{"id":4757,"date":"2022-11-21T09:15:51","date_gmt":"2022-11-21T01:15:51","guid":{"rendered":"http:\/\/dh.oncolab.cn\/index.php\/2022\/11\/21\/%e8%82%bf%e7%98%a4%e5%85%8d%e7%96%ab%e5%ad%a6-%e7%ac%ac15%e7%ab%a0-%e9%92%88%e5%af%b9hpv%e6%81%b6%e6%80%a7%e8%82%bf%e7%98%a4%e7%9a%84%e7%96%ab%e8%8b%97%ef%bc%88%e4%b8%8a%ef%bc%89\/"},"modified":"2022-11-21T09:15:51","modified_gmt":"2022-11-21T01:15:51","slug":"%e8%82%bf%e7%98%a4%e5%85%8d%e7%96%ab%e5%ad%a6-%e7%ac%ac15%e7%ab%a0-%e9%92%88%e5%af%b9hpv%e6%81%b6%e6%80%a7%e8%82%bf%e7%98%a4%e7%9a%84%e7%96%ab%e8%8b%97%ef%bc%88%e4%b8%8a%ef%bc%89","status":"publish","type":"post","link":"http:\/\/dh.oncolab.cn\/index.php\/2022\/11\/21\/%e8%82%bf%e7%98%a4%e5%85%8d%e7%96%ab%e5%ad%a6-%e7%ac%ac15%e7%ab%a0-%e9%92%88%e5%af%b9hpv%e6%81%b6%e6%80%a7%e8%82%bf%e7%98%a4%e7%9a%84%e7%96%ab%e8%8b%97%ef%bc%88%e4%b8%8a%ef%bc%89\/","title":{"rendered":"\u80bf\u7624\u514d\u75ab\u5b66-\u7b2c15\u7ae0 \u9488\u5bf9HPV\u6076\u6027\u80bf\u7624\u7684\u75ab\u82d7\uff08\u4e0a\uff09"},"content":{"rendered":"
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15.1 \u5f15\u8a00<\/strong><\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u5728\u5168\u7403\u8303\u56f4\u5185\uff0c\u5927\u7ea6\u516d\u5206\u4e4b\u4e00\u7684\u65b0\u7684\u764c\u75c7\u8bca\u65ad\u53ef\u5f52\u56e0\u4e8e\u4e00\u79cd\u7279\u5b9a\u7684\u611f\u67d3\u75c5\u539f\u4f53(Fig. 15.1<\/span>)\u3002\u4eba\u7c7b\u4e73\u5934\u7624\u75c5\u6bd2(HPV)\u5bfc\u81f4\u4e86\u5927\u7ea630%\u764c\u75c7\u76f8\u5173\u7684\u611f\u67d3\uff0c\u5305\u62ec\u5bab\u9888\u764c\u3001\u9634\u9053\u764c\u3001\u5916\u9634\u764c\u3001\u809b\u95e8\u764c\u548c\u53e3\u54bd\u764c\uff0c\u5360\u5168\u7403\u6240\u6709\u764c\u75c7\u7684\u8fd15%\u3002\u5728\u5973\u6027\u7fa4\u4f53\u4e2d\uff0c\u5927\u591a\u6570HPV\u8bf1\u53d1\u7684\u764c\u75c7\u662f\u5bab\u9888\u764c\uff1b\u5728\u7537\u6027\u7fa4\u4f53\u4e2d\uff0c\u5927\u591a\u6570HPV\u76f8\u5173\u7684\u6076\u6027\u80bf\u7624\u662f\u53e3\u54bd\u764c(Fig. 15.2<\/span>)\u3002\u5c3d\u7ba1\u6709\u9884\u9632\u6027\u7684HPV\u75ab\u82d7\u4ee5\u53ca\u68c0\u6d4b\u4e0b\u751f\u6b96\u9053\u4e2dHPV\u7684\u7b5b\u67e5\u65b9\u6cd5\uff0c\u4f46\u5728\u8d44\u6e90\u532e\u4e4f\u7684\u73af\u5883\u4e2d\uff0c\u5bab\u9888\u764c\u662f\u5973\u6027\u56e0\u764c\u75c7\u6b7b\u4ea1\u7684\u7b2c\u4e8c\u5927\u5e38\u89c1\u539f\u56e0\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u63a5\u89e6HPV\u662f\u5728\u9996\u6b21\u6027\u884c\u4e3a\u53d1\u751f\u65f6\uff0c\u57fa\u672c\u4e0a\u662f\u5730\u65b9\u6027\u75be\u75c5\u3002\u611f\u67d3\u540e\u901a\u5e38\u662f\u65e0\u75c7\u72b6\u7684\uff0c\u867d\u7136\u5927\u591a\u6570\u611f\u67d3\u662f\u6682\u65f6\u7684\uff0c\u4f46\u75ca\u6108\u53ef\u80fd\u9700\u89811-2\u5e74\u3002\u5e74\u957f\u7684\u5973\u6027\u9700\u8981\u66f4\u957f\u7684\u65f6\u95f4\u6765\u6e05\u9664\u611f\u67d3\uff0c\u5438\u70df\u8005\u548c\u60a3\u6709\u6f5c\u5728\u514d\u75ab\u6291\u5236\u7684\u5973\u6027\u4e5f\u662f\u5982\u6b64\u3002\u8fd9\u4e9b\u611f\u67d3\u7684\u4e34\u5e8a\u6c89\u9ed8\u6027\u8d28\u6709\u52a9\u4e8e\u7ef4\u6301\u5927\u91cf\u53ef\u4f20\u64adHPV\u7684\u7fa4\u4f53\u6570\u91cf\u3002\u6b64\u5916\uff0c\u5728\u7b26\u5408\u6761\u4ef6\u7684\u7f8e\u56fd\u961f\u5217\u7814\u7a76\u4e2d\uff0c9-26\u5c81\u7684\u5e74\u8f7b\u4eba\u7684\u9884\u9632\u6027\u75ab\u82d7\u63a5\u79cd\u7387\u4e00\u76f4\u5904\u4e8e\u6b21\u4f18\u6c34\u5e73\u3002\u57282015\u5e74\uff0c\u670943%\u7684\u5973\u5b69\u548c28%\u7684\u7537\u5b69\u5b8c\u6210\u4e86\u4e09\u8054\u75ab\u82d7\u63a5\u79cd\u65b9\u6848\u4e2d\u7684\u6240\u6709\u4e09\u79cd\u75ab\u82d7\u63a5\u79cd\u3002\u73b0\u6709\u7684\u9884\u9632\u75ab\u82d7 Gardasil\u00a9<\/sup>\u548cCervarix\u00a9<\/sup>\u88ab\u6279\u51c6\u7528\u4e8e\u9884\u9632\u5bab\u9888\u764c\u3001\u5916\u9634\u764c\u3001\u9634\u9053\u764c\u548c\u809b\u95e8\u764c\u3002\u7531\u4e8eHPV\u662f\u53e3\u54bd\u9cde\u72b6\u7ec6\u80de\u764c(OSCC)\u4e9a\u7fa4\u7684\u6f5c\u5728\u75c5\u56e0\uff0c\u800c\u5728\u5927\u591a\u6570\u5e74\u8f7b\u3001\u4e0d\u5438\u70df\u548c\u4e0d\u9157\u9152\u7684\u7537\u6027\u4e2d\uff0c\u5b83\u4eec\u4ec5\u9650\u4e8e\u816d\u6241\u6843\u4f53\u548c\u820c\u6839\u7684\u4e0a\u76ae\u7ec6\u80de\uff0c\u56e0\u6b64\u76ee\u524d\u6b63\u5728\u7814\u7a76\u5b83\u4eec\u7528\u4e8e\u53e3\u54bd\u764c\u7684\u9884\u9632\u4f5c\u7528\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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Fig 15.1<\/span> 2012\u5e74\u5168\u7403\u75c5\u539f\u4f53\u5f15\u8d77\u7684\u4eba\u7c7b\u6076\u6027\u80bf\u7624\u53d1\u75c5\u7387<\/span><\/p>\n<\/section>\n<\/section>\n<\/section>\n

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Fig 15.2<\/span> 2009\u5e74\u4e0e\u4eba\u4e73\u5934\u7624\u75c5\u6bd2\u76f8\u5173\u7684\u65b0\u764c\u75c7\u6570\u76ee<\/span><\/p>\n<\/section>\n<\/section>\n<\/section>\n

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15.1.1 \u4eba\u4e73\u5934\u7624\u75c5\u6bd2\u7684\u611f\u67d3\u751f\u7269\u5b66<\/p>\n<\/section>\n

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\u4eba\u4e73\u5934\u72b6\u7624\u75c5\u6bd2(HPV)\u662f\u4e00\u79cd\u65e0\u5305\u819c\u7684\u53cc\u94feDNA\u75c5\u6bd2\uff0c\u5bf9\u9ecf\u819c\u7ec4\u7ec7\u5177\u6709\u55dc\u6027\u3002\u57fa\u56e0\u7ec4\u7531\u4e09\u4e2a\u529f\u80fd\u533a\u57df\u7ec4\u6210\uff1a(A)\u975e\u7f16\u7801\u8c03\u63a7\u533a\uff1b(B)\u65e9\u671f\u86cb\u767d\u533a\u57df\uff0c\u7f16\u78016\u4e2a\u65e9\u671f\u86cb\u767d(E1\u3001E2\u3001E4-E7)\uff1b\u4ee5\u53ca(C)\u665a\u671f\u533a\u57df\uff0c\u7f16\u7801\u75c5\u6bd2\u8863\u58f3\u86cb\u767dL1\u548cL2\u3002HPV\u611f\u67d3\u57fa\u5e95\u4e0a\u76ae(\u76ae\u80a4\u6216\u7c98\u819c)\u7ec6\u80de\u3002\u76ee\u524d\u5df2\u9274\u5b9a\u51fa200\u591a\u79cdHPV\u57fa\u56e0\u578b\u3002\u81f4\u764c\u57fa\u56e0\u578b\u5305\u62ecHPV16\u300118\u300131\u300133\u300135\u300139\u300145\u300151\u300152\u300156\u300158\u300159\u548c66\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u5bab\u9888\u9cde\u764c\u3001\u5176\u4ed6\u809b\u95e8\u751f\u6b96\u9053\u764c\u548c\u5934\u9888\u764c\u7684\u53d1\u751f\u662f\u5728\u6301\u7eed\u611f\u67d3\u81f4\u764c\u6027HPV\u7684\u60c5\u51b5\u4e0b\u53d1\u751f\u7684\u3002\u4e8b\u5b9e\u4e0a\uff0c\u6240\u6709\u5bab\u9888\u9cde\u72b6\u7ec6\u80de\u764c(SCCx)\u53ca\u5176\u524d\u9a71\u75c5\u53d8–\u9ad8\u5ea6\u9cde\u72b6\u4e0a\u76ae\u5185\u75c5\u53d8\/\u5bab\u9888\u4e0a\u76ae\u5185\u7624\u53d82\/3 (HGSIL\/CIN2\/CIN3)\u90fd\u662f\u7531HPV\u5f15\u8d77\u7684\uff0c\u6700\u5e38\u89c1\u7684\u662fHPV 16(Fig. 15.3<\/span>)\u3002\u5927\u591a\u6570\u5bab\u9888\u764c\u90fd\u4e0eHPV 16\u548c18\u578b\u6709\u5173\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u5bab\u9888\u764c\u548cHGSIL\/CIN2\/CIN3\u7684\u53d1\u5c55\u90fd\u4e0eHPV\u57fa\u56e0\u7ec4\u6574\u5408\u5230\u5bbf\u4e3b\u57fa\u56e0\u7ec4\u4e2d\u4ee5\u53ca\u968f\u540e\u4e24\u4e2aHPV\u65e9\u671f\u57fa\u56e0\u4ea7\u7269E6\u548cE7\u7684\u8868\u8fbe\u6709\u5173\uff0c\u8fd9\u4e24\u4e2a\u57fa\u56e0\u4ea7\u7269\u5206\u522b\u4f7fp53\u548cpRb\u5931\u6d3b\u3002\u75c5\u6bd2\u6574\u5408\u4f4d\u70b9\u867d\u7136\u968f\u673a\u5206\u5e03\u5728\u4eba\u7c7b\u57fa\u56e0\u7ec4\u5185\uff0c\u4f46\u4e3b\u8981\u53d1\u751f\u5728\u4eba\u7c7bDNA\u5bb9\u6613\u65ad\u88c2\u7684\u4f4d\u70b9(\u4f8b\u5982\uff0c\u8106\u5f31\u4f4d\u70b9)\uff0c\u5e76\u4e14\u4f3c\u4e4e\u53ea\u5f71\u54cdHPV\u57fa\u56e0\u7ec4\u672c\u8eab\u7684\u8868\u8fbe\u3002\u5177\u4f53\u5730\u8bf4\uff0cE1\u548cE2\u5728\u6574\u5408\u8fc7\u7a0b\u4e2d\u6700\u5e38\u88ab\u7834\u574f\uff0c\u800cE6\u548cE7\u75c5\u6bd2\u764c\u57fa\u56e0\u88ab\u4fdd\u7559\uff0c\u5bfc\u81f4\u7ed3\u6784\u6027\u8868\u8fbe\u3002E6\u548cE7\u7684\u8868\u8fbe\u5728\u529f\u80fd\u4e0a\u662f\u542f\u52a8\u548c\u7ef4\u6301\u80bf\u7624\u8f6c\u5316\u6240\u5fc5\u9700\u7684\u3002\u5728\u5f62\u6001\u5b66\u4e0a\uff0c\u5728\u7ec6\u80de\u6c34\u5e73\u4e0a\uff0c\u9ad8\u5ea6\u4e0a\u76ae\u5185\u75c5\u53d8\u7684\u7279\u70b9\u662f\u6838\u6d46\u6bd4\u9ad8\u3002\u800c\u5728\u7ec4\u7ec7\u5b66\u4e0a\uff0c\u9ad8\u5ea6\u6076\u6027\u75c5\u53d8\u8868\u73b0\u4e3a\u5168\u539a\u5ea6\uff0c\u7ec6\u80de\u4e0d\u6210\u719f\uff0c\u6709\u4e1d\u5206\u88c2\u6d3b\u8dc3(Fig. 15.4<\/span>)\u3002<\/span><\/p>\n<\/section>\n<\/section>\n<\/section>\n

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Fig 15.3<\/span> \u6700\u5e38\u4e0e\u5bab\u9888\u75be\u75c5\u76f8\u5173\u7684HPV\u57fa\u56e0\u578b\u522b<\/span><\/p>\n<\/section>\n<\/section>\n<\/section>\n

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Fig 15.4<\/span> \u653e\u592720\u500dCIN-2\/CIN3\u7ec4\u7ec7\u82cf\u6728\u7cbe-\u4f0a\u7ea2\u67d3\u8272<\/span><\/p>\n<\/section>\n<\/section>\n<\/section>\n

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15.1.2 \u81ea\u7136\u611f\u67d3\u4e2d\u7684\u7cfb\u7edf\u514d\u75ab\u53cd\u5e94<\/p>\n<\/section>\n

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\u5728HPV\u81ea\u7136\u611f\u67d3\u7684\u80cc\u666f\u4e0b\uff0c\u5bf9\u75be\u75c5\u8d77\u59cb\u548c\u6301\u7eed\u53d1\u5c55\u8fc7\u7a0b\u4e2d\u6240\u9700\u7684\u5bf9HPV\u6297\u539f\u7684\u4f53\u6db2\u548c\u9002\u5e94\u6027\u7cfb\u7edf\u5185\u6e90\u6027\u514d\u75ab\u53cd\u5e94\u90fd\u5f88\u5f31\u3002\u75c5\u6bd2\u6e05\u9664\u540e\uff0c50-70%\u7684\u4eba\u53ef\u68c0\u6d4b\u5230\u6297\u4f53\u6ef4\u5ea6\u3002\u7531\u81ea\u7136\u611f\u67d3\u5f15\u8d77\u7684\u8bb0\u5fc6B\u7ec6\u80de\u4ea7\u751f\u7684\u6297\u4f53\u5927\u591a\u6570\u4eb2\u548c\u529b\u4f4e\uff0c\u662f\u975e\u4e2d\u548c\u7684\uff0c\u4e0d\u4e00\u5b9a\u80fd\u9884\u9632\u76f8\u540cHPV\u57fa\u56e0\u578b\u7684\u518d\u6b21\u611f\u67d3\u3002\u540c\u6837\uff0cT\u7ec6\u80de\u5bf9\u75c5\u6bd2\u6297\u539f\u7684\u53cd\u5e94\u662f\u6bd4\u8f83\u5f31\u7684\uff0c\u9700\u8981\u4f53\u5916\u523a\u6fc0\u624d\u80fd\u88ab\u68c0\u6d4b\u5230\uff0c\u800c\u4e14\u4e0d\u80fd\u53ef\u9760\u5730\u533a\u5206\u75c5\u53d8\u4f1a\u6d88\u9000\u7684\u4eba\u548c\u4e0d\u4f1a\u6d88\u9000\u7684\u4eba\u3002\u4e8b\u5b9e\u4e0a\uff0c\u6301\u7eed\u6027\u7684HPV\u611f\u67d3\u548c\u4fb5\u88ad\u524d\u7684HPV\u75c5\u53d8\u4ec5\u9650\u4e8e\u9cde\u72b6\u4e0a\u76ae\uff0c\u8868\u73b0\u5728\u975e\u708e\u75c7\u6027\u73af\u5883\u4e2d\uff0c\u6ca1\u6709\u5168\u8eab\u6027\u75c5\u6bd2\u8840\u75c7\u3002\u611f\u67d3\u5728\u89e3\u5256\u5b66\u4e0a\u4ec5\u9650\u4e8e\u7c98\u819c\u4e0a\u76ae\uff0c\u4e0d\u4f1a\u5f15\u8d77\u5168\u8eab\u6027\u75c7\u72b6\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u901a\u8fc7\u4f53\u5916\u523a\u6fc0\uff0c\u5728HPV 16+CIN2\/CIN3<\/span>\u643a\u5e26\u8005\u548c\u5bab\u9888\u764c\u60a3\u8005\u7684\u5916\u5468\u8840\u4e2d\u68c0\u6d4b\u5230\u4e86HPV 16 E7\u7279\u5f02\u6027\u7ec6\u80de\u6bd2T\u7ec6\u80de\u3002\u7136\u800c\uff0c\u5230\u76ee\u524d\u4e3a\u6b62\uff0c\u8840\u6db2\u4e2d\u5bf9E7\u7684\u53cd\u5e94\u7a0b\u5ea6\u548c\u4e34\u5e8a\u7ed3\u679c\u4e4b\u95f4\u8fd8\u6ca1\u6709\u660e\u786e\u7684\u8054\u7cfb\u3002\u76f8\u6bd4\u4e4b\u4e0b\uff0c\u5916\u5468\u8840\u7ec6\u80de\u6bd2\u6027T\u7ec6\u80de\u5bf9HPV 16 E6\u7684\u53cd\u5e94\u4e0e\u4e34\u5e8a\u7ed3\u679c\u6709\u5173\u3002\u7279\u522b\u662f\uff0cCD4+<\/sup>T\u7ec6\u80de\u5bf9E6 IS\u7684\u53cd\u5e94\u4e0e\u66f4\u597d\u7684\u4e34\u5e8a\u7ed3\u679c\u76f8\u5173\u3002\u76f8\u53cd\uff0c\u529f\u80fd\u53d7\u635f\u7684E6\u7279\u5f02\u6027CD4+<\/sup>T\u7ec6\u80de\u53cd\u5e94\u4e0e\u5bab\u9888\u764c\u76f8\u5173\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u5c3d\u7ba1\u8840\u6db2\u4e2dHPV\u7279\u5f02\u6027\u8bb0\u5fc6T\u7ec6\u80de\u5f88\u5c11\u89c1\uff0c\u4f46\u4e00\u90e8\u5206CIN2\/CIN3\u643a\u5e26\u8005\u786e\u5b9e\u4ea7\u751f\u4e86\u6709\u6548\u7684\u53cd\u5e94\uff1b\u5e76\u4e0d\u662f\u6240\u6709\u7684CIN2\/CIN3\u75c5\u53d8\u90fd\u8fdb\u5c55\u4e3a\u6d78\u6da6\u6027\u764c\u75c7\u3002\u6211\u4eec\u548c\u5176\u4ed6\u4eba\u5df2\u7ecf\u62a5\u9053\uff0c\u57284-6\u4e2a\u6708\u7684\u65f6\u95f4\u5185\uff0c~35%<\/span>\u7684CIN2\/CIN3\u75c5\u53d8\u7ecf\u5386\u4e86\u81ea\u53d1\u6d88\u9000\u3002\u540c\u6837\uff0c\u5728\u4e00\u9879\u9488\u5bf9HPV 16\/18 E6\u548cE7\u7684\u6cbb\u7597\u6027\u5408\u6210DNA\u75ab\u82d7VGX-3100\u7684\u7b2c\u4e8c\u9636\u6bb5\u4e34\u5e8a\u8bd5\u9a8c\u4e2d\uff0c\u4e8e\u8ba1\u5212\u7684\u6807\u51c6\u6cbb\u7597\u5207\u9664\u4e4b\u524d\uff0cHPV 16\u621618+CIN2\/CIN3\u643a\u5e26\u8005\u4e2d\uff0c30%\u7684\u63a5\u53d7\u5b89\u6170\u5242\u7684\u53d7\u8bd5\u8005\u7ecf\u5386\u4e86\u7ec4\u7ec7\u75c5\u7406\u5b66\u9000\u5316\u3002\u4e0e\u5176\u4ed6HPV\u57fa\u56e0\u578b\u76f8\u6bd4\uff0c\u7531HPV 16\u5355\u4e00\u611f\u67d3\u6240\u5f15\u8d77\u7684\u75c5\u53d8\u4e0d\u592a\u53ef\u80fd\u6d88\u9000\uff1a\u5728\u8fd9\u6bb5\u65f6\u95f4\u5185\uff0c\u5927\u7ea6\u670920-25%\u7684\u4e0eHPV16\u76f8\u5173\u7684CIN2\/CIN3\u75c5\u53d8\u6d88\u9000\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

\n

15.1.3 \u5bf9\u81ea\u7136\u611f\u67d3\u7684\u7ec4\u7ec7\u5b9a\u4f4d\u514d\u75ab\u53cd\u5e94<\/p>\n<\/section>\n

\n
\n
\n

\u5728\u8840\u6db2\u4e2d\u68c0\u6d4b\u5230\u7684\u81ea\u7136\u4ea7\u751f\u7684T\u7ec6\u80de\u53cd\u5e94\u7684\u5927\u5c0f\u548c\u5e7f\u5ea6\u90fd\u4e0d\u662f\u5bab\u9888\u4fb5\u88ad\u524dHPV\u75be\u75c5\u6d88\u9000\u7684\u6709\u529b\u9884\u6d4b\u56e0\u7d20\uff0c\u8fd9\u4e00\u4e8b\u5b9e\u63d0\u51fa\u4e86\u4e00\u4e2a\u95ee\u9898\uff0c\u5373\u662f\u5426\u6709\u53ef\u80fd\u5728\u9776\u75c5\u53d8\u4e2d\u8bc6\u522b\u53ef\u4ee5\u9884\u6d4b\u75be\u75c5\u7ed3\u5c40\u7684\u56e0\u7d20\u6216\u662f\u6d88\u9664\u611f\u67d3\u3001\u65e9\u671f\u6076\u6027\u80bf\u7624\u6216\u764c\u75c7\u7684\u514d\u75ab\u53cd\u5e94\u7684\u7279\u5f81\u3002\u5bf9HPV\u635f\u5bb3\u7684\u7ec4\u7ec7\u7814\u7a76\u6b63\u5728\u786e\u5b9a\u4e0e\u4e34\u5e8a\u7ed3\u679c\u76f8\u5173\u7684\u56e0\u7d20\u3002\u5728\u6ca1\u6709\u6d88\u9000\u7684CIN2\/CIN3\u75c5\u53d8\u4e2d\uff0c\u867d\u7136CD8+<\/sup>T\u7ec6\u80de\u5728\u7c98\u819c\u4e2d\u7684\u6d78\u6da6\u5f88\u5f3a\uff0c\u4f46\u5b83\u4eec\u4e3b\u8981\u5c40\u9650\u4e8e\u95f4\u8d28\uff0c\u4e0d\u80fd\u8fdb\u5165\u75c5\u53d8\u4e0a\u76ae\u3002\u53e6\u4e00\u65b9\u9762\uff0c\u4e0a\u76ae\u5185CD8+<\/sup>T\u7ec6\u80de\u7684\u5b58\u5728\u4e0e\u968f\u540e\u7684\u6d88\u9000\u6709\u5173\u3002\u540c\u6837\uff0c\u5728HPV\u76f8\u5173\u7684\u5bab\u9888\u764c\u548c\u53e3\u54bd\u764c\u4e2d\uff0c\u80bf\u7624\u5185CD8+<\/sup>T\u7ec6\u80de\u7684\u5b58\u5728\u4e0e\u8f83\u597d\u7684\u9884\u540e\u76f8\u5173\u3002\u5c3d\u7ba1\u5b58\u5728\u80bf\u7624\u6d78\u6da6\u6027T\u7ec6\u80de\uff0c\u4f46\u6301\u7eed\u7684HPV\u611f\u67d3\u53ef\u80fd\u4f1a\u5bfc\u81f4\u764c\u75c7\u7684\u751f\u957f\uff0c\u8fd9\u5f88\u53ef\u80fd\u662f\u80bf\u7624\u5fae\u73af\u5883\u4e2d\u514d\u75ab\u8010\u53d7\u7684\u7ed3\u679c\uff0c\u8fd9\u4e9b\u56e0\u7d20\u5305\u62ec\u8c03\u8282\u6027T\u7ec6\u80de\u7684\u5b58\u5728\uff0cCTLA-4\u548cPD-1\u7684\u8868\u8fbe\uff0c\u6216\u8005\u7ec6\u80de\u8868\u9762MHC-I\u7c7b\u5206\u5b50\u7684\u4e0b\u8c03\u3002\u5b9a\u91cf\u65b9\u6cd5\uff0c\u5305\u62ec\u56fe\u50cf\u5206\u6790\u5bfc\u5411\u7684\u5feb\u901f\u514d\u75ab\u6fc0\u5149\u6355\u83b7\u663e\u5fae\u5207\u5272\uff0c\u5c06\u4f7f\u5206\u6790\u4ece\u7279\u5b9a\u7ec4\u7ec7\u5b66\u80cc\u666f\u4e2d\u5206\u79bb\u51fa\u7279\u5b9a\u7684\u7ec6\u80de\u4e9a\u7fa4\u6210\u4e3a\u53ef\u80fd\uff0c\u5e76\u5c06\u5b83\u4eec\u4e0e\u4e34\u5e8a\u7ed3\u679c\u76f8\u5173\u8054\u3002\u6700\u540e\uff0c\u5bf9\u75be\u75c5\u6240\u9700\u7684\u75c5\u6bd2\u86cb\u767d\u7684\u7cfb\u7edf\u514d\u75ab\u53cd\u5e94\u5f88\u5f31\uff0c\u4e0d\u80fd\u53ef\u9760\u5730\u9884\u6d4b\u4e34\u5e8a\u884c\u4e3a\uff0c\u8fd9\u7a81\u663e\u4e86\u66f4\u597d\u5730\u4e86\u89e3\u7c98\u819c\u5fae\u73af\u5883\u7684\u5fc5\u8981\u6027\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

\n

15.1.4 \u9884\u9632\u6027\u75ab\u82d7<\/p>\n<\/section>\n

\n
\n
\n

\u76ee\u524d\u9884\u9632HPV\u75be\u75c5\u7684\u7b56\u7565\u5305\u62ec\u7b5b\u67e5\u3001\u4f7f\u7528\u7ec6\u80de\u5b66\u6216HPV\u68c0\u6d4b\uff0c\u53c8\u6216\u662f\u4e24\u8005\u7ed3\u5408\u3002\u9884\u9632\u611f\u67d3\u81f4\u764cHPV\u57fa\u56e0\u578b\u7684\u75ab\u82d7\u7531L1\u7684\u975e\u611f\u67d3\u6027\u91cd\u7ec4\u75c5\u6bd2\u6837\u9897\u7c92(VLP)\u7ec4\u6210\uff0cL1\u662f\u4e24\u79cdHPV\u8863\u58f3\u86cb\u767d\u4e4b\u4e00\u3002\u8fd9\u4e9bVLP\u4e0d\u542b\u75c5\u6bd2DNA\uff0c\u56e0\u6b64\u5b8c\u5168\u4e0d\u5177\u611f\u67d3\u6027\u548c\u81f4\u764c\u6027\u3002\u76ee\u524d\uff0c\u6709\u4e09\u79cd\u6784\u5efa\u7269\u53ef\u4f9b\u9009\u62e9\uff1aCervarix\u00a9<\/sup>\uff0c\u9776\u5411HPV 16\u548c18\u578b(bHPV)\u5e76\u8f85\u4ee5ASO4\u4f50\u5242\uff1bGardasil4\u00a9<\/sup>\uff0c\u9776\u5411HPV 6\u300111\u300116\u548c18\u578b(qHPV)\uff1bGardasil9\u00a9<\/sup>\uff0c\u9776\u5411HPV 6\u300111\u300116\u300118\u300131\u300133\u300145\u300152\u548c58\u578b(nHPV)(Table. 15.1<\/span>)\u3002\u6240\u6709\u914d\u65b9\u90fd\u5bf9HPV\u611f\u67d3\u975e\u5e38\u6709\u6548\uff0c\u4e0d\u4ec5\u4ec5\u5728\u5bab\u9888\uff0c\u800c\u4e14\u5728\u5176\u4ed6\u89e3\u5256\u90e8\u4f4d\u90fd\u975e\u5e38\u6709\u6548\uff0c\u4e14\u65e0\u8bba\u7537\u5973\u3002\u8fd9\u4e9b\u75ab\u82d7\u4ea7\u751f\u7684\u5f3a\u5065\u6297\u4f53\u53cd\u5e94\u6bd4\u81ea\u7136\u611f\u67d3\u5f15\u8d77\u7684\u6297\u4f53\u53cd\u5e94\u59271-2\u4e2a\u5bf9\u6570\u3002\u5728\u5df2\u77e5\u4ee5\u524d\u63a5\u89e6\u8fc7HPV\u7684\u4eba\u4e2d\uff0c\u5355\u6b21\u63a5\u79cdqHPV\u5927\u5927\u63d0\u9ad8\u4e86\u6297\u4f53\u53cd\u5e94\u7684\u5f3a\u5ea6\u548c\u8d28\u91cf\u3002\u4e0e\u81ea\u7136\u611f\u67d3\u4ea7\u751f\u7684\u975e\u4e2d\u548c\u6297\u4f53\u4e0d\u540c\uff0c\u63a5\u79cd\u75ab\u82d7\u4ea7\u751f\u7684\u6297\u4f53\u662f\u4e2d\u548c\u6297\u4f53\u3002\u867d\u7136bHPV\u548cqHPV\u75ab\u82d7\u90fd\u663e\u793a\u51fa\u5bf9\u5176\u4ed6HPV\u7c7b\u578b\u7684\u4ea4\u53c9\u4fdd\u62a4\uff0c\u4f46Cervarix\u00a9<\/sup>\u5bf9HPV 31\u300133\u300145\u300151\u548c52\u63d0\u4f9b\u4ea4\u53c9\u4fdd\u62a4\uff0c\u800cGardasil4\u00a9<\/sup>\u88ab\u8bc1\u660e\u53ea\u5bf9HPV 31\u5177\u6709\u4ea4\u53c9\u4fdd\u62a4\u4f5c\u7528\u3002Cervarix\u00a9<\/sup>\u7684\u5e7f\u6cdb\u4ea4\u53c9\u53cd\u5e94\u5f88\u53ef\u80fd\u5f52\u56e0\u4e8e\u5176\u4f50\u5242ASO4\uff0c\u8fd9\u662f\u4e00\u79cdTLR4\u6fc0\u52a8\u5242\u3002\u73b0\u6709\u7684\u9884\u9632\u6027\u75ab\u82d7Gardasil\u00a9<\/sup>\u548cCervarix\u00a9<\/sup>\u6ca1\u6709\u6cbb\u7597\u6548\u679c\u3002\u7136\u800c\uff0c\u6765\u81ea\u56db\u4ef7HPV\u75ab\u82d7\u7814\u7a76\u7684\u65b0\u8bc1\u636e\u8868\u660e\uff0cCIN2\/CIN3\u5207\u9664\u6cbb\u7597\u540e\u63a5\u79cd\u9884\u9632\u6027\u75ab\u82d7\u53ef\u663e\u8457\u964d\u4f4e\u75be\u75c5\u590d\u53d1\u7684\u53ef\u80fd\u6027\u3002\u8fd9\u79cd\u4fdd\u62a4\u4f5c\u7528\u7684\u4f5c\u7528\u65b9\u5f0f\u5c1a\u4e0d\u6e05\u695a\uff0c\u76ee\u524d\u6b63\u5728\u79ef\u6781\u8c03\u67e5\u4e2d\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

\n
<\/section>\n<\/section>\n
\n
\n
\n


<\/p>\n<\/section>\n<\/section>\n

\n
\n

Table. 15.1<\/span>  \u73b0\u6709\u7684\u9884\u9632\u6027HPV\u75ab\u82d7<\/span><\/p>\n<\/section>\n<\/section>\n<\/section>\n

\n

15.1.5 \u6cbb\u7597\u6027\u75ab\u82d7<\/p>\n<\/section>\n

\n
\n
\n

\u4e0e\u9884\u9632\u6027\u75ab\u82d7\u4e0d\u540c\uff0c\u65b0\u7684\u6cbb\u7597\u6027\u75ab\u82d7\u7684\u5f00\u53d1\u91cd\u70b9\u662f\u9488\u5bf9E6\u548cE7\u7684\u3002\u6548\u5e94T\u7ec6\u80de\u5bf9\u8fd9\u4e9b\u75c5\u6bd2\u3001\u975e\u81ea\u8eab\u764c\u86cb\u767d\u7684\u53cd\u5e94\u53ef\u80fd\u5728\u4ecb\u5bfc\u75c5\u53d8\u6d88\u9000\u4e2d\u53d1\u6325\u4f5c\u7528\uff0c\u8fd9\u4e9b\u86cb\u767d\u7531\u8f6c\u5316\u7ec6\u80de\u7ed3\u6784\u6027\u8868\u8fbe\u3002\u4e3a\u60a3\u6709\u4fb5\u88ad\u524d\u75be\u75c5\u7684\u4eba\u63d0\u4f9b\u4e86\u4e00\u4e2a\u673a\u4f1a\u6765\u8bc1\u5b9e\u514d\u75ab\u6cbb\u7597\u7b56\u7565\u7684\u6709\u6548\u6027\u3002\u8fd9\u4e9b\u75c5\u53d8\u662f\u53ef\u4ee5\u68c0\u6d4b\u5230\u7684\u4e14\u5177\u6709\u7279\u5f02\u6027\u7684\uff0c\u8fd9\u4e3a\u5728\u5e72\u9884\u524d\u540e\u8bc4\u4f30\u76f8\u5173\u7ec4\u7ec7\u63d0\u4f9b\u4e86\u673a\u4f1a\u3002\u6b64\u5916\uff0c\u6709\u4e00\u90e8\u5206\u75c5\u53d8\u4f1a\u6d88\u9000\uff0c\u56e0\u6b64\u53ef\u7528\u4e8e\u9884\u6d4b\u9884\u5904\u7406\u548c\u8bf1\u5bfc\u514d\u75ab\u53cd\u5e94\u7684\u6cbb\u7597\u6548\u679c\u3002\u7814\u7a76\u7ec4\u7ec7\u8fd8\u5c06\u63d0\u4f9b\u786e\u5b9aHPV\u75be\u75c5\u4e0d\u540c\u9636\u6bb5\u4ecb\u5bfc\u7684\u514d\u75ab\u6291\u5236\u673a\u5236\u7684\u65b9\u6cd5\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

\n
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\u672c\u6587\u7531Oncolab\u5fae\u4fe1\u516c\u4f17\u53f7\u7ffb\u8bd1\u6574\u7406\u81eaOncoimmunology: A Practical Guide for Cancer Immunotherapy\uff0c\u4ec5\u7528\u4e8e\u5b66\u4e60\u4ea4\u6d41\u4f7f\u7528\uff0c\u5982\u9700\u8d2d\u4e70\u539f\u7248\u4e66\u7c4d\u53ef\u70b9\u51fb\u9605\u8bfb\u539f\u6587\u8d2d\u4e70\u3002<\/span>
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\u2014 THE  END \u2014<\/span><\/p>\n


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\u6765\u6e90 |<\/span>Oncoimmunology: A Practical Guide <\/span><\/section>\n
f<\/span>or Cancer Immunotherapy<\/span><\/section>\n
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\u4f5c\u8005 | <\/span>Maria Agarwal and Cornelia Trimble<\/span><\/section>\n
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\u7ffb\u8bd1 | \u7f57\u4f73\u4f73 \u9648\u6653\u610f \u7ae0\u9707 \u5f90\u66fc\u65af<\/span><\/section>\n
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\u7f51\u5740\u662f\uff1aoncolab.cn<\/span><\/strong><\/p>\n<\/section>\n

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\u52a0\u5165\u77e5\u8bc6\u661f\u7403~<\/span><\/p>\n

\u7528\u4e8eOncoLab\u8bfb\u8005\u4ea4\u6d41\u4e92\u52a9\u6c38\u4e45\u514d\u8d39
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\u672c\u7bc7\u6587\u7ae0\u6765\u6e90\u4e8e\u5fae\u4fe1\u516c\u4f17\u53f7:OncoLab<\/p>\n<\/blockquote>\n<\/div>\n","protected":false},"excerpt":{"rendered":"

15.1 \u5f15\u8a00 \u5728\u5168\u7403\u8303\u56f4\u5185\uff0c\u5927\u7ea6\u516d\u5206\u4e4b\u4e00\u7684\u65b0\u7684\u764c\u75c7\u8bca\u65ad\u53ef\u5f52\u56e0\u4e8e\u4e00\u79cd\u7279\u5b9a\u7684\u611f\u67d3\u75c5\u539f\u4f53(Fig. 15.1)\u3002\u4eba\u7c7b\u4e73\u5934\u7624\u75c5\u6bd2(HPV)\u5bfc\u81f4\u4e86\u5927\u7ea630%\u764c\u75c7\u76f8\u5173\u7684\u611f\u67d3\uff0c\u5305\u62ec\u5bab\u9888\u764c\u3001\u9634\u9053…<\/p>\n","protected":false},"author":1,"featured_media":4750,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[59],"tags":[],"_links":{"self":[{"href":"http:\/\/dh.oncolab.cn\/index.php\/wp-json\/wp\/v2\/posts\/4757"}],"collection":[{"href":"http:\/\/dh.oncolab.cn\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/dh.oncolab.cn\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/dh.oncolab.cn\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/dh.oncolab.cn\/index.php\/wp-json\/wp\/v2\/comments?post=4757"}],"version-history":[{"count":0,"href":"http:\/\/dh.oncolab.cn\/index.php\/wp-json\/wp\/v2\/posts\/4757\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"http:\/\/dh.oncolab.cn\/index.php\/wp-json\/wp\/v2\/media\/4750"}],"wp:attachment":[{"href":"http:\/\/dh.oncolab.cn\/index.php\/wp-json\/wp\/v2\/media?parent=4757"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/dh.oncolab.cn\/index.php\/wp-json\/wp\/v2\/categories?post=4757"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/dh.oncolab.cn\/index.php\/wp-json\/wp\/v2\/tags?post=4757"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}