►健康◄种菜花的一天＊浅谈人类乳突病毒＊

可能很多人因为罗主任和郭采撷的八卦新闻都听过菜花?!

不过菜花到底是啥米啊？

怎样才会得到菜花？

就带大家来了解一下这名叫菜花但既不是菜也不是花的菜花吧…

其实菜花只是其中一种型态的人类乳突病毒导致的症状…

同样的道理子宫颈癌也只是人类乳突病毒某个型态导致的疾病…

所以人类乳突病毒≠菜花≠子宫颈癌…

那到底甚么又是人类乳突病毒呢？

Maybe u’ve heard of “cauliflower” form some affairs of those pop stars, but what exactly is “cauliflower”?

The following are some basic informations of it.

Actually “cauliflower” is just a symptom caused by one of the HPV types, so as the cervical cancer.

Then what is HPV?

Q：人类乳突病毒有那些症状啊???

Q：The symptoms of Human Papilloma Virus; HPV.

一般人类乳突病毒通常都没有症状，除非它是其中一种会产生疣的病毒型态。

可能在接触已经得到人类乳突病毒的性伴侣后会出现生殖器湿疣，

症状则持续数周到数月不等，少数则会是数年。

湿疣看起来就像是一群突起的鸡皮疙瘩散落在生殖器上。

或大或小，有些是平坦的有些则是突起的，因为形状像菜花所以才有这个俗称。

没治疗的话，它可能会不治而愈或保持原状或更茁壮。但湿疣通常很少会变成癌症。

Genital HPV usually has no symptoms, unless it’s a type that causes genital warts.

Genital warts may appear within weeks or months after contact with a partner who has HPV.

More rarely, genital warts may show up years after exposure.

The warts usually look like small bumps or groups of bumps in the genital area

. They can be small or large, raised or flat, or shaped like a cauliflower.

If they are not treated, genital warts might go away, stay and not change, or increase in size or number.

But warts very rarely turn into cancer.

也因为通常人类自己的免疫系统会自己对抗病毒所以都不太会有症状显现，

所以很多人都会不知道自己得了人类乳突病毒，免疫系统会在约2年内自己对抗病毒。

但如果病毒一直没被消灭的话，就很有可能会导致细胞病变数年后就会衍生为癌症。

Most people will never know they have HPV because they have no symptoms and their immune system inactivates the virus.

In about 90% of people, their immune system clears the HPV infection within 2 years.

This is true of both high-risk and low-risk HPV types. Sometimes HPV infections are not cleared.

This can lead to cell changes that over many years may develop into cancer.

Q：到底甚么是人类乳突病毒???

Q：What is HPV?

人类乳突病毒是一种缺乏人类乳突状瘤的病毒，

它其实包含了超过150种不同型态的病毒，每一个病毒都有自己的编号。

它被称作乳突病毒而非癌症是因为有些型态的病毒只会导致湿疣或乳突瘤(非癌症的肿瘤)。

HPV is short for human papilloma (pap-uh-LO-muh) virus. HPVs are a group of more than 150 related viruses.

Each HPV virus in the group is given a number, which is called an HPV type.

HPVs are called papilloma viruses because some of the HPV types cause warts or papillomas, which are non-cancerous tumors.

乳突状瘤病毒只能存活在鳞状上皮细胞里，因为它很薄又平坦。

常常在潮湿的皮肤表面被发现，

像是阴道、肛门、子宫颈、外阴部，阴茎头、口、喉咙、气管、支气管及肺部等。

其他地方则不会长，所以手不会生出菜花来，除非你一直留手汗(？！)哈哈流手汗也不会啦: P

The papilloma viruses are attracted to and are able to live only in squamous epithelial cells in the body.

Squamous epithelial cells are thin, flat cells.

They are found in the surface of the skin and in moist surfaces like the vagina, anus,

cervix (the base of the womb at the top of the vagina),

vulva (around the outside of the vagina), head of the penis,

mouth, throat, trachea (the main breathing tube), bronchi (smaller breathing tubes branching off the trachea), and lungs.

HPVs will not grow in other parts of the body.

人类乳突病毒又分成两种等级：低危险群跟高危险群。

低危险群包括第6型及第11型，虽然也会导致细胞上某些程度的改变但比较不会进展成癌症；

相较之下高危险群(16、18、31、33、35、39、45、51、52、58、59、68)则较容易进展为癌症。

This type of genital wart is called a condyloma acuminatum and is most often caused by HPV-6 or HPV-11.

Because these genital warts very rarely grow into cancer, HPV-6 and HPV-11 are called low-risk viruses.

These low-risk types can also cause low-grade changes in the cells that do not develop into cancer.

Common high-risk HPV types include:

HPV-16, HPV-18, HPV-31, HPV-33, HPV-35, HPV-39, HPV-45, HPV-51, HPV-52, HPV-58, HPV-59, HPV-68

These types are called high-risk because they can cause cancer.

They also cause low-grade and high-grade changes in the cells and pre-cancers.

Doctors worry more about the high-grade changes and pre-cancers, because they are more likely to grow into cancers over time.

Q：那么要做哪些检查才能得知并诊断自己得到人类乳突病毒呢???

Q：The diagnosis of HPV.

子宫颈抹片检查是要找出子宫颈细胞有没有细胞变化或不正常的细胞

(这些不正常的细高有可能是癌症或癌症前的病灶)。

然后取得的组织再拿到显微镜底下判断有没有不正常的细胞分化，

子宫颈抹片检查是一个很有效的检查方式，但台湾却很多人因为害羞而不敢去做，实在有点可惜。

A Pap test is used to find cell changes or abnormal cells in the cervix.

(These abnormal cells may be pre-cancer or cancer, but they may also be other things.)

Cells from the cervix are removed, processed, and then looked at under a microscope to see if the cells are normal or if changes can be seen.

The Pap test is a very good test for finding cancer cells and cells that might become cancer.

另外一个检查则是人类乳突病毒测试，因为人类乳突病毒会导致子宫颈细胞病变，

所以在你执行子宫镜抹片检查的时候同时可以做这项测试，

两项检查一起做更能让30岁以上女性早期发现子宫颈癌，以便早期治疗。

HPV is a virus that can cause cervix cell changes.The HPV test checks for HPV.

The test can be done at the same time as the Pap test, with the same swab or a second swab.

You will not notice a difference in your exam if you have both tests.

A Pap test plus an HPV test (called co-testing) is the preferred way to find early cervical cancers or pre-cancers in women 30 and older.

如果你是30岁以上的女性且没有爱滋病的病史或生殖器的癌症，

就应该在65岁前每5年做一次子宫颈抹片检查及人类乳突病毒测试。

If you have no history of HIV or genital cancer or pre-cancer, and are a woman age 30 or older,

you should have an HPV test with your Pap test (co-testing) every 5 years until you are 65.

如果你小于30岁的话，21~29岁简每三年做一次子宫颈抹片，人类乳突病毒测试在这个年龄区间则不太必要，

因为在这年龄层区间的女性会得人类乳突病毒是很常见的，但如果子宫颈抹片检查有发现异常的话，就可以再追加这个测试。

Women between ages 21 and 29 should have a Pap test every 3 years (at ages 21, 24, and 27).

These women should not get the HPV test with the Pap test because HPV is so common in women these ages that it’s not helpful to test for it.

But HPV testing may be used in this age group after an abnormal Pap test result.

阿男生又没有子宫颈怎摸测？对…所以没办法lol

What about testing men?

There is no FDA-approved HPV test for men at this time.

Q：为什么我会得到人类乳病毒呢???

Q:Why I get HPV?

主要是因为皮肤接触传染致病，至于是哪部分的皮肤呢？

就是上面有提到过的那些既平坦又潮湿的皮肤表面：阴道、口等，或借由肛交而传染。

并不会经由血液或体液传染。经由(多人)性交则会传染地相当快。

如果没有性交的话就比较不会经由生殖器接触而致病，

但偶尔还是会发生，因为借由口交或是手接触到生殖器而传染的例子还是有的。

如果是妈妈怀孕生小孩其实也不太会传染，但还是有机会发生，这样生出来的宝宝就会在呼吸道长疣。

Genital HPV is spread mainly by direct skin-to-skin contact during vaginal, oral, or anal sex.

It’s not spread through blood or body fluids.

Infection is very common soon after a person starts having sex with one or more partners.

Transmission by genital contact without sexual intercourse is not common, but it can happen.

Oral-genital and hand-genital transmission of some genital HPV types is possible and has been reported.

Transmission from mother to newborn during delivery is rare, but it can happen, too.

When it does, it can cause warts (papillomas) in the infant’s breathing tubes (trachea and bronchi) and lungs,which is called respiratory papillomatosis.

These papillomas can also grow in the voice box, which is called laryngeal papillomatosis. Both of these infections can cause life-long problems.

几乎只要是所有有从事性交活动的男生女生一生当中多少多会得到人类乳突病毒，就算你只有单一性伴侣也会。

Nearly all sexually-active men and women get HPV at some point in their lives.

This is true even for people who only have sex with one person in their lifetime.

那高危险因子有那些呢？

女生的高危险因子如下：

1.有多重性伴侣

2.你的伴侣有多重性伴侣

3.小于25岁

4.16岁以下就开始从事性交活动

5.你的伴侣没有割包皮，因为没割包皮的男生比较容易感染人类乳突病毒，然后传染给女性。

Risk factors for women

1.Having many sex partners

2.Having a partner who has had many partners

3.Being younger than 25 years of age

4.Starting to have sex at an early age (16 years or younger)

5.Having a male partner who is not circumcised (having had the foreskin of the penis removed).

Men who have not been circumcised are more likely to be infected with HPV and pass it on to their partners. The reasons for this are unclear.

男生的高危险因子如下：

1.有多重性伴侣

2.没有割包皮(但原因尚不明确，而且就算割了包皮也不保证你都不会感染)

Risk factors for men

1.Having many sex partners.

2.Not being circumcised (having had the foreskin of the penis removed).

Men who are circumcised have a lower chance of getting and staying infected with HPV.

Men who have not been circumcised are more likely to be infected with HPV and pass it on to their partners.The reasons for this are unclear.

And circumcision does not completely protect against HPV infection – men who are circumcised can still get HPV and pass it on to their partners.

Q：那得到人类乳突病毒该怎么处理治疗呢???

Q: The treatments of HPV.

很抱歉要告诉你一个坏消息，对于病毒本身并没有治疗方法。

但就像之前有提到的，我们自身的免疫系统在2年内会主动击退病毒。

即使不能针对人类乳突病毒这个东西去治疗，但却可以对于受到人类乳突病毒感染的病变细胞/产生的症状来下手。

比如说如果感染到人类乳突病毒长出生殖器湿疣，那这个症状是可以治疗的，

像其他子宫颈癌、肛门癌、生殖器癌症等也都是有治疗方法的。

No. There’s no treatment for the virus itself.

But most genital HPV infections go away with the help of a person’s immune system, usually within 2 years.

Even though HPV itself cannot be treated, the cell changes caused by an HPV infection can.

For example, genital warts can be treated.

Pre-cancer cell changes caused by HPV can be found by Pap tests and treated.

And head and neck, cervical, anal, and genital cancers can be treated, too.

Q：如何预防感染人类乳突病毒???

Q: The preventions of HPV.

有的，现在有出人类乳突病毒疫苗可以施打，

一种用来预防编号16及18的人类乳突病毒衍生成子宫颈癌，预防率约70%；

另一种则用来预防编号6及11的人类乳突病毒衍生成生殖器湿疣，预防率达90%。

Yes. At this time there are 2 vaccines available to help prevent certain types of HPV and some of the cancers linked to those types: Gardasil® and Cervarix®.

These vaccines prevent the 2 types of HPV (HPV-16 and HPV-18) that cause 70% of all cervical cancers.

Gardasil also prevents the 2 types of HPV (HPV-6 and HPV-11) that cause 90% of all genital warts.

Cervarix may also provide some protection against some high-risk types of HPV besides 16 and 18.

其实在从事性交活动前就必须施打了，之后则在6个月内施打完3剂疫苗会最有效果。

不过疫苗的效期可以持续多久并没有有效的实验根据证实，

但最新的研究指出疫苗的保护力并不会随著时间流逝而下降。

To work best, one of the HPV vaccines should be given before any type of sexual contact with another person.

Both are given as shots in a series of 3 doses within 6 months.

How long a new vaccine protects people is never known when the vaccine is first introduced.

Current research (which includes about 6 years of follow-up data) shows that the vaccines are effective,

and there is no sign that the protection decreases with time.

Research will continue to find out how long protection against HPV lasts, and if booster vaccines will be needed.

那有些人就会问男生有没有需要打疫苗啊？

要喔…男生施打的话则可以预防某种型态的人类乳突病毒进展成肛门湿疣及生殖器湿疣，

但是不是施打疫苗就能避免把人类乳突病毒传染给性伴侣或会导致喉癌的另一种病毒型态，这就无法获得证实了。

Can boys get the vaccine?

Yes. The FDA approved Gardasil to protect boys from certain anal cancers and pre-cancers as well as to prevent anal and genital warts.

It’s not yet known if the vaccine will keep boys from passing HPV to their partners,

which would also reduce cervical cancer, or if it can prevent other HPV-linked cancers in men (such as throat or penile cancer).

国内子宫颈癌预防疫苗”嘉喜”已获得卫生署核准上市，

此疫苗针对感染人类乳突病毒第6、11、16、18型的病人提供65~70%的保护效力。

须在半年内接种3剂，费用约1万元需要自费，以没有性经验的女性施打最有效，

已罹患子宫颈癌、切除子宫、正感染人类乳突病毒及50岁以上妇女则不适合接种。

虽然疫苗可以提高保护力，但安全性行为加上抹片筛检还是不能少喔。

如果有施打疫苗的相关问题其实都可以挂号门诊向医生咨询…

In Taiwan there is a vaccine called Gardasil is approved as a legal one which you have to pay about 10,000NTD to get the injection including 3doses in half a year.

This vaccine is available to help prevent certain types of HPV 6, 11, 16, 18,

and most effective for women who don’t have any sexual experience.

If women who got cervical cancer, under a hysterectomy or HPV are not suitable for the vaccine.

And you could ask any question at the outpatient department.

希望这些资讯能让大家更了解菜花这东西…

各位女性同胞们也要记得定期做子宫抹片筛检喔…

Hope these info is useful for you and remember to do the Pap test regularly.

多吃菜美如花…

但不要种菜花…

参考资料

Reference

1. Human Papilloma Virus (HPV)