Natural history of HPV and carcinogenesis of cervical cancer.

Kim, Young Tak

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Korean Journal of Obstetrics & Gynecology 2007;50(5):711-720.
Published online May 1, 2007.

Natural history of HPV and carcinogenesis of cervical cancer.

Department of Obstetrics and Gynecology, College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea. ytkim@amc.seoul.kr

Abstract

Human Papilloma Virus (HPV) infection is most important in the carcinogenesis of the cervical cancer. More than 100 types of HPV have been identified, among which 15 subtypes were revealed to be related with cervical cancers. Ninety percent of these high-risk HPV infections are removed naturally within 1-2 years, however, women with persistent infection have more than 100 times higher risk of developing cervical intraepithelial neoplasia, the precursor of cervical cancers. In high-risk HPV infection, the integration of viral DNA into host DNA results in the overexpression of E6 and E7 genes. The E6, E7 oncoproteins interfere with the function of tumor suppressor genes, p53 and pRb resulting in the abnormal cell proliferation. In order to diagnose HPV infections, Hybrid Capture IITM (Microplate System, Digene, USA) with FDA approval is most widely used, and the DNA chip method developed in Korea is expected to be useful for identification of subtypes in the future. HPV vaccines have been developed for the prevention of HPV infection. Recently, the quadrivalent HPV 6, 11 16, 18 vaccine of Merk and the bivalent HPV 16, 18 vaccine of GSK, are shown to be effective to prevent persistent HPV infection and cytologic abnormality. In order to improve the efficacy of HPV vaccines, it is necessary to set up national recommendations, regarding vaccine groups, the age of vaccination, tests before and after vaccination and the need for catch-up vaccine.

Key Words: Human papilloma virus, HPV, Cervical cancer, Carcinogenesis

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