Birley H D
Department of Medical Microbiology and Genitourinary Medicine, University of Liverpool, U.K.
Ann Trop Med Parasitol. 1995 Oct;89(5):453-63. doi: 10.1080/00034983.1995.11812977.
Carcinoma of the uterine cervix is the commonest cancer of women in the majority of developing countries; in developed countries it is much less common, as well as being less frequent than some other cancers, such as those of breast, lung and colon. The discovery of human papillomavirus (HPV) as an aetiological agent of cervical cancer (and of other anogenital malignancies) has prompted a great deal of interest in the biology and oncogenicity of this virus, including large-scale epidemiological surveys comparing the prevalence of HPV and other possible causative agents between areas of high and low incidence of cervical carcinoma. These studies have thrown up tantalizing clues concerning the virus' pathogenesis and disease associations. Sexual practices, parity, diet, smoking, other diseases (including sexually transmissible diseases) and immunogenetic characteristics may all play a contributory role in the development of cervical carcinoma. These factors may be independent of each other and of association with HPV infection. Immunization to prevent papillomavirus infection and thus cervical cancer is an attractive prospect. Although the potential in using such an approach has been demonstrated in several animal models, there are several major theoretical problems to solve before HPV vaccination becomes a practicality. Intervention to prevent exposure to other aetiological factors and to improve screening may be a more practicable strategy for reducing the burden of cervical cancer.
在大多数发展中国家，子宫颈癌是女性中最常见的癌症；在发达国家，它则要少见得多，而且比其他一些癌症（如乳腺癌、肺癌和结肠癌）的发病率也要低。人乳头瘤病毒（HPV）作为宫颈癌（以及其他肛门生殖器恶性肿瘤）的病因被发现后，引发了人们对该病毒生物学和致癌性的极大兴趣，包括大规模的流行病学调查，比较宫颈癌高发病率地区和低发病率地区HPV及其他可能致病因素的流行情况。这些研究揭示了有关该病毒发病机制和疾病关联的诱人线索。性行为、生育状况、饮食、吸烟、其他疾病（包括性传播疾病）以及免疫遗传特征都可能在子宫颈癌的发生发展中起到一定作用。这些因素可能彼此独立，也可能与HPV感染有关联。通过免疫接种预防乳头瘤病毒感染从而预防宫颈癌是一个诱人的前景。尽管在几种动物模型中已证明了这种方法的潜力，但在HPV疫苗接种成为现实之前，还有几个主要的理论问题需要解决。干预措施以防止接触其他致病因素并改进筛查可能是减轻宫颈癌负担的更可行策略。
