Hoste G, Vossaert K, Poppe W A J
Department of Obstetrics and Gynaecology, University Hospitals Leuven (Campus Gasthuisberg), Herestraat 49, 3000 Leuven, Belgium.
Obstet Gynecol Int. 2013;2013:610373. doi: 10.1155/2013/610373. Epub 2013 Jul 1.
Traditional population-based cervical screening programs, based on cytology, have successfully reduced the burden of cervical cancer. Nevertheless limitations remain and new screening methods are emerging. Despite vaccination against the 2 most oncogenic types (HPV 16/18), cervical cancer screening will have to continue as an essential public health strategy. As the acquisition of an HR-HPV infection is critical in the progression to (pre-)cancerous cervical lesions, recent research has focused on HR-HPV detection. The sensitivity of HPV testing in primary and secondary prevention outweighs that of cytology, at the cost of slightly lower specificity. Although most of the HR-HPV infections are cleared after conization, new evidence from numerous studies encourages the implementation of HR-HPV testing and genotyping to improve posttreatment surveillance. An HR-HPV test 6 months after conization is a promising useful clinical marker to detect persistence and prevent progression. This review highlights the clinical role of HPV testing in primary and secondary cervical cancer screening.
基于细胞学的传统人群宫颈筛查项目已成功减轻了宫颈癌负担。然而，局限性依然存在，新的筛查方法不断涌现。尽管已针对两种最具致癌性的HPV类型（HPV 16/18）进行了疫苗接种，但宫颈癌筛查仍须作为一项重要的公共卫生策略持续开展。由于高危型人乳头瘤病毒（HR-HPV）感染在宫颈（癌前）病变进展过程中至关重要，近期研究聚焦于HR-HPV检测。HPV检测在一级和二级预防中的敏感性超过了细胞学检查，代价是特异性略低。尽管大多数HR-HPV感染在锥切术后会被清除，但众多研究的新证据鼓励开展HR-HPV检测和基因分型以改善治疗后监测。锥切术后六个月进行HR-HPV检测是检测持续性感染和预防疾病进展的一种很有前景的有用临床指标。本综述强调了HPV检测在宫颈癌一级和二级筛查中的临床作用。
