高危型人乳头瘤病毒阴性宫颈癌的研究进展

doi:10.12280/gjszjk.20220163

摘要/Abstract

摘要：

宫颈癌是女性生殖系统最常见的恶性肿瘤,持续性高危型人乳头瘤病毒（high-risk human papillomavirus,HR-HPV）感染是导致宫颈上皮内瘤变及癌变的必要因素。目前临床上针对宫颈癌的早期筛查方法有HPV检测、宫颈脱落细胞学和阴道镜检查。临床上多数宫颈癌患者HPV检测结果为HR-HPV阳性,但有不足1%的宫颈癌患者HPV检测结果为HR-HPV阴性。与HR-HPV阳性宫颈癌患者相比,多数HR-HPV阴性宫颈癌患者的预后较差。因此寻找HR-HPV阴性宫颈癌的发病机制、探索特异性生物标志物及新的治疗靶点成为目前最为迫切的问题。综述HR-HPV阴性宫颈癌的发病原因、临床特征及分子生物学研究,以期为HR-HPV阴性宫颈癌的诊疗提供新的临床思路及依据。

关键词: 宫颈肿瘤, 乳头状瘤病毒科, 发病机制, 临床特征, 分子生物学

Abstract:

Cervical cancer is the most common malignant tumor of female reproductive system, and the persistent infection of high-risk human papillomavirus (HR-HPV) is a necessary factor of cervical intraepithelial neoplasia and canceration. Currently, the early screening methods for cervical cancer include HPV testing, cervical exfoliation cytology and colposcopy. Clinically, most patients with cervical cancer are of HR-HPV positive, but less than 1% of cervical cancer patients are of HR-HPV negative. Compared with the HR-HPV positive cervical cancer patients, the HR-HPV negative cervical cancer patients have poor prognosis. Therefore, the most urgent issues are to find the pathogenesis of HR-HPV negative cervical cancer, and to explore the specific biomarkers and new therapeutic targets. In this paper, the pathogenesis, clinical characteristics and molecular biology research progress of HR-HPV negative cervical cancer are described, in order to provide new clinical ideas and basis for the diagnosis and treatment of HR-HPV negative cervical cancer.

Key words: Uterine cervical neoplasms, Papillomaviridae, Pathogenesis, Clinical characteristics, Molecular biology

李玉兰, 刘晓, 韩逢皎, 岳玲, 许飞雪. 高危型人乳头瘤病毒阴性宫颈癌的研究进展[J]. 国际生殖健康/计划生育, 2022, 41(4): 342-346.

LI Yu-lan, LIU Xiao, HAN Feng-jiao, YUE Ling, XU Fei-xue. Research Progress of High-Risk Human Papillomavirus Negative Cervical Cancer[J]. Journal of International Reproductive Health/Family Planning, 2022, 41(4): 342-346.

图/表 1

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分类	占宫颈腺癌比例	HR-HPV阴性率
普通型	75%	0%~20%
黏液型-肠型	8%	0%~17%
绒毛管型	3%~6%	0%
黏液型-印戒细胞型	罕见	0%
子宫内膜样型	罕见	100%
胃型	未知	100%
中肾管型	罕见	100%
透明细胞型	2%~7%	72%
浆液性	非常罕见	70%

分类	占宫颈腺癌比例	HR-HPV阴性率
普通型	75%	0%~20%
黏液型-肠型	8%	0%~17%
绒毛管型	3%~6%	0%
黏液型-印戒细胞型	罕见	0%
子宫内膜样型	罕见	100%
胃型	未知	100%
中肾管型	罕见	100%
透明细胞型	2%~7%	72%
浆液性	非常罕见	70%