manage the screen positives. Now is the time for the community of scientists, doctors, and public health advocates to use the data presented at the 100th International Agency for Research on Cancer monograph meeting to rationally decide the target HPV genotypes for the next generation of HPV tests for use in high-resource and low-resource settings. The implications of including possibly HPV genotypes on HPV test performance, also for guidance on the use of these tests for cervical cancer prevention programs, are discussed.

摘要

13种人乳头瘤病毒(HPV)基因型已被判定具有致癌性或可能具有致癌性,并且几乎是全球所有宫颈癌的病因。其他HPV基因型可能也与之有关。虽然纳入可能致癌的HPV基因型可能会损害检测特异性,但它可能会间接增加HPV检测呈阴性后的安心程度(即HPV检测对宫颈上皮内瘤变和癌症的阴性预测值)。然而,在资源匮乏地区,宫颈癌筛查的未来可能包括一生一次、低成本且快速的HPV检测。然而,如果当地基础设施无法处理筛查呈阳性的结果,那么为了获得更大的安心感而出现更多假阳性的权衡可能是不可接受的。现在是科学家、医生和公共卫生倡导者群体利用在第100届国际癌症研究机构专著会议上展示的数据,合理确定用于高资源和低资源环境的下一代HPV检测的目标HPV基因型的时候了。本文讨论了纳入可能的HPV基因型对HPV检测性能的影响,以及对这些检测用于宫颈癌预防项目的指导意义。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d4f6/2686676/5e3167646d85/1750-9378-4-7-1.jpg

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