Department of Pathology, HIMSR, Jamia Hamdard, New Delhi, India.
Department of Pathology, VMMC and Safdarjang Hospital, New Delhi, India.
Pathol Res Pract. 2024 Nov;263:155574. doi: 10.1016/j.prp.2024.155574. Epub 2024 Aug 31.
Human Papillomavirus (HPV) is a widespread infection associated with various cancers, including cervical, oropharyngeal, anal, and genital cancers. This infection contributes to 5 % of global cancer cases annually, affecting approximately 625,600 women and 69,400 men. Cervical cancer remains the most prevalent HPV-linked cancer among females, with the highest incidence seen in low and middle-income countries (LMICs). While most HPV infections are transient, factors such as HPV variants, age, gender, and socioeconomic status influence transmission risks. HPV is categorized into high-risk (HR-HPV) and low-risk types, with strains like HPV 16 and 18 displaying distinct demographic patterns. The intricate pathogenesis of HPV involves genetic and epigenetic interactions, with HPV oncogenes (E6 and E7) and integration into host DNA playing a pivotal role in driving malignancies. Early diagnostics, utilizing HPV DNA testing with surrogate markers such as p16, and advanced molecular techniques like PCR, liquid biopsy, and NGS, significantly impact the management of HPV-induced cancers. Effectively managing HPV-related cancers demands a multidisciplinary approach, including immunotherapy, integrating current therapies, ongoing trials, and evolving treatments. Prevention via HPV vaccination and the inclusion of cervical cancer screening in national immunization programs by conventional Pap smear examination and HPV DNA testing remains fundamental.Despite the preventability of HPV-related cancers, uncertainties persist in testing, vaccination, and treatment. This review article covers epidemiology, pathogenesis, diagnostics, management, prevention strategies, challenges, and future directions. Addressing issues like vaccine hesitancy, healthcare disparities, and advancing therapies requires collaboration among researchers, healthcare providers, policymakers, and the public. Advancements in understanding the disease's molecular basis and clinical progression are crucial for early detection, proper management, and improved outcomes.
人乳头瘤病毒（HPV）是一种广泛存在的感染，与多种癌症有关，包括宫颈癌、口咽癌、肛门癌和生殖器癌。这种感染每年导致全球约 5%的癌症病例，影响约 625600 名女性和 69400 名男性。宫颈癌仍然是女性中最常见的与 HPV 相关的癌症，发病率最高的是低收入和中等收入国家（LMICs）。虽然大多数 HPV 感染是短暂的，但 HPV 变体、年龄、性别和社会经济地位等因素会影响传播风险。HPV 分为高危型（HR-HPV）和低危型，HPV 16 和 18 等菌株显示出不同的人口统计学模式。HPV 的复杂发病机制涉及遗传和表观遗传相互作用，HPV 致癌基因（E6 和 E7）和整合到宿主 DNA 中在驱动恶性肿瘤中起着关键作用。早期诊断，利用 HPV DNA 测试和 p16 等替代标志物，以及先进的分子技术，如 PCR、液体活检和 NGS，对 HPV 引起的癌症的管理有重大影响。有效管理 HPV 相关癌症需要多学科方法，包括免疫疗法，整合当前疗法、正在进行的试验和不断发展的治疗方法。通过 HPV 疫苗接种和将宫颈癌筛查纳入国家免疫计划，包括传统巴氏涂片检查和 HPV DNA 测试，仍然是预防 HPV 相关癌症的基础。尽管 HPV 相关癌症是可以预防的，但在检测、疫苗接种和治疗方面仍存在不确定性。这篇综述文章涵盖了流行病学、发病机制、诊断、管理、预防策略、挑战和未来方向。解决疫苗犹豫、医疗保健差异和推进治疗等问题需要研究人员、医疗保健提供者、政策制定者和公众之间的合作。了解疾病的分子基础和临床进展的进展对于早期检测、适当管理和改善结果至关重要。
