Medical Virology, Division of Experimental Virology, University Hospital Tübingen, Germany.
Radiother Oncol. 2013 Sep;108(3):397-402. doi: 10.1016/j.radonc.2013.06.004. Epub 2013 Jul 3.
Human papillomaviruses (HPV) are small oncogenic DNA viruses of which more than 200 types have been identified to date. A small subset of these is etiologically linked to the development of anogenital malignancies such as cervical cancer. In addition, recent studies established a causative relationship between these high-risk HPV types and tonsillar and oropharyngeal cancer. Clinical management of cervical cancer and head and neck squamous cell carcinomas (HNSCCs) is largely standardized and involves surgical removal of the tumor tissue as well as adjuvant chemoradiation therapy. Notably, the response to therapeutic intervention of HPV-positive HNSCCs has been found to be better as compared to HPV-negative tumors. Although the existing HPV vaccine is solely licensed for the prevention of cervical cancer, it might also have prophylactic potential for the development of high-risk HPV-associated HNSCCs. Another group of viruses, which belongs to the beta-HPV subgroup, has been implicated in nonmelanoma skin cancer, however, the etiology remains to be established. Treatment of HPV-induced nonmelanoma skin cancer is based on local excision. However, topically applied immune-modulating substances represent non-surgical alternatives for the management of smaller cutaneous tumors. In this review we present the current knowledge of the role of HPV in cancer development and discuss clinical management options as well as targets for the development of future intervention therapies.
人乳头瘤病毒(HPV)是小型致瘤性 DNA 病毒,迄今为止已鉴定出超过 200 种。其中一小部分与肛门生殖器恶性肿瘤的发展有关,如宫颈癌。此外,最近的研究确立了这些高危 HPV 类型与扁桃体和口咽癌之间的因果关系。宫颈癌和头颈部鳞状细胞癌(HNSCC)的临床治疗在很大程度上是标准化的,包括肿瘤组织的手术切除以及辅助放化疗。值得注意的是,与 HPV 阴性肿瘤相比,HPV 阳性 HNSCC 的治疗反应更好。尽管现有的 HPV 疫苗仅被许可用于预防宫颈癌,但它也可能对高危 HPV 相关 HNSCC 的发展具有预防潜力。另一组属于β-HPV 亚组的病毒与非黑色素瘤皮肤癌有关,但病因仍有待确定。HPV 诱导的非黑色素瘤皮肤癌的治疗基于局部切除。然而,局部应用免疫调节物质是管理较小皮肤肿瘤的非手术替代方法。在这篇综述中,我们介绍了 HPV 在癌症发展中的作用的现有知识,并讨论了临床管理选择以及未来干预治疗的开发目标。