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人乳头瘤病毒时代的宫颈癌:将分子机制转化为预防性公共卫生行动

Cervical Cancer in the Era of HPV: Translating Molecular Mechanisms into Preventive Public Health Action.

作者信息

Boldeanu Lidia, Assani Mohamed-Zakaria, Boldeanu Mihail Virgil, Siloși Isabela, Manolea Maria-Magdalena, Văduva Constantin-Cristian, Assani Alexandru-Dan, Dijmărescu Anda Lorena

机构信息

Department of Microbiology, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania.

Department of Immunology, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania.

出版信息

Int J Mol Sci. 2025 Aug 30;26(17):8463. doi: 10.3390/ijms26178463.

Abstract

Cervical cancer remains a significant public health challenge, disproportionately affecting women in low- and middle-income countries (LMICs). Persistent infection with high-risk types of human papillomavirus (HPV), particularly HPV16 and HPV18, is the central cause of cervical carcinogenesis, driven by the viral oncoproteins E6 and E7, which disrupt the host tumor suppressors p53 and retinoblastoma protein (pRb). Advances in molecular understanding have catalyzed effective primary and secondary prevention strategies. Prophylactic HPV vaccination, especially the nonavalent formulation, has demonstrated high efficacy in reducing HPV infections and cervical precancer. Concurrently, HPV deoxyribonucleic acid (DNA) testing, self-sampling, and screen-and-treat protocols are transforming screening paradigms, particularly in resource-limited settings. However, global disparities in vaccine access, screening coverage, and health infrastructure persist, impeding progress toward the World Health Organization's (WHO) 90-70-90 elimination targets. By synthesizing recent advances in virology, prevention strategies, and implementation innovations, such as therapeutic vaccines, artificial-intelligence (AI)-driven diagnostics, and mobile health solutions, this review sheds light on their potential to narrow these equity gaps.

摘要

宫颈癌仍然是一项重大的公共卫生挑战,对低收入和中等收入国家(LMICs)的女性影响尤为严重。高危型人乳头瘤病毒(HPV)的持续感染,尤其是HPV16和HPV18,是宫颈癌发生的主要原因,由病毒癌蛋白E6和E7驱动,它们会破坏宿主肿瘤抑制因子p53和视网膜母细胞瘤蛋白(pRb)。分子认识的进展催生了有效的一级和二级预防策略。预防性HPV疫苗接种,尤其是九价疫苗,已证明在减少HPV感染和宫颈癌前病变方面具有高效性。与此同时,HPV脱氧核糖核酸(DNA)检测、自我采样以及筛查与治疗方案正在改变筛查模式,尤其是在资源有限的环境中。然而,在疫苗可及性、筛查覆盖率和卫生基础设施方面的全球差距依然存在,阻碍了实现世界卫生组织(WHO)90-70-90消除目标的进程。通过综合病毒学、预防策略以及实施创新(如治疗性疫苗、人工智能(AI)驱动的诊断和移动健康解决方案)等方面的最新进展,本综述揭示了它们缩小这些公平差距的潜力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3b48/12429327/40ab53513bdf/ijms-26-08463-g001.jpg

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