Department of Applied Tumor Biology, Institute of Pathology, University of Heidelberg, and Clinical Cooperation Unit Applied Tumor Biology, German Cancer Research Center (DKFZ), Heidelberg, Germany.
Department of Applied Tumor Biology, Institute of Pathology, University of Heidelberg, and Clinical Cooperation Unit Applied Tumor Biology, German Cancer Research Center (DKFZ), Heidelberg, Germany.
Mutat Res Rev Mutat Res. 2017 Apr-Jun;772:51-66. doi: 10.1016/j.mrrev.2016.06.005. Epub 2016 Jun 22.
Human papillomaviruses (HPV) are widespread DNA viruses that can infect epithelial cells of the skin and mucosa. Most HPV infections remain clinically unapparent and clear spontaneously. In few cases, however, HPV infections persist and can cause benign and malignant neoplasms at different anatomic locations. Malignant HPV-induced neoplasms are caused by distinct types of HPV (oncogenic or high-risk (HR) HPV types) and present in the anogenital (anus, penis, uterine cervix, vagina and vulva) and head and neck (particularly oropharynx) region. In the anogenital region defined precancerous stages precede invasive cancer. In the head and neck region there is clear evidence only for the invasive stage of HPV-induced neoplasia. In early infection stages the HPV oncogenes (E6/E7) are under tight control in the basal and parabasal cell layers. In more advanced precancerous stages increased expression of the HPV oncogenes E6 and E7 occurs (transforming infection) that may result in transformation of these cells. The defined carcinogenesis in the anogenital tract enables cancer early detection, particularly at the uterine cervix where cytologic and molecular tests contribute to early diagnosis and treatment at a non-invasive stage. Up to now, the treatment of HPV-related precancerous stages (high-grade intraepithelial neoplasia) and cancer is not specifically targeting molecular characteristics of the virus. This article reviews the current state and new developments in epidemiology, prevention, diagnosis and treatment of HPV-associated neoplasia in various anatomic locations.
人乳头瘤病毒（HPV）是广泛存在的 DNA 病毒，可感染皮肤和黏膜的上皮细胞。大多数 HPV 感染在临床上无明显表现，并可自行清除。然而，在少数情况下，HPV 感染持续存在，并可导致不同解剖部位的良性和恶性肿瘤。恶性 HPV 诱导的肿瘤由特定类型的 HPV（致癌或高危（HR）HPV 类型）引起，存在于肛门生殖器（肛门、阴茎、子宫颈、阴道和外阴）和头颈部（特别是口咽）区域。在肛门生殖器区域，定义了癌前阶段，然后是浸润性癌症。在头颈部区域，仅明确存在 HPV 诱导的肿瘤的侵袭性阶段。在早期感染阶段，HPV 癌基因（E6/E7）在基底和副基底细胞层受到严格控制。在更高级的癌前阶段，HPV 癌基因 E6 和 E7 的表达增加（转化感染），这可能导致这些细胞的转化。在肛门生殖道的明确致癌作用使癌症能够早期发现，特别是在子宫颈，细胞学和分子检测有助于在非侵袭性阶段进行早期诊断和治疗。到目前为止，针对 HPV 相关癌前阶段（高级别上皮内瘤变）和癌症的治疗并未特异性针对病毒的分子特征。本文综述了不同解剖部位与 HPV 相关肿瘤的流行病学、预防、诊断和治疗的现状和新进展。
