课件：HPV与宫颈癌筛查.ppt

* If instead of using HPV DNA testing, we screen using both HPV and liquid-based cytology there would be only one woman with CIN 2,3 who was missed by the screening. However, in order to identify the 2 additional women with CIN 2,3 missed using HPV DNA testing alone, we would have had to perform 5,000 liquid-based cytology specimens. Is this really useful, especially when realizing that previously we utilized cytology alone to screen with and would have missed 13 cases of CIN 2,3. Because of these types of considerations it is possible that at some point in the future HPV DNA testing may be approved for use as screening test without simultaneous use of cervical cytology. * 钱德英课件里的片子，没有做HC2给耽误了，其实是腺癌，细胞学检测不到；外边看起来光滑，其实容易漏诊 * VLP = Virus-like particle Kirnbauer R, Booy F, Cheng N, Lowy DR, Schiller JT. Proc Natl Acad Sci USA. 1992;89:12180–12184. Syrj?nen KJ, Syrj?nen SM. Chichester, United Kingdom: John Wiley Sons, Inc; 2000:11–51. Key Point Virus-like particles spontaneously assemble when the HPV L1 protein is overexpressed in several different cell types. Virus-like particles consist of 72 capsomeres, each of which is composed of 5 L1 molecules. Background When overexpressed in mammalian,1 insect,2 yeast,3 or bacterial cells,4 the papillomavirus L1 protein spontaneously assembles to form VLPs that are devoid of the oncogenic viral genome.5 High-resolution cryoelectron microscopic analysis has determined that the HPV structure consists of 72 pentameric capsomeres, each composed of 5 L1 molecules.2,6 References Hagensee ME, Yaegashi N, Galloway DA. Self-assembly of human papillomavirus type 1 capsids by expression of the L1 protein alone or by coexpression of the L1 and L2 capsid proteins. J Virol. 1993;67:315–322. Kirnbauer R, Booy F, Cheng N, Lowy DR, Schiller JT. Papillomavirus L1 major capsid protein self-assembles into virus-like particles that are highly immunogenic. Proc Natl Acad Sci USA. 1992;89:12180–12184. Jansen KU, Rosolowsky M, Schu