Department of Urology, Ludwig-Maximilians-University of Munich, Munich, Germany.
Department of Urology, Hospital Memmingen, Memmingen, Germany.
Eur Urol Focus. 2019 Jan;5(1):42-45. doi: 10.1016/j.euf.2018.09.010. Epub 2018 Sep 24.
Penile cancer remains an aggressive disease with poor prognosis in advanced stages. Another specific problem of any rare disease is that the population is not aware of prevention strategies and higher chances for curation by early diagnosis. In penile carcinogenesis, two major pathways are known. Besides a non-human papilloma virus (HPV)-related pathway (mainly caused by phimosis and chronic inflammation), up to 50% of penile carcinomas are HPV-related (HPV high-risk types). Prophylactic HPV vaccination has proven its efficacy against cervical cancer; its B-cell-mediated immunity against HPV capsid proteins provides probably lifelong protection against specific HPV subtypes covered by the vaccine. Therefore, a consequent HPV vaccination program for children of both sexes might dramatically reduce the incidence of not only cervical cancer but also partially prevent penile cancer. However, for the treatment of already existing intracellular HPV infections, an antigen-specific T-cell immunity is necessary. Appropriate therapeutic HPV vaccines are under investigation. This article gives an overview about different levels of prevention of the HPV-related penile cancer.
阴茎癌在晚期仍然是一种预后不良的侵袭性疾病。任何罕见病的另一个具体问题是，人们不知道预防策略，也不知道通过早期诊断来提高治愈的可能性。在阴茎癌发生中，已知有两种主要途径。除了非人乳头瘤病毒（HPV）相关途径（主要由包茎和慢性炎症引起）外，高达 50%的阴茎癌与 HPV 相关（HPV 高危型）。预防性 HPV 疫苗已被证明对宫颈癌有效；其针对 HPV 衣壳蛋白的 B 细胞介导的免疫可能为针对疫苗涵盖的特定 HPV 亚型提供终生保护。因此，对男女儿童进行持续的 HPV 疫苗接种计划可能会显著降低宫颈癌的发病率，同时也能部分预防阴茎癌。然而，对于已经存在的细胞内 HPV 感染，需要抗原特异性 T 细胞免疫。正在研究适当的治疗性 HPV 疫苗。本文概述了 HPV 相关阴茎癌的不同预防水平。
