Prophylaxe des Vulva- und des Vaginalkarzinoms und ihrer Vorstufen

Hampl, M. und Dannecker, C. (2019): Prophylaxe des Vulva- und des Vaginalkarzinoms und ihrer Vorstufen. In: Onkologe, Bd. 25, Nr. 5: S. 411-419

Abstract

BackgroundVulvar and vaginal carcinomas are increasingly diagnosed tumor entities in Germany. Vulvar and vaginal carcinomas arise via two different pathogenetic mechanisms: Persistent infection with the human papillomavirus (HPV;especially types16, 31, 33) can lead to invasive vulvar/vaginal carcinomas via undifferentiated vulvar/vaginal intraepithelial neoplasia (VIN/VAIN). These tumors are more likely to be found in younger women. These tumors have to be distinguished from vulvar cancer in older women, which results from mutations in the tumor suppressor gene p53 on the background of achronic skin disease (e.g., lichen sclerosus et atrophicus, LSA). One of the risk factors for vaginal carcinoma is also lichen sclerosis or lichen planus;these tumors are HPV negative. There are also anumber of tumors whose cause is unknown.ObjectiveAre there are primary or secondary preventive measurements to help to reduce or erase the induction of vulvar cancer?ResultsHPV-induced vulvar and vaginal cancers can be prevented primarily by HPV vaccination of HPV-naive young women. The nonavalent vaccine covers the relevant HPV types16, (18), 31, and 33 with an efficacy of 97%;the bivalent vaccine has comparably high efficiencies but only for HPV16 and 18. Whether lichen sclerosis-induced vulvar/vaginal carcinoma can be prevented primarily by preventive local long-term therapy with locally applied cortisone or calcineurin inhibitors is discussed. First data suggest that this is the case.

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• ISSN: 0947-8965
• Sprache: Deutsch