Obstetrics & gynecology science

Korean Society of Obstetrics and Gynecology (대한산부인과학회)
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Natural history of HPV and carcinogenesis of cervical cancer

HPV의 자연사와 자궁경부암의 발암기전

Kim, Young-Tak
김영탁

  • Published : 20070500
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Abstract

=인유두종바이러스 (human papilloma virus, HPV)의 감염은 자궁경부암의 발암기전에 있어 매우 중요한 역할을 한다. 현재까지 알려진 100여종의 아형 가운데 15여 아형의 HPV가 자궁경부 종양 발생과 관련이 있는 것으로 밝혀졌다. 이들 고위험 HPV의 감염은 90%의 환자에서 1-2년 내에 자연 소실되지만, 지속적 감염이 있는 여성은 정상 여성보다 자궁경부암 전단계인 자궁경부 이형증이 발생할 확률이 100배 이상 증가한다. 고위험 HPV는 E6와 E7 유전자를 과도하게 발현시키며, 이들이 다시 종양억제유전자인 p53과 pRb의 기능을 억제함으로서 비정상적 세포의 과도증식을 초래하게 된다. 따라서 자궁경부암의 발생을 예방하기 위해 HPV 감염에 대한 진단 및 예방법이 개발되어 왔다. 현재 HPV 감염의 진단을 위해 미국에서는 FDA 공인 하에 DNA검사법인 Hybrid Capture IITM (Microplate System, Digene, USA)을 자궁경부암의 선별 검사로 이용하고 있으며, 국내 연구진들에 의해 개발된 DNA chip 방법도 널리 실용화될 전망이다. 최근에는 HPV의 감염을 차단하는 목적으로 HPV 백신이 개발되고 있으며, HPV 6/11/16/18형을 대상으로 한 Merk사의 Quadrivalent 백신과 HPV 16/18형을 대상으로 한 GSK사의 Bivalent 백신이 HPV의 지속감염 및 ASCUS 이상의 병변에 대한 예방효과가 입증되었고 대단위 연구를 지속하고 있다. HPV 백신의 개발과 더불어 국가나 지역에 따른 백신의 투여대상, 투여방법 및 투여 전후의 검사 시행여부 등 구체적 사항들에 대한 결정이 필요하다.

Keywords

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