編譯：腫瘤資訊
Maura L Gillison教授
MD Anderson Cancer Center
HPV感染同宮頸癌、肛管鱗癌、口咽癌等多種腫瘤發展有關。目前，HPV陽性口咽癌是美國發生率增長最快的腫瘤。
一級預防：HPV疫苗接種，預防HPV感染。
Gillison教授的研究團隊通過一項納入2627位美國青年人（接受至少1次HPV疫苗接種）的橫斷面調查，表明HPV疫苗接種確實能夠降低口腔HPV感染。進而，如果讓更多的人接種疫苗從而從中獲益變得至為重要。
二級預防：發現高危人群
通過多個數據庫合併分析，Gillision教授等建立了口咽癌發病風險模型。由此，口咽癌高危人群可被識別，進而可對他們進行二級預防。
三級預防：發現口咽癌中預後不良人群。
HPV陽性口咽癌患者預後顯著好於HPV陰性患者。在陽性患者中，HPV持續感染患者預後明顯差於HPV轉陰患者。
Oral HPV DNA Detection and Primary, Secondary and Tertiary Prevention
Maura L Gillison
MD Anderson Cancer Center
Human papilloma virus is associated with carcinoma of cervix, anus, oropharynx, oral cavity, and so on. Currently, HPV-positive oropharyngeal cancer is the most rapidly rising cancer among US men.
Primary Prevention
In order to evaluate the impact of HPV vaccination on oral HPV infections among young adults in the US, Maura et al. did a cross-sectional study including 2,627 men and women aged 18-33 years with self-reported HPV vaccination receipt > 1 dose. The results showed that HPV vaccines may prevent oral HPV infections that lead to cancer in men. Methods to improve vaccine uptake are warranted.
Secondary Prevention
Identifying individuals at high-risk of oropharyngeal cancer is of vital importance. Using database of Ohio State University case-series, National Health and Nutrition Examination Survey and SEER, an individualized 1-year absolute risk model for oropharyngeal cancer was developed. Individuals at high-risk of oropharyngeal cancer can be identified and therefore secondary prevention is possible.
Tertiary Prevention
HPV DNA is a biomarker for cancer persistence and progression. Patients with HPV positive at diagnosis had better 2-year overall survival than patients without HPV infections. In patients with HPV positive, those with persistence HPV infections had poorer survival than patients with HPV cleared after treatment.
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