نقش واکسن HPV در پیشگیری از سرطان دهانه رحم، مقاله مروری

نوع مقاله: مروری

نویسندگان

1 دانشیار گروه انکولوژی زنان، مرکز تحقیقات سلامت زنان، دانشکده پزشکی، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

2 رزیدنت جراحی زنان و مامایی، دانشکده پزشکی، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

3 دانشیار گروه زنان، دانشکده پزشکی، دانشگاه علوم پزشکی ایران، تهران، ایران.

چکیده

مقدمه: سرطان دهانه رحم، یکی از علل عمده مرگ ‌و ‌میر زنان سنین باروری در کشورهای در حال توسعه و چهارمین بیماری بدخیم زنان در دنیا است. 95% سرطان‌های دهانه رحم با ویروس HPV مرتبط هستند. مطالعه حاضر با هدف بررسی نقش واکسن در پیشگیری از ابتلاء به HPV و سرطان دهانه رحم انجام شد.
روش‌کار: در این مطالعه مروری اطلاعات بین سالهای 2004 تا 2015از طریق جستجو در پایگاه‌های اطلاعاتی Embase، Medline، Scopus، ISI، Pubmed و موتور جستجوی گوگل با وارد کردن کلمات‌کلیدی ویروس یا پیلومای انسانی HPV، واکسن پاپیلوما (HPV vaccine) و سرطان دهانه رحم استخراج شد. معیارهای ورود مقالات به مطالعه شامل درج کلمات مورد جستجو در بخش عنوان یا کلمات‌‌کلیدی مقالات بود. مقالات با داده‌های ناقص و مقالاتی که کمتر به موضوع مورد بحث مربوط بودند، از مطالعه خارج شدند.
یافته‌ها‌: HPV شایع‌ترین عفونت منتقله جنسی است و خود محدود شونده است. HPV در مردان و زنان ضایعات پیش بدخیمی دهنی- مقعدی ایجاد می‌کند که ممکن است به سمت بدخیمی پیشرفت کنند. واکسیناسیون HPV از عفونت HPV که همراه پیشرفت سرطان دهانی- مقعدی از جمله سرطان دهانه رحم و زگیل تناسلی است، جلوگیری می‌کند.
نتیجه‌گیری: واکسیناسیون HPV اثر و ایمونوژنیسیته بالا دارد و ایمنی قابل قبول ایجاد می‌کند. بر اساس مطالعات انجام شده، واکسن گارداسیل می‌تواند تا 90% در برابر سرطان دهانه رحم محافظت ایجاد کند در حالیکه واکسن نه‌‌گانه جدید تا 97% در برابر سرطان‌های با درجه بالای بدخیم دهانه رحم و ولو واژن مؤثر است. افزایش آگهی روز افزون درباره شیوع HPV و راه‌های انتقال و بیماری‌زایی و درمان واکسیناسیون این ویروس منجر به بهبود در کنترل بیماری و در نهایت کنترل پیامدهای ناشی از این ویروس و نیز امکان ریشه‌کن کردن سرطان سرویکس در دهه‌های آینده خواهد شد.

کلیدواژه‌ها


عنوان مقاله [English]

The role of Human Papilloma Virus (HPV) vaccines in prevention of Cervical Cancer, review article

نویسندگان [English]

  • Malihe Hasanzadeh Mofrad 1
  • Lida Jedi 2
  • Shahnaz Ahmadi 3
1 Associate professor, Department of Gynecology Oncology, Women's Health Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
2 Resident, Department of Surgical Obstetrics and Gynecology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
3 Associate professor, Department of Obstetrics and Gynecology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
چکیده [English]

Introduction:Cervical cancer is a major cause of women's mortality at reproductive age in developing countries and is the fourth malignant disease of women in the world. 95% of cervical cancers are related to HPV. This study was performed with aim to investigate the role of vaccine in preventing HPV and cervical cancer.
Methods: in this review article, the information was obtained through searching in databases of Pubmed, ISI, Scopus, Medline, Embase, and Google search by entering the keywords of virus or Human Papilloma Virus (HPV), HPV vaccine, and cervical cancer during 2004 to 2015. Inclusion criteria for entering the studies in this research included the searching keywords being mentioned in title or keywords of the articles. The articles with incomplete data and articles which were less relevant to the subject were excluded.
 
Results: HPV is the most common sexually transmitted infection and is self-limiting. HPV causes oral-anal premalignant lesions in men and women which may progress to malignancy. HPV vaccination prevents from HPV infections that accompany the development of oral-anal cancer including cervical cancer and genital warts.
Conclusion: HPV vaccination has high effect and immunogenicity and causes acceptable safety. According to studies, the Gardasil vaccine can protect against cervical cancer up to 90%, while new nine-vaccine is effective up to 97% against high degree malignant cancers with a of cervical and vaginal vulva. The increasing knowledge about prevalence of HPV and transmission ways and pathology and treatment vaccine of this virus leads to an improvement in disease control and ultimately controlling the consequences of this virus and the possible eradicating of cervical cancer in the coming decades. 

کلیدواژه‌ها [English]

  • Cervical malignancy
  • Human Papilloma Virus vaccine
  • HPV
  • incidence
  • Prevention
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