Institute of Cancer Sciences, University of Manchester, Oxford Road, Manchester, UK.
Lancet. 2013 Sep 7;382(9895):889-99. doi: 10.1016/S0140-6736(13)60022-7. Epub 2013 Apr 23.
Cervical cancer is caused by human papillomavirus infection. Most human papillomavirus infection is harmless and clears spontaneously but persistent infection with high-risk human papillomavirus (especially type 16) can cause cancer of the cervix, vulva, vagina, anus, penis, and oropharynx. The virus exclusively infects epithelium and produces new viral particles only in fully mature epithelial cells. Human papillomavirus disrupts normal cell-cycle control, promoting uncontrolled cell division and the accumulation of genetic damage. Two effective prophylactic vaccines composed of human papillomavirus type 16 and 18, and human papillomavirus type 16, 18, 6, and 11 virus-like particles have been introduced in many developed countries as a primary prevention strategy. Human papillomavirus testing is clinically valuable for secondary prevention in triaging low-grade cytology and as a test of cure after treatment. More sensitive than cytology, primary screening by human papillomavirus testing could enable screening intervals to be extended. If these prevention strategies can be implemented in developing countries, many thousands of lives could be saved.
宫颈癌由人乳头瘤病毒感染引起。大多数人乳头瘤病毒感染是无害的，并可自行清除，但高危型人乳头瘤病毒（尤其是 16 型）的持续感染可导致宫颈癌、外阴癌、阴道癌、肛门癌、阴茎癌和口咽癌。该病毒专门感染上皮细胞，仅在上皮细胞完全成熟时才产生新的病毒颗粒。人乳头瘤病毒破坏正常的细胞周期控制，促进不受控制的细胞分裂和遗传损伤的积累。两种有效的预防性疫苗已在许多发达国家推出，由人乳头瘤病毒 16 型和 18 型以及人乳头瘤病毒 16 型、18 型、6 型和 11 型病毒样颗粒组成，作为初级预防策略。人乳头瘤病毒检测在细胞学低度病变的二级预防和治疗后疗效检测中具有重要的临床价值。人乳头瘤病毒检测比细胞学检测更敏感，可通过人乳头瘤病毒检测进行初级筛查，从而延长筛查间隔。如果这些预防策略能在发展中国家实施，将能挽救数千人的生命。
