MEDIX, God. 19 Br. 104/105  •  Pregledni članak  •  Ginekologija HR ENG

Infekcija humanim papiloma virusom (HPV) i genitalni karcinom u ženaHuman papillomavirus infection and genital cancer in women

Ante Ćorušić, Lana Škrgatić, Magdalena Karadža, Pavao Planinić, Helena Lovrić Gršić

Veliko istraživanje Međunarodne agencije za istraživanje raka (engl. International Agency for Research on Cancer – IARC) iz 1995. godine, na temelju uzoraka iz 22 zemlje širom svijeta, otkrilo je u 99,7% svih karcinoma materničnoga vrata genom HPV-a. Uglavnom, tj. u oko 90–95% slučajeva, infekcija HPV-om prolazi spontano. Za razvoj preinvazivnih lezija materničnoga vrata (cervikalna intraepitelna novotvorina – CIN) i potom karcinoma, potrebna je trajna infekcija visokoonkogenim sojevima HPV-a. Dobro vođenim organiziranim programom probira, pojavnost karcinoma materničnoga vrata može se smanjiti za 80%. Prema posljednjim smjernicama Europskog odjela Svjetske zdravstvene organizacije primarna zadaća javnoga zdravstvenoga sustava jest uvođenje sekundarne prevencije dobro organiziranim programima probira. Karcinom stidnice podrijetlom od pločastih stanica, povezan s HPV-om, uglavnom je bazaloidno-kondilomatozan. Pojavljuje se multifokalno na koži stidnice u mlađih žena (prosječna dob pojavnosti je oko 45 godina). U pozadini je ove promjene trajna infekcija visokoonkogenim sojevima HPV-a, najčešće sojevima 16 i 18. U 50–60% žena kojima je dijagnosticiran sVIN (simplex vulvarna intraepitelna novotvorina) prisutna je i multicentrična intraepitelna novotvorina donjega genitalnog trakta (maternični vrat, rodnica ili anus). 

Ključne riječi:
cervikalna intraepitelna neoplazija; humani papiloma virus 16; humani papiloma virus 18; karcinom stidnice; karcinom vrata maternice

Članak u cijelosti pročitajte u tiskanom izdanju MEDIX, God. 19 Br. 104/105

A large study carried out by the International Agency for Research on Cancer (IARC) on the material from 22 countries around the world revealed human papillomavirus (HPV ) genome in 99.7% of all cases of cervical cancer. It is estimated that around 90-95% of HPV infections resolve spontaneously. Persistent HPV infection with oncogenic strains is necessary for the development of preinvasive cervical lesions (CIN - cervical intraepithelial neoplasia) and cervical cancer. It is believed that well-organized screenings could reduce the incidence of the cervical cancer by up to 80%. According to the latest guidelines of the European Department of the World Health Organization, the primary task of public health system is the introduction of secondary prevention through well-organized screening programs. Squamous carcinoma of the vulva is the fourth most common genital malignancy in women. It is associated with HPV and often occurs as a multifocal vulvar skin lesion in younger women (average age at onset is about 45 years). In the background of these changes, there is a persistent infection with oncogenic HPV , most commonly strains 16 and 18. About 50-60% of women with VIN (vulvar intraepithelial neoplasia) also present with multicentric intraepithelial neoplasia of the lower genital tract (cervix, vagina or anus). 

Key words:
cervical intraepithelial neoplasia; human papillomavirus, 16; human papillomavirus, 18; uterine cervical neoplasms; vulvar neoplasms