Skip to main content
SpringerLink
Log in

Das humane Papillomavirus (HPV) in der Gynäkoonkologie

Human papillomavirus (HPV) in gynecology

  • Leitthema
  • Published:
Der Gynäkologe Aims and scope

Zusammenfassung

Erkenntnisse zum Stellenwert der humanen Papillomaviren (HPV) in der Pathogenese des Zervixkarzinoms und anderer Genitalkarzinome hat in den letzten Jahren zu einem Umdenken in der Prävention geführt. Neben dem seit 1971 bestehenden jährlichen Krebsvorsorgeabstrich konnte eine wirksame Impfung gegen HPV entwickelt werden. Diese Prävention richtet sich an prä- und pubertäre Mädchen vor dem ersten Geschlechtsverkehr. Erste Studienergebnisse sind positiv, Langzeitergebnisse werden erwartet. Die zweite Säule der Prävention ist die regelmäßige Krebsvorsorge durch den zytologischen Abstrich und ggf. ergänzender Kolposkopie. Leider wird diese Vorsorge bislang nur von der Minderheit der Patientinnen in Deutschland wahrgenommen. Es stellt sich daher die Frage, ob in der Zukunft die Impfprävention diese Lücke schließen und somit zu einer Reduktion der Inzidenz an Zervixkarzinomen und anderen genitalen Karzinomen führen kann.

Abstract

Knowledge concerning the human papillomavirus in the development of cervical cancer and other genital cancers has led to a rethinking and therefore renewal of primary prevention. In addition to the annually offered cytological check for preventing cervical cancer, a vaccination has also been developed which targets adolescent girls. Current results of clinical trials are positive but long-term follow-up results are still awaited. The second pillar of the prevention of cervical cancer is the annual cytological check up. Unfortunately, only the minority of women in Germany undergo this check. Therefore it remains questionable whether the new vaccination strategy is able to close this gap and reduce the incidence of cervical cancer.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Abb. 1
Abb. 2
Abb. 3

Literatur

  1. Syrjanen KJ, Syrjanen SM (1985) Human papilloma virus (HPV) infections related to cervical intraepithelial neoplasia (CIN) and squamous cell carcinoma of the uterine cervix. Ann Clin Res 17(2):45–56

    PubMed  CAS  Google Scholar 

  2. Chang AR et al (1986) A comparison of the ages of patients with cervical smears showing human papilloma virus, dysplasia and carcinoma in situ changes. N Z Med J 99(798):205–206

    PubMed  CAS  Google Scholar 

  3. Schneider A, Durst M, Kaufmann AM (2001) HPV infection and cervical carcinoma – epidemiology, detection and immunology. Zentralbl Gynakol 123(4):179–185

    Article  PubMed  CAS  Google Scholar 

  4. Weltgesundsheitsorganisation (WHO) (2005) Report der Beratung über Humane Papillomvirus Impfstoffe. Genf

  5. http://www.ago-online.de/_download/unprotected/zervix_epidemiologie_europa.pdf

  6. Gesellschaft der epidemiologischen Krebsregister in Deutschland e. V., das Robert-Koch-Institut (RKI) (Hrsg) (2006) Krebs in Deutschland, 5. überarbeitete aktualisierte Ausgabe. Saarbrücken

  7. Arbeitsgemeinschaft Bevölkerungsbezogener Krebsregister in Deutschland in Zusammenarbeit mit dem Robert-Koch-Institut (2002) Krebs in Deutschland – Häufigkeiten und Trends

  8. Cooper K et al (1993) p53 antigen in cervical condylomata, intraepithelial neoplasia, and carcinoma: relationship to HPV infection and integration. J Pathol 171(1):27–34

    Article  PubMed  CAS  Google Scholar 

  9. Munoz N, Bosch FX, Sanjose S de et al (2003) Epidemiologic classification of human papillomavirus types associated with cervical cancer. N Engl J Med 348 (6):518–527

    Article  PubMed  Google Scholar 

  10. Jones RW, Baranayai J, Stables S (1997) Trends in squamous cell carcinoma of the vulva: the influence of vulvar intraepithelial neoplasia. Obstet Gynecol 90:448–452

    Article  PubMed  CAS  Google Scholar 

  11. Carter JJ, Koutsky LA, Wipf GC et al (1996) The natural history of human papillomavirus type 16 capsid antibodies among a cohort of university women. J Infect Dis 174 (5):927–936

    Article  PubMed  CAS  Google Scholar 

  12. Hampl M, Sarajuuri H, Wentzensen N et al (2006) Effect of human papillomavirus vaccines on vulvar, vaginal, and anal intraepithelial lesions and vulvar cancer. Obstet Gynecol 108(6):1361–1368

    Article  PubMed  CAS  Google Scholar 

  13. AWMF-S3-Leitlinie Impfprävention HPV-assoziierter Neoplasien (Stand 6/2008)

  14. Saghravanian N et al (2011) Low prevalence of high risk genotypes of human papilloma virus in normal oral mucosa, oral leukoplakia and verrucous carcinoma. Acta Odontol Scand 69(6):406–409

    Article  PubMed  Google Scholar 

  15. Finan RR et al (2001) Detection of human papillomavirus (HPV) genotypes in cervico-vaginal scrapes of women with normal and abnormal cytology. Clin Microbiol Infect 7(12):688–692

    Article  PubMed  CAS  Google Scholar 

  16. Zielinski GD et al (2003) The presence of high-risk HPV combined with specific p53 and p16INK4a expression patterns points to high-risk HPV as the main causative agent for adenocarcinoma in situ and adenocarcinoma of the cervix. J Pathol 201(4):535–543

    Article  PubMed  CAS  Google Scholar 

  17. Kucera E et al (2000) p53 polymorphism at codon 72 – does it constitute a risk for squamous intraepithelial lesions and invasive cancer of the cervix in Central Europeans? Wien Klin Wochenschr 112(18):817–820

    PubMed  CAS  Google Scholar 

  18. Poljak M et al (2002) Hybrid Capture II HPV Test detects at least 15 human papillomavirus genotypes not included in its current high-risk probe cocktail. J Clin Virol 25(Suppl 3):89–97

    Article  Google Scholar 

  19. Salimovic-Besic I (2007) Evaluation of hybrid capture 2 HPV DNA test and two variants of polymerase chain reaction (PCR-PGMY11/PGMY09 and PCR-CPI/CPIIG) according to HPV types. Med Arh 61(3):135–137

    PubMed  Google Scholar 

  20. Schneider A, Koutsky LA (1992) Natural history and epidemiological features of genital HPV infection. IARC Sci Publ (119):25–52

    Google Scholar 

  21. Wright TC et al (2012) The ATHENA human papillomavirus study: design, methods, and baseline results. Am J Obstet Gynecol 206(1):46 e1–46 e11

    Article  PubMed  Google Scholar 

  22. Stoler MH et al (2012) The Interplay of age stratification and HPV testing on the predictive value of ASC-US cytology: results from the ATHENA HPV study. Am J Clin Pathol 137(2):295–303

    Article  PubMed  Google Scholar 

  23. DGGG-Leitlinie Diagnostik und Therapie des Zervixkarzinoms (Stand 8/2008)

  24. Michels KB, Hausen H zur (2009) HPV vaccine for all. Lancet 374(9686):268–270

    Article  PubMed  Google Scholar 

  25. Hausen H zur (1986) Will there soon be better weapons against cancer? An interview with Professor zur Hausen, director of the Germany Cancer Research Center. Fortschr Med 104(46):56–57

    PubMed  Google Scholar 

  26. Launay O (2008) Papillomavirus and cervical carcinoma. Med Sci 24(11):981–982

    Google Scholar 

  27. Howard M, Lytwyn A (2007) The HPV vaccine: an analysis of the FUTURE II study. Can Fam Physician 53(12):2157–2159

    PubMed  Google Scholar 

  28. Garland SM, Hernandez-Avila M, Wheeler CM et al (2007) Quadrivalent vaccine against humanpapillomavirus to prevent anogenital diseases. N Engl J Med 356:1928–1943

    Article  PubMed  CAS  Google Scholar 

  29. FUTURE II Study Group (2007) Quadrivalent vaccine against human papillomavirus to prevent high-grade cervical lesions. N Engl J Med 356:1915–1927

    Article  Google Scholar 

  30. Harper DM, Franco EL, Wheeler C et al (2004) Efficacy of a bivalent L1 virus-like particle vaccine in prevention of infection with human papillomavirus types 16 and 18 in young women: a randomised controlled trial. Lancet 364:1757–1765

    Article  PubMed  CAS  Google Scholar 

  31. Paavonen J, Jenkins D, Bosch FX et al (2007) Efficacy of a prophylactic adjuvanted bivalent L1 virus-like-particle vaccine against infection with human papillomavirus types 16 and 18 in young women: an interim analysis of a phase III double-blind, randomised controlled trial. Lancet 369:2161–2170

    Article  PubMed  CAS  Google Scholar 

  32. AWMF-S2-Leitlinie Prävention, Diagnostik und Therapie der HPV-Infektion und präinvasiver Läsionen des weiblichen Genitale (Stand 10/2010)

  33. Marquardt K (2011) Korrelation zytologischer und histologischer Befunde an der Cervix uteri. Pathologe 32:491–496

    Article  PubMed  CAS  Google Scholar 

Download references

Interessenkonflikt

Keine Angaben

Author information

Authors and Affiliations

  1. Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum Schleswig Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Deutschland

    I. Mebes, F. Amari, K. Diedrich, M. Thill & D.A. Beyer

Authors
  1. I. Mebes
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. F. Amari
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. K. Diedrich
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. M. Thill
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. D.A. Beyer
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to I. Mebes.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Mebes, I., Amari, F., Diedrich, K. et al. Das humane Papillomavirus (HPV) in der Gynäkoonkologie. Gynäkologe 45, 289–295 (2012). https://doi.org/10.1007/s00129-011-2893-5

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00129-011-2893-5

Schlüsselwörter

Keywords

Search

Navigation