Ramachandran Balaji
Department of Molecular OncologyCancer Institute (W.I.A.), Adyar, Chennai, India
Endocr Relat Cancer. 2017 Apr;24(4):R99-R108. doi: 10.1530/ERC-16-0571.
Repeated parity and usage of oral contraceptives have demonstrated an increased risk of cervical cancer (CC) in HPV-infected women. These lifestyle observations raise the likelihood that oestrogens and HPV infection might act synergistically to affect cancers of the cervix. studies have indicated the requirement of oestrogens and ERα in the development of atypical squamous metaplasia followed by cervical intraepithelial neoplasia (CIN) I, II and III. CIN II and III are precancerous cervical lesions that can progress over time to CC as an invasive carcinoma. Recently, there has been evidence suggesting that ERα signalling in the tumour epithelium is a preliminary requisite during cancer initiation that is subsequently lost during tumorigenic progression. Conversely, continued expression of stromal ERα gains control over tumour maintenance. This review summarises the current information on the association between oestrogens and HPV infection in contributing to CC and the possibility of SERMs as a therapeutic option.
多次生育和口服避孕药的使用已表明,人乳头瘤病毒(HPV)感染女性患宫颈癌(CC)的风险增加。这些生活方式方面的观察结果增加了雌激素与HPV感染可能协同作用影响宫颈癌的可能性。研究表明,雌激素和雌激素受体α(ERα)是不典型鳞状化生发展为宫颈上皮内瘤变(CIN)I、II和III的必要条件。CIN II和III是宫颈癌前病变,随着时间的推移可能发展为浸润性癌CC。最近,有证据表明,肿瘤上皮中的ERα信号传导是癌症发生过程中的一个初步必要条件,随后在致瘤进展过程中消失。相反,基质ERα的持续表达则控制着肿瘤的维持。本综述总结了目前关于雌激素与HPV感染在导致CC方面的关联信息,以及选择性雌激素受体调节剂(SERM)作为一种治疗选择的可能性。