人乳头瘤病毒预防性疫苗及其策略展望

Prospectives for Human Papillomavirus,Prophylactic Vaccine and Vaccination Policy

宫颈癌是中国女性最常见的肿瘤之一。人乳头瘤病毒(HPV)感染是宫颈癌及其癌前病变的必要因子。HPV的病毒样颗粒(由HPV病毒基因组L1基因编码)可产生中和抗体,其结果是HPV病毒样颗粒的注射可有效地预防某个HPV型别的感染。由于HPV16和18两个型别在宫颈癌中具有较高的流行率,这两个型别的病毒样颗粒已被开发成为预防性疫苗。近年来,由两家主要的疫苗厂商生产的两种HPV预防性疫苗的临床结果表明,HPV预防性疫苗是安全的。同时,对于预防低等级的宫颈上皮内瘤变(宫颈癌早期)有效。正是基于对于疫苗应用的期望,一些发达国家正在考虑调整宫颈癌的控制策略。

Cervical cancer is a top leading cause of cancer deaths among Chinese women.Human papillomavirus infection is the essential factor in the development of nearly all cases of cervical cancer.The virus-like particle（VLP） derived from L1 gene coded by HPV genome induces the neutralization,as a result,the administration of VLP is effective against the infection of an HPV genotype.Since two HPV genotypes,i.e.,HPV16 and 18 are most prevalent in the cervical cancer,VLPs of both genotypes were developed as prophylactic vaccine for cervical cancer.So far,the clinical trial of HPV vaccines from two medical manufacturers showed safe,and more importantly,effective in the disease control of low grade cervical intraepithelial neoplasia,the pre-stage of cervical tumorgenesis.Based on the prospective effect from vaccination,the developed countries were in consideration for adjusting the control policy for cervical cancer.