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Papillomvireninfektion und Tumorigenese

Papillomavirus infection and tumorigenesis

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coloproctology Aims and scope

Zusammenfassung

Analkarzinome treten in der Allgemeinbevölkerung selten auf. In bestimmten Risikogruppen, wie bei HIV-positiven (HIV: „human immunodeficiency virus“) Männern, die Sexualkontakt mit anderen Männern haben (MSM), ist ihr Anteil stark erhöht. Analkanal- und Zervixkarzinome sind sich aus biologischer Sicht sehr ähnlich. Beiden geht eine persistente Infektion mit humanen Papillomaviren (HPV) der Hochrisikogruppe voraus. HPV werden durch Geschlechtsverkehr übertragen. Sie sind weit verbreitet und werden meist erfolgreich durch das Immunsystem eliminiert. Erst die Persistenz einer Infektion mit HPV der Hochrisikogruppe kann durch eine Deregulation der infizierten Zellen maligne Veränderungen hervorrufen. Eine wichtige Rolle kommt den frühen Onkoproteinen E6 und E7 zu. Diese setzen die Tumorsuppressorproteine pRB und p53 außer Kraft, sodass dem unbegrenzten Wachstum der infizierten Zellen nichts mehr entgegensteht und es zur genomischen Instabilität kommt. Das Analkarzinom entsteht über Vorstufen, anale intraepitheliale Neoplasien oder hochgradige Läsionen des Plattenepithels. Diese können mittels Abstrichuntersuchung bzw. Anoskopie entdeckt und frühzeitig behandelt werden. Als primäre Prävention dient die HPV-Impfung.

Abstract

Anal carcinomas occur rarely in the general population. In certain risk groups, such as human immunodeficiency virus (HIV) positive men who have sexual contact with other men, the proportion is strongly increased. Anal canal carcinomas and cervical carcinomas are very similar from a biological point of view because in both high risk groups carcinomas are preceded by a persistent human papillomavirus (HPV) infection. The HPV infection is transmitted by sexual contact and infections are very common but in most cases successfully eliminated by the immune system. Persistence of an infection with HPV in high risk groups initiate malignant alterations due to deregulation of infected cells. The early oncoproteins E6 and E7 play an important role because they deactivate the tumor suppressor proteins pRB and p53 so that nothing stands in the way of unlimited growth of infected cells and leads to genomic instability. Anal cancer originates from precursors, anal intraepithelial neoplasms or high-grade lesions of squamous cells. These can be detected using anal swab examination or anoscopy and treated early. Primary prevention is by HPV inoculation.

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Authors and Affiliations

  1. Sektion Experimentelle Virologie, Institut für Medizinische Virologie, Elfriede-Aulhorn-Straße 6, 72076, Tübingen, Deutschland

    T. Kindermann &  T. Iftner

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  1. T. Kindermann
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  2. T. Iftner
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Correspondence to T. Iftner.

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Der Beitrag wurde erstpubliziert in Onkologe (2012) 18:660–665.

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Kindermann, T., Iftner, T. Papillomvireninfektion und Tumorigenese. coloproctology 35, 257–261 (2013). https://doi.org/10.1007/s00053-013-0377-x

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  • DOI: https://doi.org/10.1007/s00053-013-0377-x

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