Laurent R
Service de dermatologie II, CHU Saint-Jacques, Besançon.
Rev Prat. 1996 Oct 15;46(16):1961-8.
The incidence of condyloma acuminata is increasing in all developed countries with highest rates recorded for young sexually males and females, between the ages of 16 and 25 years. Subclinical and latent genital human papillomavirus (HPV) infections are highly prevalent. Direct correlation between number of sexual partners and presence of HPV is evident. Clinical HPV infections such as condylomas (acuminata and papular) are easily recognized, but acetowhite flat macular condylomas require colposcopic examination. High grade IN (cervical CIN II, III, vulvar VIN, anal AIN, penile PIN) are considered to be related to HPV type 16 and 18 (less frequently other types 31, 33, 35, 51), the oncogenic potential of which was demonstrated by in vitro transformation assays and by the fact that they are detected in 50 to 90% of genital neoplasia. Clinical HPV infections (condylomas and low grade IN) are associated with "low risk" HPV types 6/11. The requirement for routine HPV-DNA typing is limited and in general, management is based on clinical and conventional light microscope evaluation. Immunosuppression is a most important risk-factor for the development, the progression and the recurrences of cervical and anal condylomas and neoplasia. Whatever treatment is applied a 30% recurrences rates occur, implying a regular clinical follow up after treatment to prevent recurrences development and neoplasia.
在所有发达国家，尖锐湿疣的发病率都在上升，16至25岁的年轻性活跃男性和女性发病率最高。亚临床和潜伏性生殖器人乳头瘤病毒（HPV）感染非常普遍。性伴侣数量与HPV感染之间存在明显的直接关联。临床HPV感染，如尖锐湿疣（尖锐型和丘疹型）很容易识别，但醋酸白扁平斑状湿疣需要进行阴道镜检查。高级别上皮内瘤变（宫颈CIN II、III，外阴VIN，肛门AIN，阴茎PIN）被认为与HPV 16和18型有关（较少见其他类型如31、33、35、51型），体外转化试验以及它们在50%至90%的生殖器肿瘤中被检测到这一事实证明了其致癌潜力。临床HPV感染（尖锐湿疣和低级别上皮内瘤变）与“低风险”HPV 6/11型有关。常规HPV-DNA分型的需求有限，一般来说，治疗是基于临床和传统光学显微镜评估。免疫抑制是宫颈和肛门尖锐湿疣及肿瘤发生、进展和复发的最重要危险因素。无论采用何种治疗方法，复发率都为30%，这意味着治疗后需要定期临床随访以预防复发和肿瘤形成。
