人类乳头瘤病毒 (HPV) 疫苗接种在女性化
Philipp Kapp1, Christine Schmucker1, Waldemar Siemens1
1Institute for Evidence in Medicine, Medical Center - University of Freiburg / Medical Faculty - University of Freiburg, Freiburg, Germany.
The Cochrane database of systematic reviews
|September 8, 2025
概括
在宫缩的时间内进行的HPV疫苗接种可以降低2级或更高 (CIN 2+) 的宫内皮质瘤的风险. 然而,证据有限,需要进一步的随机对照试验才能得出强有力的结论.
科学领域:
- 妇科 妇科 妇科 妇科
- 在瘤学瘤学.
- 疫苗学 疫苗学 疫苗学
背景情况:
- 子宫癌是一个全球性的健康问题,主要是由持续的人类乳头瘤病毒 (HPV) 感染引起的.
- 高度的宫内皮瘤 (CIN 2和CIN 3) 通常需要宫化,这是一种具有复发和进展风险的程序.
- HPV 疫苗接种在经过化的女性中的作用尚不清楚.
研究的目的:
- 评估HPV疫苗接种在经过化的妇女中所带来的益处和危害.
- 为了比较HPV疫苗接种之前,在接种期间或接种后与没有接种疫苗.
主要方法:
- 包括到2023年5月发表的随机对照试验 (RCT) 和非随机干预研究 (NRSI).
- 搜索了主要的数据库,包括CENTRAL,MEDLINE,Embase和科学网络.
- 使用Cochrane RoB 2和ROBINS-I工具评估偏差风险,证据确定性被评为GRADE.
主要成果:
- 接种HPV疫苗可能会降低CIN 2+的风险 (来自2个RCT和11个NRSI的低确定性证据).
- 对CIN 3+和其他关键结局 (如侵入性宫癌和持续性HPV感染) 的证据主要是非常不确定的.
- 一个RCT报告了轻微的局部反应和罕见的严重过敏作为不良事件.
结论:
- 围绕化的HPV疫苗接种可能会降低CIN 2+风险,但证据主要基于具有显著偏差的NRSI.
- 有限的RCT数据需要进一步进行高质量的试验,特别是使用非价值疫苗和安慰剂对照.
- 未来的研究应该根据先前的疫苗接种情况和年龄组探索最佳的疫苗接种时间及其影响.
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