Papastamelos Christine, Linder Mitchell
University of Rochester Medical Center, Internal Medicine, Rochester, NY, USA.
University of Rochester Medical Center, Obstetrics and Gynecology, Rochester, NY, USA.
Arch Gynecol Obstet. 2023 Apr;307(4):1277-1283. doi: 10.1007/s00404-022-06577-2. Epub 2022 Apr 27.
To provide a narrative review of anogenital screening for human papillomavirus in solid organ transplant recipients.
Keyword searches of PubMed and Ovid MEDLINE databases were performed. Keywords included human papillomavirus, malignancy, cervical cancer, Pap smear, solid organ transplant, and immunosuppression. Manual searches were also conducted of other relevant journals and reference lists of primary articles.
Forty-one studies, articles, or clinical practice guidelines across 25 years of literature were included. Eligible literature was written in English or offered an English translation.
Human papillomavirus-related anogenital malignancies disproportionately affect transplant recipients compared to the general population. Evidence-based guidelines for cervical cancer screening and prevention in transplant patients are lacking. Current practice guidelines generally agree on increased Pap screening for transplant recipients compared to the general population. However, recommended screening frequency differs between organizations and amongst medical specialties. Vaccination against HPV remains the most effective strategy to prevent HPV-driven pre-malignant and malignant lesions.
对实体器官移植受者的肛门生殖器人乳头瘤病毒筛查进行叙述性综述。
对PubMed和Ovid MEDLINE数据库进行关键词检索。关键词包括人乳头瘤病毒、恶性肿瘤、宫颈癌、巴氏涂片、实体器官移植和免疫抑制。还对其他相关期刊和主要文章的参考文献列表进行了手工检索。
纳入了25年文献中的41项研究、文章或临床实践指南。符合条件的文献以英文撰写或提供了英文翻译。
与普通人群相比，人乳头瘤病毒相关的肛门生殖器恶性肿瘤对移植受者的影响尤为严重。缺乏针对移植患者宫颈癌筛查和预防的循证指南。目前的实践指南普遍认为，与普通人群相比，移植受者应增加巴氏涂片筛查。然而，不同组织和医学专科之间推荐的筛查频率有所不同。接种人乳头瘤病毒疫苗仍然是预防人乳头瘤病毒驱动的癌前病变和恶性病变的最有效策略。
