臨床婦人科産科61巻6号

2007年06月発行

今月の臨床 子宮頸癌の治療─現状と展望

HPVワクチンの展望

著者： 川名敬¹ 武谷雄二¹

所属機関： ¹東京大学医学部産科婦人科

ページ範囲：P.837 - P.841

はじめに

　ヒトパピローマウイルス（以下，HPV）が子宮頸癌の発がんに深く関与していることがわかって以来，この四半世紀の間HPVワクチンの研究が精力的に行われてきた．そして最近になって，ようやく初のHPVワクチンが製剤化され，昨年欧米で認可され，本邦への導入も間近となっている．しかし，現行のHPVワクチンはまだ多くの課題を抱えており，製剤化されたとはいえ，まだ第一歩を踏み出したばかりである．本稿では，現状のHPVワクチンの課題を挙げ，本邦における活用法と今後の展望を考えたい．

参考文献

1) zur Hausen H : Papillomavirus and cancer : from basic studies to clinical application. Nat Rev Cancer 2 : 342-350, 2002

2) Dunne EF, Unger ER, Stenberg M, et al : Prevalence of HPV infection among females in the United States. JAMA 297 : 813-819, 2007

3) The current status of development of prophylactic vaccines against human papillomavirus infection. Report of a technical meeting. pp16-18, Geneva, 1999

4) Bosch FX, de Sanjose S : Human papillomavirus and cervical cancer - burden and assessment of causality. J Natl Cancer Inst Monogr 31 : 3-13, 2003

5) 川名　敬，八杉利治，武谷雄二 : STDは子宮頸がん・外陰がんを増加させているか？産科と婦人科70 : 1173-1179, 2003

6) Ho GY, Bierman R, Beardsley L, et al : Natural history of cervicovaginal papillomavirus infection in young women. N Engl J Med 338 : 423, 1998

7) Trottier H, Franco EL : The epidemiology of genital human papillomavirus infection. Vaccine 24(Supp1) : S1-S15, 2006

8) Koutsky LA, Ault KA, Wheeler CM, et al : A controlled trial of a human papillomavirus type 16 vaccine. N Engl J Med 347 : 1645-1651, 2002

9) Villa LL, Ault KA, Giuliano AR, et al : Immunologic responses following administration of a vaccine targeting human papillomavirus Types 6, 11, 16, and 18. Vaccine 24(27-28): 5571-5583, 2006

10) Villa LL, Costa RL, Petta CA, et al : High sustained efficacy of a prophylactic quadrivalent human papillomavirus types 6／11／16／18L1 virus-like particle vaccine through 5 years of follow-up. Br J Cancer 95 : 1459-1466, 2006

11) Harper DM, Franco EL, Wheeler CM, et al : Sustained efficacy up to 4・5 years of a bivalent L1 virus-like particle vaccine against human papillomavirus types 16 and 18 : follow-up from a randomised control trial. Lancet 367 : 1247-1255, 2006

12) Miura S, Matsumoto K, Okai A, et al : Do we need a different strategy for HPV screening and vaccination in East Asia？Int J Cancer 119 : 2713-2715, 2006

13) Kawana K, Yoshikawa H, Taketani Y, et al : Neutralizing epitope of L2 minor capsid protein common to human papillomavirus type 16 and 6. J Virol 73 : 6188-6190, 1999

14) Kondo K, Ishii Y, Kanda T, et al : Neutralization of HPV16, 18, 31, and 58 pseudovirions with antisera induced by immunizing rabbits with synthetic peptides representing segments of the HPV16 minor capsid protein L2 surface region. Virology 358 : 266-272, 2007

15) Kawana K, Yasugi T, Kanda T, et al : Neutralizing antibodies against oncogenic human papillomavirus(HPV)as a possible determinant of the fate of low-grade cervical intraepithelial neoplasia. Biochem Biophys Res Commun 296 : 102-105, 2002