Skip to main content
SpringerLink
Log in

Stellenwert der Vakzine gegen humane Papillomaviren in der Prävention von Krebserkrankungen

Importance of human papillomavirus vaccines in the prevention of cancer

  • Leitthema
  • Published:
Der Onkologe Aims and scope

Zusammenfassung

Hintergrund

Humane Papillomviren (HPV) sind die häufigsten Erreger genitaler Virusinfektionen. HPV-Infektionen heilen meist folgenlos aus, können jedoch auch persistieren und dadurch Läsionen unterschiedlicher Dignität verursachen. Infektionen mit den Hochrisiko-HPV-Typen (hrHPV) 16, 18, 31, 33, 45, 52 und 58 sind zu 90 % ursächlich für das Zervixkarzinom in Europa. Kopf- und Halskarzinome, Vaginal- und Vulvakarzinome sowie deren entsprechende Vorstufen und Penis- oder Analkarzinome können ebenfalls hrHPV-assoziiert sein.

Ziel

Ziel dieser Arbeit ist die Darlegung des Stellenwerts der HPV-Vakzine in der Prävention von Karzinomen im Genital- sowie im Kopf-Hals-Bereich.

Material und Methoden

Diese Arbeit basiert auf einer selektiven Literaturrecherche in der Datenbank PubMed zum Zusammenhang zwischen HPV-Vakzinen und HPV-assoziierten Karzinomen.

Ergebnisse

HPV-Impfungen gewährleisten einen hohen Schutz gegen präkanzeröse Läsionen und Karzinome der Zervix, Vagina, Vulva, Anus sowie gegen Genitalwarzen.

Schlussfolgerung

Erfolge bei HPV-assoziierten Kopf-Hals-Tumoren werden erst in den nächsten Jahrzehnten erwartet.

Abstract

Background

Human papillomaviruses (HPV) are the most common causes of genital viral infections. HPV infections usually heal, but can also persist and thus cause lesions of different grades. Infections with high-risk HPV types (hrHPV) 16, 18, 31, 33, 45, 52, and 58 are responsible for causing 90% of cervical cancer cases in Europe. Head and neck cancer, vaginal and vulvar cancer and their precursors, as well as penile or anal cancer may also be associated with hrHPV.

Objectives

The aim of this work is to demonstrate the importance of HPV vaccines in the prevention of genital as well as head and neck cancers.

Materials and methods

This work is based on a selective literature search in the PubMed database on the correlation between HPV vaccines and HPV-associated cancer.

Results

HPV vaccination ensures a high level of protection against precancerous lesions and cancer of the cervix, vagina, vulva, anus, and genital warts.

Conclusions

Results of HPV vaccination and its positive effects on head and neck tumors is expected within the next few decades.

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. Schulmeyer CE, Mehlhorn G, Renner SK, Beckmann MW, Koch MC (2017) Gynäkologische Krebsfrüherkennung des Zervixkarzinoms im Wandel der Zeit. Gyn 2017(22):386–398

    Google Scholar 

  2. Diagnosis, Therapy, and Follow-Up Care of Vaginal Cancer and its Precursors. Guideline of the DGGG and OEGGG (S2k-Level, AWMF-Registry No. 032/042, October 2018) http://www.awmf.org/leitlinien/detail/II/032-042.html. Available from: https://www.awmf.org/uploads/tx_szleitlinien/015-059k_S2k_Vulvakarzinom_und_Vorstufen_Diagnostik_Therapie_2016-11.pdf.

  3. Impfprävention HPV-assoziierter Neoplasien. Guideline of the DGGG and OEGGG (S3-Level, AWMF-Registry No. 082/002, May 2020) https://www.awmf.org/uploads/tx_szleitlinien/082-002l_S3_Impfpraevention-HPV-assoziierter-Neoplasien_2020-07_01.pdf. Available from: https://www.awmf.org/uploads/tx_szleitlinien/082-002l_Impfpr%C3%A4vention_HPV_assoziierter_Neoplasien_2013-12.pdf.

  4. Horn LC et al (2011) HPV-associated alterations of the vulva and vagina. Morphology and molecular pathology. Pathologe 32(6):467–475

    PubMed  Google Scholar 

  5. Moody CA, Laimins LA (2010) Human papillomavirus oncoproteins: pathways to transformation. Nat Rev Cancer 10(8):550–560

    CAS  PubMed  Google Scholar 

  6. Yang R et al (2003) Interaction of L2 with beta-actin directs intracellular transport of papillomavirus and infection. J Biol Chem 278(14):12546–12553

    CAS  PubMed  Google Scholar 

  7. RKI Humane Papillomviren. https://www.rki.de/DE/Content/Infekt/EpidBull/Merkblaetter/Ratgeber_HPV.html. Zugegriffen: 24. Juli 2021

  8. Walboomers JM, Manos MM, Bosch FX, Kummer JA, Shah KV, Snijders PJ, Peto J, Meijer CJ, Muñoz N (1999) Human papillomavirus is a necessary cause of invasive cervical cancer worldwide. J Pathol 189(1):12–19

    CAS  PubMed  Google Scholar 

  9. Herfs M et al (2012) A discrete population of squamocolumnar junction cells implicated in the pathogenesis of cervical cancer. Proc Natl Acad Sci U S A 109(26):10516–10521

    CAS  PubMed  PubMed Central  Google Scholar 

  10. Palefsky JM Human papillomavirus infections: Epidemiology and disease associations. https://www.uptodate.com/contents/human-papillomavirus-infections-epidemiology-and-disease-associations. Zugegriffen: 24. Juli 2021

  11. Doorbar J et al (2012) The biology and life-cycle of human papillomaviruses. Vaccine 30(Suppl 5):F55–70

    CAS  PubMed  Google Scholar 

  12. Cogliano V et al (2005) Carcinogenicity of human papillomaviruses. Lancet Oncol 6(4):204

    PubMed  Google Scholar 

  13. de Sanjose S et al (2010) Human papillomavirus genotype attribution in invasive cervical cancer: a retrospective cross-sectional worldwide study. Lancet Oncol 11(11):1048–1056

    PubMed  Google Scholar 

  14. Tribius S, Hoffmann M (2013) Human papilloma virus infection in head and neck cancer. Dtsch Arztebl Int 110(11):184–190e1

    PubMed  PubMed Central  Google Scholar 

  15. Andratschke M, Betz C, Leunig A (2008) Laryngeal papillomatosis: etiology, diagnostics and therapy. HNO 56(12):1190–1196

    CAS  PubMed  Google Scholar 

  16. Europa EU Cervarix, INN-Human Papillomavirus Vaccine. http://www.ema.europa.eu/docs/de_DE/document_library/EPAR_-_Product_Information/human/000721/WC500024632.pdf. Zugegriffen: 24. Juli 2021

  17. gardasil_9_Fachinformation (Zusammenfassung der Merkmale des Arzneimittels). https://www.msd.de/fileadmin/files/fachinformationen/gardasil_9.pdf. Zugegriffen: 24. Juli 2021

  18. Epidemiologisches Bulletin-Wissenschaftliche Begründung für die Empfehlung der HPV-Impfung für Jungen im Alter von 9 bis 14 Jahren. https://www.rki.de/DE/Content/Infekt/EpidBull/Archiv/2018/Ausgaben/26_18.pdf?__blob=publicationFile. Zugegriffen: 24. Juli 2021

  19. Herrero R et al (2011) Prevention of persistent human papillomavirus infection by an HPV16/18 vaccine: a community-based randomized clinical trial in Guanacaste, Costa Rica. Cancer Discov 1(5):408–419

    PubMed  PubMed Central  Google Scholar 

  20. Markowitz LE, Tsu V, Deeks SL, Cubie H, Wang SA, Vicari AS, Brotherton JML (2012) Human papillomavirus vaccine introduction—the first five years. Vaccine 30(Suppl 5):F139–F148. https://doi.org/10.1016/j.vaccine.2012.05.039

    Article  PubMed  Google Scholar 

  21. Mirghani H, Jung AC, Fakhry C (2017) Primary, secondary and tertiary prevention of human papillomavirus-driven head and neck cancers. Eur J Cancer 78:105–115

    PubMed  Google Scholar 

  22. Munoz N et al (2010) Impact of human papillomavirus (HPV)-6/11/16/18 vaccine on all HPV-associated genital diseases in young women. J Natl Cancer Inst 102(5):325–339

    CAS  PubMed  Google Scholar 

  23. Palefsky JM et al (2011) HPV vaccine against anal HPV infection and anal intraepithelial neoplasia. N Engl J Med 365(17):1576–1585

    CAS  PubMed  Google Scholar 

  24. Gillison ML et al (2015) Epidemiology of human papillomavirus-positive head and neck squamous cell carcinoma. J Clin Oncol 33(29):3235–3242

    CAS  PubMed  PubMed Central  Google Scholar 

  25. Wittekindt CK, Peter JWS (2018) Oropharynxkarzinome: Wenn humane Papillomviren die Tumorauslöser sind. Dtsch Arztebl Int. https://doi.org/10.3238/PersOnko.2018.11.23.02-10-11547 (https://www.aerzteblatt.de/int/article.asp?id=203112. November 23, 2018)

    Article  Google Scholar 

  26. Suzich JA et al (1995) Systemic immunization with papillomavirus L1 protein completely prevents the development of viral mucosal papillomas. Proc Natl Acad Sci USA 92(25):11553–11557

    CAS  PubMed  PubMed Central  Google Scholar 

  27. Graham DM, Isaranuwatchai W, Habbous S, De Oliveira C, Liu G, Siu LL, Hoch JS (2015) A cost-effectiveness analysis of human papillomavirus vaccination of boys for the prevention of oropharyngeal cancer. Cancer 121(11):1785–1792. https://doi.org/10.1002/cncr.29111

    Article  PubMed  Google Scholar 

  28. Mirghani H et al (2018) Smoking impact on HPV driven head and neck cancer’s oncological outcomes? Oral Oncol 82:131–137

    PubMed  Google Scholar 

  29. RKI (2020) Aktuelle Daten und Informationen zu Infektionskrankheiten und Public Health. https://www.rki.de/DE/Content/Infekt/EpidBull/Archiv/2020/Ausgaben/32-33_20.pdf?__blob=publicationFile. Zugegriffen: 24. Juli 2021

  30. Methodenbewertung-Eckpunkte für zukünftiges Screening auf Gebärmutterhalskrebs geändert. https://www.g-ba.de/downloads/34-215-641/38-2016-09-15_KFE-RL_Eckpunkte%20Zervix.pdf. Zugegriffen: 24. Juli 2021

  31. Leitlinienprogramm Onkologie (Deutsche Krebsgesellschaft, Deutsche Krebshilfe, AWMF): Prävention des Zervixkarzinoms, Langversion 1.0, 2017, AWMF Registernummer: 015/027OL, http://www.leitlinienprogramm onkologie.de/leitlinien/zervixkarzinom-praevention/ (abgerufen am: 14. Mai 2021). Available from: https://www.awmf.org/uploads/tx_szleitlinien/015-027OLl_Praevention_Zervixkarzinom_2018-01.pdf.

  32. European guidelines for quality assurance in cervical cancer screening.pdf. https://publications.europa.eu/en/publication-detail/-/publication/a41a4c40-0626-4556-af5b-2619dd1d5ddc. Zugegriffen: 24. Juli 2021

  33. Saslow D et al (2012) American Cancer Society, American Society for Colposcopy and Cervical Pathology, and American Society for Clinical Pathology screening guidelines for the prevention and early detection of cervical cancer. CA Cancer J Clin 62(3):147–172

    PubMed  PubMed Central  Google Scholar 

  34. Strander B, Hallgren J, Sparen P (2014) Effect of ageing on cervical or vaginal cancer in Swedish women previously treated for cervical intraepithelial neoplasia grade 3: population based cohort study of long term incidence and mortality. BMJ 348:f7361

    PubMed  PubMed Central  Google Scholar 

  35. Ellerbrock TV et al (2000) Incidence of cervical squamous intraepithelial lesions in HIV-infected women. JAMA 283(8):1031–1037

    CAS  PubMed  Google Scholar 

  36. Guo T, Eisele DW, Fakhry C (2016) The potential impact of prophylactic human papillomavirus vaccination on oropharyngeal cancer. Cancer 122(15):2313–2323

    PubMed  Google Scholar 

  37. Fakhry C et al (2011) Associations between oral HPV16 infection and cytopathology: evaluation of an oropharyngeal “pap-test equivalent” in high-risk populations. Cancer Prev Res 4(9):1378–1384

    Google Scholar 

  38. Franceschi S et al (2015) Deep brush-based cytology in tonsils resected for benign diseases. Int J Cancer 137(12):2994–2999

    CAS  PubMed  Google Scholar 

  39. Schiffman M, Wentzensen N (2013) Human papillomavirus infection and the multistage carcinogenesis of cervical cancer. Cancer Epidemiol Biomarkers Prev 22(4):553–560

    PubMed  PubMed Central  Google Scholar 

  40. Gillison ML et al (2012) Prevalence of oral HPV infection in the United States, 2009–2010. JAMA 307(7):693–703

    CAS  PubMed  PubMed Central  Google Scholar 

  41. Chaturvedi AK (2012) Epidemiology and clinical aspects of HPV in head and neck cancers. Head Neck Pathol 6(Suppl 1):S16–24

    PubMed  Google Scholar 

  42. Kuhs LKA et al (2015) Human papillomavirus 16 E6 antibodies in individuals without diagnosed cancer: a pooled analysis. Cancer Epidemiol Biomarkers Prev 24(4):683–689

    Google Scholar 

  43. Piazza C et al (2008) Narrow-band imaging: a new tool for evaluation of head and neck squamous cell carcinomas. Review of the literature. Acta Otorhinolaryngol Ital 28(2):49–54

    CAS  PubMed  PubMed Central  Google Scholar 

  44. Ebisumoto K et al (2016) Successful detection of a minute tonsillar cancer lesion on transoral examination with narrow band imaging: A report of 2 cases. Head Neck 38(S1):E2421–E2424

    PubMed  Google Scholar 

  45. Kang WD, Choi HS, Kim SM (2013) Is vaccination with quadrivalent HPV vaccine after loop electrosurgical excision procedure effective in preventing recurrence in patients with high-grade cervical intraepithelial neoplasia (CIN2–3)? Gynecol Oncol 130(2):264–268

    CAS  PubMed  Google Scholar 

  46. S3-Leitlinie Diagnostik, Therapie und Nachsorge der Patientin mit Zervixkarzinom; Version 1.0 – September 2014.

  47. Dannecker C, Strnad V, Hegewisch-Becker S (2014) Nachsorge beim Vulva- und Vaginalkarzinom. Onkologe 20(4):355–357

    Google Scholar 

  48. Rettig EM et al (2015) Prognostic implication of persistent human papillomavirus type 16 DNA detection in oral rinses for human papillomavirus-related oropharyngeal carcinoma. JAMA Oncol 1(7):907–915

    PubMed  PubMed Central  Google Scholar 

  49. Baay MF et al (1999) Humoral immune response against proteins E6 and E7 in cervical carcinoma patients positive for human papilloma virus type 16 during treatment and follow-up. Eur J Clin Microbiol Infect Dis 18(2):126–132

    CAS  PubMed  Google Scholar 

  50. Hamsikova E et al (2000) Longitudinal follow-up of antibody response to selected antigens of human papillomaviruses and herpesviruses in patients with invasive cervical carcinoma. Int J Cancer 86(3):351–355

    CAS  PubMed  Google Scholar 

  51. Mestecky J, Moldoveanu Z, Russell MW (2005) Immunologic uniqueness of the genital tract: challenge for vaccine development. Am J Reprod Immunol 53(5):208–214

    CAS  PubMed  Google Scholar 

  52. Russell MW, Mestecky J (2010) Tolerance and protection against infection in the genital tract. Immunol Invest 39(4–5):500–525

    PubMed  Google Scholar 

  53. Combes JD et al (2014) Antibodies against high-risk human papillomavirus proteins as markers for invasive cervical cancer. Int J Cancer 135(10):2453–2461

    CAS  PubMed  Google Scholar 

  54. Fakhry C et al (2016) Serum antibodies to HPV16 early proteins warrant investigation as potential biomarkers for risk stratification and recurrence of HPV-associated Oropharyngeal cancer. Cancer Prev Res 9(2):135–141

    CAS  Google Scholar 

  55. Koslabova E et al (2013) Markers of HPV infection and survival in patients with head and neck tumors. Int J Cancer 133(8):1832–1839

    CAS  PubMed  Google Scholar 

  56. Rubenstein LM et al (2011) Human papillomavirus serologic follow-up response and relationship to survival in head and neck cancer: a case-comparison study. Infect Agents Cancer 6:9

    Google Scholar 

  57. Pornthanakasem W et al (2001) Human papillomavirus DNA in plasma of patients with cervical cancer. Bmc Cancer 1(1):2

    CAS  PubMed  PubMed Central  Google Scholar 

  58. Sathish N et al (2004) HPV DNA in plasma of patients with cervical carcinoma. J Clin Virol 31(3):204–209

    CAS  PubMed  Google Scholar 

  59. Cao H et al (2012) Quantitation of human papillomavirus DNA in plasma of oropharyngeal carcinoma patients. Int J Radiat Oncol Biol Phys 82(3):e351–8

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Frauenklinik, Universitätsklinikum Erlangen, Comprehensive Cancer Center Erlangen/Europäische Metropolregion Nürnberg (CCC ER-EMN), Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Universitätsstraße 21–23, 91054, Erlangen, Deutschland

    Carla E. Schulmeyer &  Matthias W. Beckmann

  2. Virologisches Institut – Klinische und Molekulare Virologie, Lehrstuhl für Klinische und Molekulare Virologie, Comprehensive Cancer Center Erlangen/Europäische Metropolregion Nürnberg (CCC ER-EMN), Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Universitätsstraße 21–23, 91054, Erlangen, Deutschland

    Antje Knöll

  3. Hals-Nasen-Ohren-Klinik, Universitätsklinikum Erlangen, Comprehensive Cancer Center Erlangen/Europäische Metropolregion Nürnberg (CCC ER-EMN), Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Universitätsstraße 21–23, 91054, Erlangen, Deutschland

    Heinrich Iro & Sarina K. Müller

Authors
  1. Carla E. Schulmeyer
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Antje Knöll
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Heinrich Iro
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Sarina K. Müller
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Matthias W. Beckmann
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Matthias W. Beckmann.

Ethics declarations

Interessenkonflikt

C.E. Schulmeyer, A. Knöll, H. Iro, S.K. Müller und M.W. Beckmann geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

Additional information

figure qr

QR-Code scannen & Beitrag online lesen

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Schulmeyer, C.E., Knöll, A., Iro, H. et al. Stellenwert der Vakzine gegen humane Papillomaviren in der Prävention von Krebserkrankungen. Onkologe 28, 5–14 (2022). https://doi.org/10.1007/s00761-021-01050-2

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00761-021-01050-2

Schlüsselwörter

Keywords

Search

Navigation