Advances in cervical high-risk human papillomavirus infection diagnose and treatment
宫颈高危型乳头瘤病毒感染诊断及治疗最新研究进展

摘要

人乳头瘤病毒（human papillomavirus，HPV）是一种具有特殊的嗜上皮性的微小无包膜环状双链 DNA 病毒，是女性较为多发的性传播疾病之一。目前已发现200多种不同的HPV基因型，大部分HPV感染没有明显临床症状。可将其分为高危型（high-risk human papillomavirus，HR-HPV）与低危型(low-risk huamn papillomavirus, LR-HPV)，低危型如HPV11与HPV6等，主要与尖锐湿疣发生密切相关，高危型如 HPV18、HPV16、HPV52等。持续性高危型HPV感染和宫颈上皮内瘤变与宫颈癌的进展密切相关，宫颈恶性肿瘤是目前唯一可预防、病因明确的肿瘤。预防性HPV疫苗已广泛用于临床，HPV治疗性疫苗目前正处于临床试验阶段[1]。现阶段，治疗宫颈高危型HPV感染的方法较多，主要分为物理、药物治疗与手术治疗、HPV疫苗干预等。由于HPV具有复杂免疫逃逸机制，传统治疗方法存在治疗周期长、复发率高、多次手术、宫颈机能不全及流产等，目前尚缺乏切实有效治疗方法。本研究就近年来宫颈高危型HPV病毒感染的机制及治疗现状与进展进行综述。

Abstract

Human papillomavirus (HPV) is a small, non-enveloped, circular double-stranded DNA virus with a unique predilection for epithelial tissues. It is one of the most common sexually transmitted diseases among women. To date, more than 200 different HPV genotypes have been identified, with most HPV infections being clinically asymptomatic. HPV can be classified into high-risk (HR-HPV) and low-risk (LR-HPV) types. The low-risk group, which includes HPV11 and HPV6, is primarily associated with the development of genital warts, while the high-risk group, such as HPV18 and HPV16, is strongly linked to the development of cervical cancer. Persistent infection with HR-HPV is closely associated with the progression of cervical intraepithelial neoplasia and cervical cancer, making cervical malignancy the only preventable and causally linked tumor. Prophylactic HPV vaccines have been widely used in clinical practice, while therapeutic HPV vaccines are currently in the clinical trial phase [1]. Currently, there are multiple methods available for treating HR-HPV infection of the cervix, including physical, pharmacological, and surgical interventions, as well as HPV vaccine interventions. Due to the immune evasion capability of HPV, traditional treatment approaches suffer from drawbacks such as long treatment periods, high recurrence rates, multiple surgeries, cervical dysfunction, and miscarriages. Thus, there is currently a lack of practical and effective treatment methods. This review provides an overview of the mechanisms underlying high-risk HPV infection of the cervix, as well as the current status and advancements in treatment approaches in recent years