Effect of human papillomavirus vaccines on vulvar, vaginal, and anal intraepithelial lesions and vulvar cancer
Effect of human papillomavirus vaccines on vulvar, vaginal, and anal intraepithelial lesions and vulvar cancer
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DOI：
10.1097/01.aog.0000245786.86267.80
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发表时间：
2006-12-01
影响因子：
7.2
通讯作者：
Kueppers, Volkmar
中科院分区：
文献类型：
--
作者：
Hampl, Monika;Sarajuuri, Heidi;Kueppers, Volkmar
目的：人乳头瘤病毒(HPV)是宫颈癌的重要病因，它与外阴癌、阴道癌、外阴(VIN)、阴道(VAIN)和肛门(AIN)上皮内瘤变有关。我们评估了HPV的患病率(及其类型)，以评估HPV疫苗在预防下生殖道疾病方面的可能效果。方法：本研究包括258例女性VIN、Vain、AIN和外阴癌样本。手术标本的诊断是根据已公布的组织形态标准进行的。结果：对210例宫颈上皮内瘤变标本(VIN2/3、VaIN2/3、AIN2/3)和48例外阴癌标本进行了HPV检测。人乳头瘤病毒DNA在VIN、VAIN、AIN和外阴癌样本中分别检测到92%、91%、89%和60%。高危型HPV16或18型在VIN2/3、VAIN2/3、AIN和外阴癌中分别为76%、%、81%和42%。HPV阳性样本的女性比HPV阴性样本的女性年轻(VIN2/3和外阴癌样本分别为46岁和51岁，而VIN2/3和外阴癌样本为61岁)。人类乳头瘤病毒阳性外阴癌在56岁以下女性中的发生率(77%)高于56岁及以上女性(41%)。结论：根据本研究获得的数据，广泛实施预防性HPV疫苗接种可以为降低宫颈癌风险做出重要贡献，还可以预防约一半年轻女性的外阴癌和约三分之二的下生殖道上皮内病变。
OBJECTIVE: Human papillomavirus (HPV) is a necessary cause for cervical cancer, and it has been associated with vulvar and vaginal cancer and vulvar (VIN) and vaginal (VaIN) and anal (AIN) intraepithelial neoplasia. We assessed the prevalence of HPV (and the types) to estimate the possible effect of a HPV vaccine on lower genital tract disease prevention.METHODS: Two hundred fifty-eight samples of VIN, VaIN, AIN, and vulvar cancer from 241 women were included in the study. The diagnosis of surgical samples was made using published histomorphologic criteria. The DNA was extracted for HPV detection and typed using polymerase chain reaction and sequencing.RESULTS: The analyses were performed on 210 intraepithelial neoplasia samples (VIN2/3, VaIN2/3, AIN2/3) and 48 vulvar carcinoma samples. Human papillomavirus DNA was detected in 92%, 91%, 89%, and 60% of the VIN, VaIN, AIN, and vulvar carcinoma samples, respectively. High-risk HPV types 16 or 18 were detected in 76%, 64%, 81%, and 42% of the VIN2/3, VaIN2/3, AIN, and vulvar carcinoma samples. Women with HPV-positive samples were younger than those with HPV-negative samples (46 years compared with 55 years and 51 years compared with 61 years, for the VIN2/3 and vulvar carcinoma samples, respectively). Human papillomavirus-positive vulvar carcinoma was more frequent in women aged younger than 56 years (77%), than in those aged 56 years or older (41%).CONCLUSION: Based on the data obtained in this study, widely-implemented prophylactic HPV vaccination could make an important contribution to the reduction of the risk for cervical cancer and could also prevent about half the vulvar carcinomas in younger women and about two thirds of the intraepithelial lesions in the lower genital tract.