Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo Bunkyo-ku, Tokyo, 113-8655, Japan.
Laboratory of Human Single Cell Immunology, World Premier International Immunology Frontier Research Center (WPI-IFReC), Osaka University, 3-1 Yamadaoka, Suita, Osaka, 565-0871, Japan.
Int J Clin Oncol. 2023 Aug;28(8):965-974. doi: 10.1007/s10147-023-02337-7. Epub 2023 Jun 9.
Approximately 95% of cervical cancer are caused by human papillomavirus (HPV) infection. Although it is estimated that HPV-associated cervical cancer will decrease with the widespread use of HPV vaccine, it may take time for HPV-associated cervical cancer to be eliminated. For the appropriate management of HPV-associated cervical cancer, it is important to understand the detailed mechanisms of cervical cancer development. First, the cellular origin of most cervical cancers is thought to be cells in the squamocolumnar junction (SCJ) of the uterine cervix. Therefore, it is important to understand the characteristics of SCJ for cervical cancer screening and treatment. Second, cervical cancer is caused by high risk HPV (HR-HPV) infection, however, the manner of progression to cervical cancer differs depending on the type of HR-HPV: HPV16 is characterized by a stepwise carcinogenesis, HPV18 is difficult to detect in precancerous lesions, and HPV52, 58 tends to remain in the state of cervical intraepithelial neoplasia (CIN). Third, in addition to the type of HPV, the involvement of the human immune response is also important in the progression and regression of cervical cancer. In this review, we demonstrate the carcinogenesis mechanism of HPV-associated cervical cancer, management of CIN, and the current treatment of CIN and cervical cancer.
大约 95%的宫颈癌是由人乳头瘤病毒（HPV）感染引起的。尽管据估计，随着 HPV 疫苗的广泛使用，HPV 相关的宫颈癌将会减少，但 HPV 相关的宫颈癌可能需要一段时间才能被消除。为了对 HPV 相关的宫颈癌进行适当的管理，了解宫颈癌发展的详细机制非常重要。首先，大多数宫颈癌的细胞起源被认为是子宫颈的鳞柱状交界（SCJ）处的细胞。因此，了解 SCJ 的特点对于宫颈癌的筛查和治疗非常重要。其次，宫颈癌是由高危型 HPV（HR-HPV）感染引起的，但进展为宫颈癌的方式因 HR-HPV 的类型而异：HPV16 的特点是逐步致癌，HPV18 在癌前病变中难以检测到，而 HPV52、58 往往保持在宫颈上皮内瘤变（CIN）的状态。第三，除了 HPV 的类型外，人类免疫反应的参与也在宫颈癌的进展和消退中非常重要。在这篇综述中，我们展示了 HPV 相关宫颈癌的致癌机制、CIN 的管理以及 CIN 和宫颈癌的当前治疗方法。
