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要旨●頭頸部癌の主な危険因子は従来,飲酒や喫煙とされてきたが,近年,ヒト乳頭腫ウイルス(HPV)の持続感染が頭頸部癌,特に中咽頭癌に関与していることが明らかとなり注目されている.頭頸部癌におけるHPV陽性率は年々増加傾向にあり,HPV由来の癌遺伝子高発現に伴う癌抑制遺伝子であるp53およびRbの不活性化が発癌に関与すると考えられている.HPV陽性の中咽頭癌は,HPV陰性の中咽頭癌に比べ,若年で飲酒・喫煙歴が少ない,重複癌の合併が少ない,予後良好であるなどの臨床的特徴を有しており,HPV感染の有無に応じた新たな治療戦略が必要である.
Conventionally, alcohol consumption and smoking are the main risk factors for head and neck cancers. HPV(human papillomavirus)has also been established as a cause of head and neck cancers, particularly oropharyngeal cancer. Recently, the incidence rate of HPV-positive head and neck cancers is rising rapidly. Oncogenes derived from HPV are known to inactivate the major tumor suppressors, p53 and pRB. Additionally, the epidemiologic and biological features between HPV-positive and HPV-negative oropharyngeal cancer differ completely. Therefore, novel treatment strategies for head and neck cancers should be designed according to their HPV-positive and HPV-negative statuses.
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