Human papillomaviruses: are we ready to type?
Human papillomaviruses: are we ready to type?
复制标题
人乳头瘤病毒：我们准备好打字了吗？
DOI：
10.1128/cmr.2.2.166
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发表时间：
1989
影响因子：
36.8
通讯作者：
Fife,KH
中科院分区：
文献类型：
--
作者：
Roman,A;Fife,KH
确定临床标本（HPVs分型标本）中存在哪种人乳头瘤病毒（HPV）的问题正受到关注，因为HPV引起尖锐湿疣，并与从发育异常到浸润性生殖器癌的疾病连续体相关。癌前病变的形态学检查不足以确定哪些病变会进展，哪些不会。已经开发了一些主要基于脱氧核糖核酸杂交的研究工具。这些允许在生殖道刮片或活检中识别和分型HPV。一些HPV类型（例如，HPV-16和HPV-18）在高度发育不良和癌症中比其他类型（例如，HPV-6），并已被指定为宫颈癌的“高危”类型。因此，问题是HPV分型是否会通过提高检测高危患者的灵敏度或提供预后指标来改善患者管理。在这篇综述中，现有的分型方法从其灵敏度，特异性和易于应用于大规模筛查计划的角度进行了审查。生殖道癌的发生中涉及HPV的数据进行审查，因为是特定的HPV类型与特定的结果的关联。我们的结论是，目前还没有简单，廉价的HPV类型的检测方法，虽然这样的检测方法可能会在未来开发。对分型数据的分析表明，虽然HPV类型可以被指定为高风险和低风险，但这些指定不是绝对的，因此不应忽视低风险组。此外，在没有疾病迹象的个体中发现高风险类型使数据的解释变得复杂。没有足够的数据来表明是否存在给定的HPV类型的知识是一个更好的预后指标比细胞学或组织学结果。因此，在确定分型信息是否会增强目前用于决定治疗方案的方法以及是否值得广泛使用之前，需要进行更多的研究。
The issue of determining which human papillomavirus (HPV) is present in a clinical specimen (typing specimens for HPVs) is receiving attention because HPVs cause condyloma acuminata and are associated with the continuum of disease which ranges from dysplasia to invasive genital cancer. Morphological inspection of precancerous lesions is not sufficient to determine which lesions will progress and which will not. A number of research tools based primarily on deoxyribonucleic acid hybridization have been developed. These permit identification and typing of HPV in genital tract scrapings or biopsies. Some HPV types (e.g., HPV-16 and HPV-18) have been identified in high-grade dysplasias and carcinomas more commonly than other types (e.g., HPV-6) and have been designated "high risk" types for cervical cancer. Thus, the question arises whether HPV typing would improve patient management by providing increased sensitivity for detection of patients at risk or by providing a prognostic indicator. In this review, the available typing methods are reviewed from the standpoint of their sensitivity, specificity, and ease of application to large-scale screening programs. Data implicating HPVs in the genesis of genital tract cancers are reviewed, as is the association of specific HPV types with specific outcomes. We conclude that there is currently no simple, inexpensive assay for HPV types, although such assays may be developed in the future. Analysis of the typing data indicates that, while HPV types can be designated high risk and low risk, these designations are not absolute and thus the low-risk group should not be ignored. In addition, interpretation of the data is complicated by finding high-risk types in individuals with no indication of disease. Insufficient data exist to indicate whether knowledge of the presence of a given HPV type is a better prognostic indicator than cytological or histological results. Thus, more research is needed before it can be determined whether typing information will augment the method currently in use for deciding treatment regimen and whether it warrants widespread use.