Human Papillomavirus(HPV)感染と口腔癌の関係について─最近の研究から─  [in Japanese] Association of Human Papillomavirus (HPV) Infection with Oral Cancer: Review of Recent Research  [in Japanese]

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    • 重石 英生 SHIGEISHI Hideo
    • 広島大学大学院医歯薬保健学研究科医歯薬学専攻歯学講座口腔外科学研究室 Department of Oral and Maxillofacial Surgery, Program of Dentistry, Graduate School of Biomedical and Health Sciences, Hiroshima University
    • 杉山 勝 SUGIYAMA Masaru
    • 広島大学大学院医歯薬保健学研究科口腔健康科学専攻口腔健康科学講座公衆口腔保健学研究室 Department of Public Oral Health, Program of Oral Health Science, Graduate School of Biomedical and Health Sciences, Hiroshima University


<p><b> </b>Human Papillomavirus(HPV)の感染は子宮頸癌の最大の危険因子であり,頭頸部領域では中咽頭癌の発症や治療の予後に関係している.一方,口腔へのHPV感染と口腔癌との因果関係についてはいまだ不明な点が多い.そこで本稿では,最新の疫学研究や基礎的研究の結果をもとに,口腔のHPV感染の危険因子や,口腔癌におけるHPV陽性率および HPV陽性口腔癌の分子生物学的特徴について検討した.その結果,口腔癌におけるHPV DNAの陽性率は4.0 〜32.0%で,高リスク型HPVの中では,HPV16が高い陽性率を示した.上皮異形成症や口腔扁平上皮癌では,正常口腔上皮と比較してHPV16陽性率が高く,HPV16が口腔癌の発生において何らかの役割を担う可能性がある.また,口腔癌では,E6, E7 mRNAの陽性率は数%であり,HPV DNA陽性率と比較しても低いため,HPV関連口腔癌(口腔のHPV感染が原因で生じる口腔癌)において,E6, E7の安定高発現を介さない悪性形質の獲得機構の存在が示唆される.HPV16陽性口腔癌患者は陰性口腔癌患者と比較して,予後が良好であるとの報告があるが,HPV関連口腔癌の予後についてはいまだ明らかになっていない.口腔内の衛生状態とHPV感染には関連性があり,口腔ケアや禁煙対策は,口腔へのHPV感染を予防するうえで重要であると考えられる.今後,HPV関連口腔癌の予防を科学的根拠に基づいて行うためには,HPV DNA陽性口腔癌におけるHPVの存在意義と役割を明確にする必要があり,口腔HPV感染の基礎的,臨床的研究の推進が強く望まれる.</p>

<p>Human papillomavirus (HPV) infection is a major risk factor for cervical cancer, and may also be associated with the development of oropharyngeal cancer and prognosis of affected patients. However, the causal relationship between HPV infection and oral cancer has not been fully elucidated. In this review, we examined recent results of epidemiologic and basic research studies to elucidate risk factors associated with oral HPV infection, HPV prevalence in oral cancer patients, and the characteristics of the molecular mechanism of HPV-positive oral cancer. We found that HPV DNA was positive in 4.0-32.0% of oral cancer cases, with HPV16 being a common high-risk type found in oral cancer specimens. Also, the rate of HPV16-positivity was higher in epithelial dysplasia lesion and oral squamous cell carcinoma samples compared with normal epithelial tissues, suggesting that HPV16 is involved in oral cancer development. A low percentage of oral cancer cases showed E6 and E7 mRNA-positivity, and the positive rates of E6 and E7 mRNA were lower than those of HPV DNA; thus, we suggest that molecular mechanisms independent of stable E6 and E7 expression may be involved in the malignant transformation of HPV-related oral cancer (i.e., oral cancer caused by oral HPV infection). Although HPV16-positive oral cancers were associated with a better prognosis compared with HPV16-negative oral cancers, it remains unclear whether HPV-related oral cancers are associated with a better prognosis. Since oral HPV infection is associated with poor oral hygiene, oral health care and smoking cessation may play significant roles in its prevention. For the development of evidence-based prevention strategies for the treatment of HPV-related oral cancer, it is necessary to clarify the significance of the existence and role of HPV in HPV DNA-positive oral cancer. It is strongly anticipated that the results of basic and clinical studies of oral HPV infection will be presented in the near future.</p>



    JOURNAL OF DENTAL HEALTH 67(3), 149-159, 2017

    Japanese Society for Oral Health


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