Chirwere chemhondi
Maererano nehuwandu hweWorld Health Organisation muna 2012, kune vanhu vatsva vanosvika mazana mashanu nemakumi matatu ezviuru zvegomarara remuromo wechibereko pasi rose gore rega rega, uye vanhu vakafa pagore vanosvika zviuru mazana maviri nemakumi matanhatu nematanhatu. Varwere vanodarika 530,000% vari munyika dzichiri kusimukira, uye kuChina kune vanhu vatsva vanodarika 266,000 85 vane gomarara remuchibereko gore rega rega. Kuitika kwegomarara remuromo wechibereko kunoenderana zvakanyanya nehutachiona. Nhamba huru yezvidzidzo zvemamolecular epidemiological yakawana kuti hutachiona hunoramba huine ngozi huru yevanhu papillomavirus (HPV) ndiyo honzeri huru yegomarara rechibereko uye chinhu chinodiwa. Pasi pezvimwe zvinhu zvinobatsira (reproductive tract inflammation) Inokonzera gomarara remuromo wechibereko uye kukurudzira kukura kwebundu.
Epidemiological kuongororwa kwecancer yechibereko HPV hutachiona
HPV hutachiona hweDNA hutete-hwakakomberedzwa. Parizvino, anodarika zana nemakumi masere e HPV subtypes anowanikwa, angangoita makumi mana acho ari anal anal reproductive tract infection subtypes, and 180 types can cause anal reproductive tract malignant tumors, known as a high-risk HPV.
Yakanyanya-njodzi hutachiona hweHIVV mamiriro anodikanwa ecancer yemuromo wechibereko, asi havazi vese vanhu vane hutachiona hweHIVV vanozoita gomarara remuchibereko. Zvidzidzo zveEpidemiological zvakaratidza kuti huwandu hwehutachiona hweHIVV hune huwandu muhuwandu hwevanhu hunosvika 15% kusvika 20%, vanopfuura makumi mashanu muzana evakadzi vane hutachiona hweHIVV mushure mebonde rekutanga, uye makumi masere evakadzi vakatapukirwa neHIVV panguva yeupenyu hwavo. . Zvisinei, vanopfuura makumi mapfumbamwe muzana emadzimai vanokwanisa kujekeswa nema immune system mukati memakore matatu mushure meHIVV hutachiona. Chete gumi muzana yevarwere vanogona kunge vaine hutachiona husingaperi, uye <50% yevarwere vane hutachiona husingaperi vanozopedzisira vaita gomarara remuchibereko. Pakati pevanhu vasina kukwana [kunyanya avo vane hutachiona hwehutachiona hwehutachiona hweHIV (HIV)], njodzi yegomarara remuromo wechibereko yakawedzera zvakanyanya, zvinoenderana nekutadza kwemuviri kubvisa HPV. Izvo zvinoitika zvegomarara remuromo wechibereko inzira yakaoma yakawanda yematanho inoda matanho matatu: hutachiona hutachiona, maronda anonamira, uye kenza inopinda. Kazhinji zvinotora anopfuura makore gumi kubva kuhutachiona hwehutachiwana hweHIVV kusvika pagomarara remuromo wechibereko.
Zviratidzo zvekuratidzwa kwehutachiona hweHIVV hazvina kutaurwa
Nzira huru yehutachiona hweHIVV kusangana pabonde. HPV inobata maseru ebasal kuburikidza neganda rakakuvara uye mucous membranes. Nekuti hutachiona hweHIVV hwakavanzwa, hapana viremia ichaitika pasina kusangana neropa uye immune system yekutanga, saka hakuzove nekuzvimba kuri pachena mukiriniki. Panguva imwecheteyo, HPV inogona kunzvenga immune system clearance nekudzika-kudzora iyo interferon nzira kana kudzikisira kutaura kweToll-senge ma receptors.
Kudzokororwa kwehutachiona hweHPV kunoenderana neyakagashira DNA replication system. Sezvo maseru ebasal achisiyanisa uye akakura kuita maseru epamusoro, kudzokorora kwehutachiona kunowedzera uye zvimedu zvehutachiona zvinoburitswa sezvo masero anopinda apoptosis. Izvi zvinotora anenge mavhiki matatu. Kana hutachiona hwaonekwa nekutanga uye kuwana immune system, muviri unotanga nhevedzano yekuzvimba kwekudzivirira hutachiona kubvisa hutachiona, asi kuratidzwa kwekiriniki kwese hakuna kujeka.
Parizvino, hapana chaicho kurapwa kwehutachiwana hwehutachiona hweHIVV mukiriniki. Chinhu chakanyanya kukosha mushure mehutachiona hweHIVV kuongororwa kwechibereko, kuongororwa kwegore reHIVV, uye colposcopy kana zvichidikanwa kusabvisa gomarara remuromo wechibereko uye maronda anonamira. Mashandiro ehutachiwana hweHIVV anokonzera gomarara remuromo wechibereko
Iyo carcinogenesis yeiyo yakanyanya njodzi HPV inowanzoitika kuburikidza nehutachiona E6 uye E7 oncoproteins, ayo akabatana neP53 neRb mapuroteni anokanganisa kuwanda kwesero uye maseru kutenderera mutemo, zvichikonzera kuwanda kwesero kuwanda uye shanduko, uye E6 uye E7 oncoprotein ane imwe Synergy. Chidzidzo chacho chakawana zvakare kuti E5 oncoprotein inoitawo basa rakakosha mukudzivirira immune uye carcinogenesis.
Hukama pakati peHIVV carcinogenesis uye zvimwe zvekubereka hutachiona hutachiona uye kuzvimba
Zvidzidzo zvakawana kuchinja kukuru mukervical local cytokines [zvakadai se interferon (IFN), interleukin 10 (IL-10), IL-1, IL6, uye tumor necrosis factor (TNF), nezvimwewo] mukenza yekervical uye precancerous maronda, zvichiratidza. kuzvimba kwenzvimbo Pane imwe basa mukuitika kwegomarara remuromo wechibereko. Zvidzidzo zvakaratidza kuti HPV's E5, E6, uye E7 oncoprotein inogona kupinza cyclooxygenase-prostaglandin (COX-PG) axis. Zvidzidzo zvakapfuura zvakawana kuti COX2 inobata basa mukukuvadzwa kweDNA, kuvharidzira apoptosis, angiogenesis, uye bundu kukura Basa rakakosha. Zvidzidzo zveEpidemiological zvakawana kuti varwere vane hutachiona hwehutachiona hwakadai segonococcus, chlamydia, uye herpesvirus rudzi rwechipiri vane njodzi yakawedzera yegomarara remuchibereko. Iyo nzira yekuwedzera njodzi yekenza yechibereko muvarwere vane hutachiona hwemunharaunda uye kuzvimba kwenzvimbo kunogona kukonzera metaplasia yemuno. Aya metaplastic epithelia anogona kuwedzera mukana wekutapukirwa neHPV uye HPV viral load. Meta-analysis inoratidza kuti Chlamydia utachiona chinhu synergistic chinhu chegomarara rechibereko. Naizvozvo, kuderedza hutachiona hwenhengo dzesikarudzi uye kudzora kuzvimba kwenzvimbo kungavewo chinhu chakakosha mukuderedza gomarara remuchibereko.
