关于HPV
<P class=MsoNormal style="MARGIN: 0cm 0cm 0pt; TEXT-INDENT: 28pt; LINE-HEIGHT: 150%; mso-char-indent-count: 2.0"><SPAN style="FONT-SIZE: 14pt; LINE-HEIGHT: 150%; FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'">人乳头瘤病毒（</SPAN><SPAN lang=EN-US style="FONT-SIZE: 14pt; LINE-HEIGHT: 150%"><FONT face="Times New Roman">HPV</FONT></SPAN><SPAN style="FONT-SIZE: 14pt; LINE-HEIGHT: 150%; FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'">）是一类在自然界中广泛存在的，具有和宿主特异性，可致人类皮肤粘膜异常增生，引起宿主组织病变及乳头状瘤的</SPAN><SPAN lang=EN-US style="FONT-SIZE: 14pt; LINE-HEIGHT: 150%"><FONT face="Times New Roman">DNA</FONT></SPAN><SPAN style="FONT-SIZE: 14pt; LINE-HEIGHT: 150%; FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'">病毒，其病毒颗粒由核酸和衣壳蛋白组成，病毒是一闭环，双连</SPAN><SPAN lang=EN-US style="FONT-SIZE: 14pt; LINE-HEIGHT: 150%"><FONT face="Times New Roman">DNA</FONT></SPAN><SPAN style="FONT-SIZE: 14pt; LINE-HEIGHT: 150%; FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'">。（</SPAN><SPAN style="FONT-SIZE: 14pt; COLOR: black; LINE-HEIGHT: 150%; FONT-FAMILY: 宋体; mso-hansi-font-family: 'Times New Roman'">正常人群（</SPAN><SPAN lang=EN-US style="FONT-SIZE: 14pt; COLOR: black; LINE-HEIGHT: 150%"><FONT face="Times New Roman">HPV</FONT></SPAN><SPAN style="FONT-SIZE: 14pt; COLOR: black; LINE-HEIGHT: 150%; FONT-FAMILY: 宋体; mso-hansi-font-family: 'Times New Roman'">＋）</SPAN><SPAN lang=EN-US style="FONT-SIZE: 14pt; COLOR: black; LINE-HEIGHT: 150%"><FONT face="Times New Roman">4</FONT></SPAN><SPAN style="FONT-SIZE: 14pt; COLOR: black; LINE-HEIGHT: 150%; FONT-FAMILY: 宋体; mso-hansi-font-family: 'Times New Roman'">～</SPAN><SPAN lang=EN-US style="FONT-SIZE: 14pt; COLOR: black; LINE-HEIGHT: 150%"><FONT face="Times New Roman">31%</FONT></SPAN><SPAN style="FONT-SIZE: 14pt; COLOR: black; LINE-HEIGHT: 150%; FONT-FAMILY: 宋体; mso-ascii-font-family: 'Arial Unicode MS'; mso-hansi-font-family: 'Times New Roman'">；</SPAN><SPAN lang=EN-US style="FONT-SIZE: 14pt; COLOR: black; LINE-HEIGHT: 150%"><FONT face="Times New Roman">CIN</FONT></SPAN><SPAN style="FONT-SIZE: 14pt; COLOR: black; LINE-HEIGHT: 150%; FONT-FAMILY: 宋体; mso-hansi-font-family: 'Times New Roman'">Ⅰ</SPAN><SPAN style="FONT-SIZE: 14pt; COLOR: black; LINE-HEIGHT: 150%"><FONT face="Times New Roman"> </FONT></SPAN><SPAN style="FONT-SIZE: 14pt; COLOR: black; LINE-HEIGHT: 150%; FONT-FAMILY: 宋体; mso-hansi-font-family: 'Times New Roman'">（</SPAN><SPAN lang=EN-US style="FONT-SIZE: 14pt; COLOR: black; LINE-HEIGHT: 150%"><FONT face="Times New Roman">HPV</FONT></SPAN><SPAN style="FONT-SIZE: 14pt; COLOR: black; LINE-HEIGHT: 150%; FONT-FAMILY: 宋体; mso-hansi-font-family: 'Times New Roman'">＋）</SPAN><SPAN lang=EN-US style="FONT-SIZE: 14pt; COLOR: black; LINE-HEIGHT: 150%"><FONT face="Times New Roman">30%</FONT></SPAN><SPAN style="FONT-SIZE: 14pt; COLOR: black; LINE-HEIGHT: 150%; FONT-FAMILY: 宋体; mso-hansi-font-family: 'Times New Roman'">↑；</SPAN><SPAN lang=EN-US style="FONT-SIZE: 14pt; COLOR: black; LINE-HEIGHT: 150%"><FONT face="Times New Roman">CIN </FONT></SPAN><SPAN style="FONT-SIZE: 14pt; COLOR: black; LINE-HEIGHT: 150%; FONT-FAMILY: 宋体; mso-hansi-font-family: 'Times New Roman'">Ⅱ</SPAN><SPAN style="FONT-SIZE: 14pt; COLOR: black; LINE-HEIGHT: 150%"><FONT face="Times New Roman"> </FONT></SPAN><SPAN style="FONT-SIZE: 14pt; COLOR: black; LINE-HEIGHT: 150%; FONT-FAMILY: 宋体; mso-hansi-font-family: 'Times New Roman'">（</SPAN><SPAN lang=EN-US style="FONT-SIZE: 14pt; COLOR: black; LINE-HEIGHT: 150%"><FONT face="Times New Roman">HPV</FONT></SPAN><SPAN style="FONT-SIZE: 14pt; COLOR: black; LINE-HEIGHT: 150%; FONT-FAMILY: 宋体; mso-hansi-font-family: 'Times New Roman'">＋）</SPAN><SPAN lang=EN-US style="FONT-SIZE: 14pt; COLOR: black; LINE-HEIGHT: 150%"><FONT face="Times New Roman">55%</FONT></SPAN><SPAN style="FONT-SIZE: 14pt; COLOR: black; LINE-HEIGHT: 150%; FONT-FAMILY: 宋体; mso-hansi-font-family: 'Times New Roman'">↑；</SPAN><SPAN lang=EN-US style="FONT-SIZE: 14pt; COLOR: black; LINE-HEIGHT: 150%"><FONT face="Times New Roman">CIN </FONT></SPAN><SPAN style="FONT-SIZE: 14pt; COLOR: black; LINE-HEIGHT: 150%; FONT-FAMILY: 宋体; mso-hansi-font-family: 'Times New Roman'">Ⅲ</SPAN><SPAN style="FONT-SIZE: 14pt; COLOR: black; LINE-HEIGHT: 150%"><FONT face="Times New Roman"> </FONT></SPAN><SPAN style="FONT-SIZE: 14pt; COLOR: black; LINE-HEIGHT: 150%; FONT-FAMILY: 宋体; mso-hansi-font-family: 'Times New Roman'">（</SPAN><SPAN lang=EN-US style="FONT-SIZE: 14pt; COLOR: black; LINE-HEIGHT: 150%"><FONT face="Times New Roman">HPV</FONT></SPAN><SPAN style="FONT-SIZE: 14pt; COLOR: black; LINE-HEIGHT: 150%; FONT-FAMILY: 宋体; mso-hansi-font-family: 'Times New Roman'">＋）</SPAN><SPAN lang=EN-US style="FONT-SIZE: 14pt; COLOR: black; LINE-HEIGHT: 150%"><FONT face="Times New Roman"> 60%</FONT></SPAN><SPAN style="FONT-SIZE: 14pt; COLOR: black; LINE-HEIGHT: 150%; FONT-FAMILY: 宋体; mso-hansi-font-family: 'Times New Roman'">↑；宫颈癌（</SPAN><SPAN lang=EN-US style="FONT-SIZE: 14pt; COLOR: black; LINE-HEIGHT: 150%"><FONT face="Times New Roman">HPV</FONT></SPAN><SPAN style="FONT-SIZE: 14pt; COLOR: black; LINE-HEIGHT: 150%; FONT-FAMILY: 宋体; mso-hansi-font-family: 'Times New Roman'">＋）</SPAN><SPAN lang=EN-US style="FONT-SIZE: 14pt; COLOR: black; LINE-HEIGHT: 150%"><FONT face="Times New Roman">100%</FONT></SPAN><SPAN style="FONT-SIZE: 14pt; COLOR: black; LINE-HEIGHT: 150%; FONT-FAMILY: 宋体; mso-hansi-font-family: 'Times New Roman'">（浸润癌)</SPAN></P>0V7G/Y j9C'?%I hl6\<P class=MsoNormal style="MARGIN: 0cm 0cm 0pt; TEXT-INDENT: 28pt; LINE-HEIGHT: 150%; mso-char-indent-count: 2.0"><SPAN style="FONT-SIZE: 14pt; COLOR: black; LINE-HEIGHT: 150%; FONT-FAMILY: 宋体; mso-hansi-font-family: 'Times New Roman'"></SPAN><SPAN lang=EN-US style="FONT-SIZE: 14pt; LINE-HEIGHT: 150%; FONT-FAMILY: 宋体">HPV</SPAN><SPAN style="FONT-SIZE: 14pt; LINE-HEIGHT: 150%; FONT-FAMILY: 宋体">首先通过生殖道粘膜轻微破损处进入上皮的基底细胞，脱去外层衣壳蛋白后，病毒进入细胞核内，此后在细胞内以两种形式存在，<SPAN lang=EN-US><O:p></O:p></SPAN></SPAN></P>
<P class=MsoNormal style="MARGIN: 0cm 0cm 0pt 84pt; TEXT-INDENT: -21pt; LINE-HEIGHT: 150%; mso-list: l0 level4 lfo1; tab-stops: list 84.0pt"><SPAN lang=EN-US style="FONT-SIZE: 14pt; LINE-HEIGHT: 150%; FONT-FAMILY: 宋体; mso-bidi-font-family: 宋体"><SPAN style="mso-list: Ignore">⑴、<SPAN style="FONT: 7pt 'Times New Roman'"> </SPAN></SPAN></SPAN><SPAN style="FONT-SIZE: 14pt; LINE-HEIGHT: 150%; FONT-FAMILY: 宋体">与细胞染色体整合。</SPAN><SPAN lang=EN-US style="FONT-SIZE: 14pt; LINE-HEIGHT: 150%; FONT-FAMILY: 宋体; mso-bidi-font-family: 宋体"><SPAN style="mso-list: Ignore"><SPAN style="FONT: 7pt 'Times New Roman'"> </SPAN></SPAN></SPAN><SPAN style="FONT-SIZE: 14pt; LINE-HEIGHT: 150%; FONT-FAMILY: 宋体">游离于细胞染色体外.</SPAN><SPAN style="FONT-SIZE: 14pt; LINE-HEIGHT: 150%; FONT-FAMILY: 宋体">这两种形态决定了病变的性质，经研究证实，游离状态多见于生殖道湿疣和癌前病变中，而在癌细胞中多见于整合状态。在侵润性子宫颈癌中，则以游离和整合两种形式共存。高危型HPV-16和HPV-18是浸润性宫颈癌中最常见的两个亚型。</SPAN></P>d1p1~ x-ht%v7j
<P class=MsoNormal style="MARGIN: 0cm 0cm 0pt; TEXT-INDENT: 28pt; LINE-HEIGHT: 150%; mso-char-indent-count: 2.0; tab-stops: 333.0pt"><SPAN style="FONT-SIZE: 14pt; LINE-HEIGHT: 150%; FONT-FAMILY: 宋体">在基础与临床的大量研究中表明：<SPAN lang=EN-US>HPV</SPAN>—<SPAN lang=EN-US>16</SPAN>引发鳞癌，<SPAN lang=EN-US>HPV</SPAN>—<SPAN lang=EN-US>18</SPAN>诱发腺癌。其相对而言，绝大多数以<SPAN lang=EN-US>HPV</SPAN>—<SPAN lang=EN-US>16</SPAN>感染为多，故临床统计<SPAN lang=EN-US>95%</SPAN>左右的子宫颈癌为鳞癌、腺癌只占<SPAN lang=EN-US>5%</SPAN>左右，然而愈后则是<SPAN lang=EN-US>HPV</SPAN>—<SPAN lang=EN-US>18</SPAN>感染的腺癌较差，复发性在临床也是最为常见。</SPAN></P>)z [ l l} s
<P class=MsoNormal style="MARGIN: 0cm 0cm 0pt; TEXT-INDENT: 28pt; LINE-HEIGHT: 150%; mso-char-indent-count: 2.0; tab-stops: 333.0pt"><SPAN style="FONT-SIZE: 14pt; LINE-HEIGHT: 150%; FONT-FAMILY: 宋体">HPV长期持续感染存在并进展是造成宫颈癌的重要因素。预防HPV感染以成为了预防宫颈癌的一个重要因素。预防性HPV疫苗已于2006年6月8日经美国FDA批准上市。目前有两种，一种是默克公司生产的四价疫苗，一种是葛兰素史克公司生产的两价疫苗。不过对于疫苗的预防效果，仍需观察。</SPAN></P>
<P class=MsoNormal style="MARGIN: 0cm 0cm 0pt; TEXT-INDENT: 28pt; LINE-HEIGHT: 150%; mso-char-indent-count: 2.0; tab-stops: 333.0pt"><SPAN style="FONT-SIZE: 14pt; LINE-HEIGHT: 150%; FONT-FAMILY: 宋体">随着人们对HPV的认识上的深入，很自然的会提出诸如为什么感染，如何处理等问题。下面是几点意见供大家参考。1.强调HPV检测阳性只说明是一种感染，而不是一种疾病。感染是常见的，发展成癌的是少见的。2.仅仅是HPV阳性，无宫颈变化，无需治疗。3.90%以上的妇女都会自身清除HPV感染。4.HPV感染主要是经过性传播，但是也不除外其他途径。5.定期体检，发现HPV感染，动态观察，定期随访。</SPAN></P>
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[[i] 本帖最后由 shuang829 于 2008-11-21 15:36 编辑 [/i]]
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