子宫颈人乳头瘤病毒16/18型感染患者的临床管理策略变迁及辅助管理技术进展

Clinical Management Strategy Evolution and Advances in Adjunctive Management Techniques for Patients Infected with Human Papillomavirus 16/18

高危型人乳头瘤病毒(human papillomavirus,HPV)感染,是子宫颈癌发生的主要原因,超过70%的子宫颈癌是由HPV16、18引起。当前,我国宫颈癌筛查指南要求,HPV16/18型感染的妇女转诊阴道镜检查。然而,临床实践中存在诸多问题,比如不践行指南建议、阴道镜质控不过关、随访策略执行不满意等,使得部分高风险患者错失最佳治疗时机。本文比较了国内外指南的异同,阐述了近年来国内外指南中关于HPV16/18型感染患者临床管理方式的变化;重点分析对于HPV16/18型感染患者,采用风险评估的技术进行辅助管理的必要性。展望未来,对HPV16/18感染者的精准筛查和分流管理模式,将有助于防止大部分宫颈癌的发生,是宫颈癌防控的重要组成部分。

Cervical cancer is mainly caused by high-risk human papillomavirus(HPV),with over 70%of cases attributed to HPV16 and HPV18.Currently,the cervical cancer screening guidelines in China recommend colposcopy referrals for women infected with HPV16/18.However,clinical practice faces numerous issues,such as non-compliance with guideline recommendations,inadequate quality control of colposcopy,and unsatisfactory follow-up strategies,resulting in some high-risk patients missing the optimal treatment window.This article compares domestic and international guidelines,elaborates on recent changes in clinical management approaches for patients with HPV16/18 infections in these guidelines,and emphasizes the necessity of utilizing risk assessment techniques for the auxiliary management of HPV16/18-infected patients.Looking ahead,precise screening and triage management models for HPV16/18 HPV16/18-infected patients will help prevent most cervical cancers and become an essential component of cervical cancer prevention and control.