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Virale Kanzerogenese von Kopf-Hals-Tumoren

  • Schwerpunkt: Orale Pathologie/Pathologie der Speicheldrüsen
  • Published:
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Zusammenfassung

Infektiöse Erreger sind für etwa 15% aller Krebserkrankungen weltweit verantwortlich. Humane Papillomviren (HPV) werden häufig in oralen Karzinomen, v. a. der Tonsillen, gefunden. Für eine Gruppe dieser Tumoren konnte eine klare virale Ätiologie nachgewiesen werden: Hochrisiko-Papillomviren kommen in allen Tumorzellen vor, die viralen Onkogene E6 und E7 werden konstant exprimiert und führen zu der diagnostisch richtungsweisenden Überexpression des zellulären Proteins p16INK4a, einem cyclinabhängigen Kinaseinhibitor. Nikotin- oder Alkoholabusus—typisch für die nicht virusassoziierten Karzinome—liegt bei den Patienten nur selten vor.

Epstein-Barr-Viren sind für lymphoproliferative Erkrankungen verantwortlich, aber auch für das Nasopharynx-Karzinom (NPC). In Ostasien ist das NPC nicht selten, und das Screening auf virale Marker hat einen hohen klinischen Stellenwert erlangt.

In dieser Übersicht werden die grundlegenden Mechanismen der molekularen Pathogenese von HPV- und EBV-assoziierten Malignomen dargestellt und klinische Konsequenzen der vorliegenden Ergebnisse für die Diagnostik diskutiert.

Abstract

Approximately 15% of malignant diseases are caused by infectious agents. Human papilloma viruses (HPV) can be frequently found in oral carcinomas, especially tonsillar cancer. A group of HPV-infected tumors shows clear signs for a virally induced transformation process: high-risk HPVs can be detected in all tumor cells, the viral oncogenes E6 and E7 are constantly expressed and lead to upregulation of cellular p16INK4a, a cyclin-dependent kinase inhibitor. The patients frequently lack typical risk factors associated with head and neck cancers such as drinking and smoking.

Epstein-Barr viruses (EBV) are associated with lymphoproliferative disorders and cause nasopharyngeal carcinoma (NPC). NPC has a high incidence in some East Asian countries.

In this review, the molecular pathogenesis of HPV- and EBV-associated malignancies are described and the clinical relevance of the presented findings is discussed.

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Interessenkonflikt:

Der korrespondierende Autor weist auf eine Verbindung mit folgender Firma/Firmen hin: Der Autor ist Gründer, Anteilseigner, Berater und AR-Mitglied der Firma mtm-laborationes AG, die einen p16INK4a-Antikörper vertreibt.

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  1. Abteilung für Molekulare Pathologie, Pathologisches Institut der Universität Heidelberg

    N. Wentzensen &  M. von Knebel Doeberitz

  2. Abteilung für Molekulare Pathologie, Pathologisches Institut der Universität Heidelberg, Im Neuenheimer Feld 220, 69120 , Heidelberg

    M. von Knebel Doeberitz

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  1. N. Wentzensen
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  2. M. von Knebel Doeberitz
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Correspondence to M. von Knebel Doeberitz.

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Wentzensen, N., von Knebel Doeberitz, M. Virale Kanzerogenese von Kopf-Hals-Tumoren. Pathologe 25, 21–30 (2004). https://doi.org/10.1007/s00292-003-0669-y

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  • DOI: https://doi.org/10.1007/s00292-003-0669-y

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