Department of Gynecological oncology, The First Affiliated Hospital of Sun Yat-sen University, Zhongshan 2nd Road, Yuexiu, Guangzhou, Guangdong, China.
Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China.
Cancer Med. 2018 Oct;7(10):5217-5236. doi: 10.1002/cam4.1501. Epub 2018 Sep 14.
Cervical cancer is the third most common cancer in women worldwide, with concepts and knowledge about its prevention and treatment evolving rapidly. Human papillomavirus (HPV) has been identified as a major factor that leads to cervical cancer, although HPV infection alone cannot cause the disease. In fact, HPV-driven cancer is a small probability event because most infections are transient and could be cleared spontaneously by host immune system. With persistent HPV infection, decades are required for progression to cervical cancer. Therefore, this long time window provides golden opportunity for clinical intervention, and the fundament here is to elucidate the carcinogenic pattern and applicable targets during HPV-host interaction. In this review, we discuss the key factors that contribute to the persistence of HPV and cervical carcinogenesis, emerging new concepts and technologies for cancer interventions, and more urgently, how these concepts and technologies might lead to clinical precision medicine which could provide prediction, prevention, and early treatment for patients.
宫颈癌是全球女性中第三大常见癌症,其预防和治疗的概念和知识正在迅速发展。人乳头瘤病毒(HPV)已被确定为导致宫颈癌的主要因素,但 HPV 感染本身并不能导致该疾病。事实上,HPV 驱动的癌症是一个小概率事件,因为大多数感染是短暂的,并且可以被宿主免疫系统自发清除。在持续的 HPV 感染后,需要几十年的时间才能发展为宫颈癌。因此,这个长时间窗口为临床干预提供了黄金机会,而这里的基础是阐明 HPV-宿主相互作用过程中的致癌模式和适用靶点。在这篇综述中,我们讨论了导致 HPV 持续存在和宫颈癌发生的关键因素、癌症干预的新兴新概念和新技术,以及更紧迫的是,这些概念和技术如何可能导致临床精准医学,为患者提供预测、预防和早期治疗。