除 16 型和 18 型以外的高危型人乳头瘤病毒在宫颈癌前病变中的重要性。

The Importance of High-Risk Human Papillomavirus Types Other Than 16 and 18 in Cervical Neoplasia.

机构信息

From the Department of Pathology, Anatomy and Laboratory Medicine, West Virginia University School of Medicine, Morgantown. Dr Pharaon is currently in the Department of Pathology, Allegheny Health Network, Allegheny General Hospital, Pittsburgh, Pennsylvania. Dr Ducatman is currently in the Department of Pathology, Beaumont Health and Oakland University William Beaumont School of Medicine, Royal Oak, Michigan.

出版信息

Arch Pathol Lab Med. 2018 Jun;142(6):693-695. doi: 10.5858/arpa.2017-0563-RA.

DOI:10.5858/arpa.2017-0563-RA

PMID:29848032

Abstract

CONTEXT

Types 16 and 18 are the most widely studied high-risk types of human papillomavirus (HPV). However, other high-risk HPV types (HPV non-16/18) also play a significant role in cervical neoplasia. Currently, screening and management algorithms separate out HPV 16/18 from all other HPV non-16/18 types. In addition, most of the previously vaccinated population has only been vaccinated for these high-risk types, so many women are still vulnerable to HPV non-16/18 infections.

OBJECTIVE

To review the prevalence and role of HPV non-16/18 neoplasia and to review current surveillance, management, and vaccination strategies in view of these findings.

DATA SOURCES

The study comprised a review of the literature.

CONCLUSIONS

Although HPV non-16/18 types are less frequently associated with cervical intraepithelial neoplasia and cancer, they are nonetheless a significant cause of disease. Further stratification of higher-risk HPV non-16/18 may be necessary to improve prevention and management, however, regional prevalence differences may make a unified approach difficult. As HPV 16/18 infections decrease owing to vaccination of at-risk women, the relative frequency of HPV non-16/18 will increase, although the latest vaccine covers several more high-risk types.

摘要

背景

16 型和 18 型是研究最多的人乳头瘤病毒（HPV）高危型。然而，其他高危型 HPV（HPV 非 16/18 型）在宫颈癌前病变中也起着重要作用。目前，筛查和管理算法将 HPV 16/18 与所有其他 HPV 非 16/18 型分开。此外，大多数以前接种过疫苗的人群仅接种了这些高危型疫苗，因此许多女性仍然容易感染 HPV 非 16/18 型。

目的

综述 HPV 非 16/18 型肿瘤的流行率和作用，并鉴于这些发现，审查当前的监测、管理和疫苗接种策略。

数据来源

本研究包括文献复习。

结论

尽管 HPV 非 16/18 型与宫颈上皮内瘤变和癌症的相关性较低，但它们仍是疾病的重要原因。可能需要对高危型 HPV 非 16/18 型进行进一步分层，以改善预防和管理，但区域流行率差异可能使采用统一方法变得困难。随着高危型 HPV 感染妇女疫苗接种的减少，HPV 非 16/18 型的相对频率将会增加，尽管最新的疫苗涵盖了更多的高危型。