Human papillomavirus in genital carcinogenesis.
Human papillomavirus (HPV) is known to induce three different manifestations: clinical, subclinical, and latent infection. Clinical infections (exophytic, endophytic, or flat condylomas) frequently are associated with intraepithelial neoplasia and invasive squamous cell cancer. Colposcopy, cytology, and histopathology play a central role in diagnosis of clinical HPV infections, whereas DNA hybridization techniques and DNA amplification with polymerase chain reaction (PCR) are needed to detect the subclinical and latent HPV infections. The biologic behavior of genital HPV infections is a complex one: regression, persistence, progression, and fluctuation are recognized disease patterns. In young women, the prevalence of HPV infections in Papanicolaou smears is 3%, and the annual incidence approximately 8%. The lifetime risk approaches 80% for women between 20 and 80 years of age. The number of sexual partners during the past 2 years (relative risk [RR] > 9.0) and current smoking (RR > 5.0) proved to be the two most significant risk factors for clinical HPV infection in a recent case-control study. In the author's prospective follow-up study, clinical progression was significantly related to the grade of HPV lesion (P < 0.0001), and to HPV type, with the progression rate of HPV 16 lesions being more than five times greater than that of HPV 6 or 11 lesions. The detection rate of HPV in men is significantly lower (approximately 30%) than in women, and the concordance of HPV types in the couples having sexual relations is surprisingly low (5% to 10%).(ABSTRACT TRUNCATED AT 250 WORDS)
Syrjänen
K J
KJ
Department of Pathology and Forensic Medicine, University of Kuopio, Finland.
D005260:Female; D005833:Genital Neoplasms, Female / Q000628:therapy / Q000821:virology*; D006801:Humans; D008297:Male; D027383:Papillomaviridae; D030361:Papillomavirus Infections / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D015229:Sexually Transmitted Diseases, Viral / Q000175:diagnosis / Q000453:epidemiology; D014412:Tumor Virus Infections / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy