Department of Microbiology, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong Special Administrative Region, People's Republic of China.
Crit Rev Clin Lab Sci. 2012 Jul-Aug;49(4):117-36. doi: 10.3109/10408363.2012.707174.
Human papillomavirus (HPV) infection is associated with a wide spectrum of disease that ranges from self-limited skin warts to life-threatening cancers. Since HPV plays a necessary etiological role in cervical cancer, it is logical to use HPV as a marker for early detection of cervical cancer and precancer. Recent advances in technology enable the development of high-throughput HPV assays of different formats, including DNA-based, mRNA-based, high-risk group-specific and type-specific methods. The ultimate goal of these assays is to improve the accuracy and cost-effectiveness of cervical screening programs. HPV testing has several potential advantages compared to cytology-based screening. However, since the cancer to transient infection ratio is always low in the general population, HPV test results are bound to have a low positive predictive value that may subject women to unnecessary follow-up investigations. The wide-spread administration of prophylactic HPV vaccine will substantially decrease the incidence of cancer and precancer. This poses a number of challenges to cytology-based screening, and the role of HPV testing is expected to increase. Finally, apart from technical and cost-effectiveness considerations, one should also keep in mind the psycho-social impact of using sexually-transmitted agents as a marker for cancer screening.
人乳头瘤病毒（HPV）感染与广泛的疾病相关，从自限性皮肤疣到危及生命的癌症。由于 HPV 在宫颈癌中起着必要的病因学作用，因此将 HPV 用作宫颈癌和癌前病变的早期检测标志物是合理的。技术的最新进展使不同格式的高通量 HPV 检测方法得以发展，包括基于 DNA、基于 mRNA、高危型特异性和型特异性方法。这些检测方法的最终目标是提高宫颈癌筛查计划的准确性和成本效益。与细胞学筛查相比，HPV 检测具有几个潜在的优势。然而，由于在普通人群中癌症到一过性感染的比例总是很低，HPV 检测结果必然具有较低的阳性预测值，这可能导致女性接受不必要的随访检查。预防性 HPV 疫苗的广泛应用将大大降低癌症和癌前病变的发病率。这给基于细胞学的筛查带来了许多挑战，预计 HPV 检测的作用将会增加。最后，除了技术和成本效益方面的考虑外，还应考虑将性传播标志物用于癌症筛查的心理社会影响。
