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浙江大学学报（医学版）
浙江大学学报（医学版）  2018, Vol. 47 Issue (4): 338-343    DOI: 10.3785/j.issn.1008-9292.2018.08.02
专题报道     
人乳头瘤病毒相关宫颈癌的精准筛查和治疗
胡争1(),马丁2,*()
1. 中山大学附属第一医院妇产科, 广东 广州 510080
2. 华中科技大学同济医学院附属同济医院妇产科, 湖北 武汉 430030
Precision screening and treatment of human papilloma virus related cervical cancer
HU Zheng1(),MA Ding2,*()
1. Department of Obstetrics and Gynecology, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
2. Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan 430030, China
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摘要：

宫颈癌是自身和环境共同作用下的复杂疾病。在宿主遗传易感性的基础上，高危型人乳头瘤病毒（HPV）持续感染并整合入宿主、宿主基因组的甲基化及体细胞突变等基因组及表观基因组特征变化在宫颈癌的发生和发展中具备分子分型、早期预警及指示预后的关键作用。因此，基于第二代测序技术的HPV等分子检测及动态机器学习模型将更精准地预测真正可能致癌的患者，减轻反复筛查负担；与此同时，基因编辑技术的靶向定点切割将使HPV感染相关宫颈病变的治疗成为可能。本文回顾了HPV相关宫颈癌分子生物学研究进展，提出未来我国宫颈癌精准防治的方向。
关键词： 分子结构;  宫颈肿瘤/诊断;  宫颈肿瘤/治疗;  乳头状瘤病毒科/遗传学;  病毒整合;  RNA编辑;  序列分析, DNA/方法;  普查    
Abstract:

Cervical cancer is a complex disease caused by both genetic susceptibility and environmental factors. Inherited genomic variance, high-risk human papilloma virus (HPV) infection/integration, genome methylation and somatic mutation could all constitute one machine learning model, laying the ground for molecular classification and the precision medicine of cervical cancer. Therefore, for cervical screening, next generation sequencing (NGS)-based HPV DNA and other molecular tests as well as dynamic machine learning models would accurately predict patients with potential to develop the cancer, thereby reducing the burden of repeated screening. Meantime, genome-editing tools targeting HPV would emerge as the next generation gene therapy for HPV-related cervical lesions. In this article, we review the substantial progress on molecular mechanism of cervical cancer development and suggest the future for precise prevention and early treatment of cervical cancer.
Key words: Molecular structure    Uterine cervical neoplasms/diagnosis    Uterine cervical neoplasms/therapy    Papillomaviridae/genetics    Virus integration    RNA editing    Sequence analysis, DNA/methods    Mass screening
收稿日期: 2018-06-03 出版日期: 2018-12-04
:  R737.33  
基金资助: 艾滋病和病毒性肝炎等重大传染病防治科技重大专项(2018ZX10301402);国家自然科学基金(81761148025, 81630060)
通讯作者: 马丁     E-mail: huzheng1998@163.com;dma@tjh.tjmu.edu.cn
作者简介: 胡争(1982-), 男, 博士, 研究员, 副主任医师, 博士生导师, 主要从事HPV相关宫颈癌的发病机制及精准靶向防治研究; E-mail:huzheng1998@163.com; https://orcid.org/0000-0001-9306-9442
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引用本文:

胡争,马丁. 人乳头瘤病毒相关宫颈癌的精准筛查和治疗[J]. 浙江大学学报（医学版）, 2018, 47(4): 338-343.

HU Zheng,MA Ding. Precision screening and treatment of human papilloma virus related cervical cancer. J Zhejiang Univ (Med Sci), 2018, 47(4): 338-343.

链接本文:

http://www.zjujournals.com/med/CN/10.3785/j.issn.1008-9292.2018.08.02    或    http://www.zjujournals.com/med/CN/Y2018/V47/I4/338

图 1  人乳头瘤病毒检测在宫颈癌筛查中发展的时间简史
图 2  基因编辑技术治疗人乳头瘤病毒(HPV)感染的示意图
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