Human Papillomavirus Type-Distribution in Vulvar and Vaginal Cancers and Their Associated Precursors
Human Papillomavirus Type-Distribution in Vulvar and Vaginal Cancers and Their Associated Precursors
复制标题
DOI：
10.1097/aog.0b013e31819bd6e0
复制
发表时间：
2009-04-01
影响因子：
7.2
通讯作者：
Pimenta, Jeanne M.
中科院分区：
文献类型：
--
作者：
Smith, Jennifer S.;Backes, Danielle M.;Pimenta, Jeanne M.
目的：外阴和阴道癌中人类乳头瘤病毒（HPV）患病率的数据有限。这些数据对于预测预防性HPV疫苗的潜在未来效果非常重要。我们的目的是对外阴和阴道浸润性癌、外阴上皮内瘤变（VIN）和阴道上皮内瘤变中的HPV型别分布进行系统回顾。资料来源：MEDLINE检索使用外阴/阴道癌、上皮内瘤变和HPV/人乳头瘤病毒进行，检索截止到2007年9月，没有指定的起始日期或语言限制。研究选择：共回顾了725篇摘要（564篇外阴，161篇阴道），其中67篇研究（56篇外阴，11篇阴道）符合使用聚合酶链反应（PCR）或混合捕获法检测HPV DNA的纳入标准，并且有1例以上的HPV数据可用。汇总、整合和结果：本综述共发现2790例外阴（1379例浸润性，1340例VIN2/3, 71例VIN1）和315例阴道病例（83例浸润性，166例阴道上皮内瘤变2/3,66例阴道上皮内瘤变1）。多数病例来自北美和欧洲（87.2%），少数病例来自亚洲（5.5%）和南美（7.3%）。人乳头瘤病毒在外阴癌、VIN2/3和VIN1中的患病率分别为40.1%、80.4%和77.5%。HPV在阴道癌、阴道上皮内瘤变（VAIN）2/3和VAIN1中的患病率相对较高，分别为65.5%、92.6%和98.5%。HPV16型在外阴（29.3%）和阴道（55.4%）癌中最常见，VIN2/3型（71.2%）和VAIN2/3型（65.8%）癌中最常见。结论：人乳头瘤病毒在阴道的感染率高于外阴，HPV16型在两种肿瘤中均占多数。尽管HPV疫苗对这些妇科癌症的潜在影响可能不如宫颈癌那样高，因为它们的原因更多样化，但为年轻女性接种HPV16/18疫苗可能有助于减少HPV相关病例的发生率。
OBJECTIVE: Data on human papillomavirus (HPV) prevalence in vulvar and vaginal cancers are limited. These data are important to predict the potential future effect of prophylactic HPV vaccines. Our aim was to conduct a systematic review of HPV type distribution in vulvar and vaginal invasive carcinomas, vulvar intraepithelial neoplasia (VIN), and vaginal intraepithelial neoplasia.DATA SOURCES: A MEDLINE search was conducted using the terms vulvar/vaginal cancer, intraepithelial neoplasia, and HPV/human papillomavirus through September 2007 with no specified start date or language restrictions.METHODS OF STUDY SELECTION: A total of 725 abstracts (564 vulvar, 161 vaginal) were reviewed, of which 67 studies (56 vulvar, 11 vaginal) met the inclusion criteria of using polymerase chain reaction (PCR) or hybrid capture assays for HPV DNA detection and having more than one case with HPV data available.TABULATION, INTEGRATION AND RESULTS: This review identified 2,790 vulvar (1,379 invasive, 1,340 VIN2/3, 71 VIN1) and 315 vaginal cases (83 invasive, 166 vaginal intraepithelial neoplasia 2/3, 66 vaginal intraepithelial neoplasia 1). Most cases were from North America and Europe (87.2%), with few from Asia (5.5%) and South America (7.3%). Human papillomavirus prevalence in vulvar cancer, VIN2/3, and VIN1 was 40.1%, 80.4%, and 77.5%, respectively. HPV prevalence in vaginal cancer, vaginal intraepithelial neoplasia (VAIN)2/3, and VAIN1 was relatively higher at 65.5%, 92.6%, and 98.5%, respectively. HPV16 was the most common type in vulvar (29.3%) and vaginal (55.4%) cancers, VIN2/3 (71.2%) and VAIN2/3 (65.8%).CONCLUSION: Human papillomavirus prevalence was higher among vaginal than vulvar cases, and HPV16 accounted for most HPV-positive cases for both cancers. Although the potential effect of HPV vaccines on these gynecologic cancers may not be as high as for cervical cancer due to their more diverse causes, vaccinating young women against HPV16/18 may help to reduce the incidence of HPV-related cases.