►健康◄種菜花的一天＊淺談人類乳突病毒＊

可能很多人因為羅主任和郭採擷的八卦新聞都聽過菜花?!

不過菜花到底是啥米啊？

怎樣才會得到菜花？

就帶大家來瞭解一下這名叫菜花但既不是菜也不是花的菜花吧…

其實菜花只是其中一種型態的人類乳突病毒導致的症狀…

同樣的道理子宮頸癌也只是人類乳突病毒某個型態導致的疾病…

所以人類乳突病毒≠菜花≠子宮頸癌…

那到底甚麼又是人類乳突病毒呢？

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：人類乳突病毒有那些症狀啊???

Q：The symptoms of Human Papilloma Virus; HPV.

一般人類乳突病毒通常都沒有症狀，除非它是其中一種會產生疣的病毒型態。

可能在接觸已經得到人類乳突病毒的性伴侶後會出現生殖器濕疣，

症狀則持續數周到數月不等，少數則會是數年。

濕疣看起來就像是一羣突起的雞皮疙瘩散落在生殖器上。

或大或小，有些是平坦的有些則是突起的，因為形狀像菜花所以纔有這個俗稱。

沒治療的話，它可能會不治而癒或保持原狀或更茁壯。但濕疣通常很少會變成癌症。

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.

也因為通常人類自己的免疫系統會自己對抗病毒所以都不太會有症狀顯現，

所以很多人都會不知道自己得了人類乳突病毒，免疫系統會在約2年內自己對抗病毒。

但如果病毒一直沒被消滅的話，就很有可能會導致細胞病變數年後就會衍生為癌症。

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：到底甚麼是人類乳突病毒???

Q：What is HPV?

人類乳突病毒是一種缺乏人類乳突狀瘤的病毒，

它其實包含了超過150種不同型態的病毒，每一個病毒都有自己的編號。

它被稱作乳突病毒而非癌症是因為有些型態的病毒只會導致濕疣或乳突瘤(非癌症的腫瘤)。

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.

乳突狀瘤病毒只能存活在鱗狀上皮細胞裡，因為它很薄又平坦。

常常在潮濕的皮膚表面被發現，

像是陰道、肛門、子宮頸、外陰部，陰莖頭、口、喉嚨、氣管、支氣管及肺部等。

其他地方則不會長，所以手不會生出菜花來，除非你一直留手汗(？！)哈哈流手汗也不會啦: 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.

人類乳突病毒又分成兩種等級：低危險羣跟高危險羣。

低危險羣包括第6型及第11型，雖然也會導致細胞上某些程度的改變但比較不會進展成癌症；

相較之下高危險羣(16、18、31、33、35、39、45、51、52、58、59、68)則較容易進展為癌症。

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：那麼要做哪些檢查才能得知並診斷自己得到人類乳突病毒呢???

Q：The diagnosis of HPV.

子宮頸抹片檢查是要找出子宮頸細胞有沒有細胞變化或不正常的細胞

(這些不正常的細高有可能是癌症或癌症前的病竈)。

然後取得的組織再拿到顯微鏡底下判斷有沒有不正常的細胞分化，

子宮頸抹片檢查是一個很有效的檢查方式，但臺灣卻很多人因為害羞而不敢去做，實在有點可惜。

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.

另外一個檢查則是人類乳突病毒測試，因為人類乳突病毒會導致子宮頸細胞病變，

所以在你執行子宮鏡抹片檢查的時候同時可以做這項測試，

兩項檢查一起做更能讓30歲以上女性早期發現子宮頸癌，以便早期治療。

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歲以上的女性且沒有愛滋病的病史或生殖器的癌症，

就應該在65歲前每5年做一次子宮頸抹片檢查及人類乳突病毒測試。

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.

如果你小於30歲的話，21~29歲簡每三年做一次子宮頸抹片，人類乳突病毒測試在這個年齡區間則不太必要，

因為在這年齡層區間的女性會得人類乳突病毒是很常見的，但如果子宮頸抹片檢查有發現異常的話，就可以再追加這個測試。

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.

阿男生又沒有子宮頸怎摸測？對…所以沒辦法lol

What about testing men?

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

Q：為什麼我會得到人類乳病毒呢???

Q:Why I get HPV?

主要是因為皮膚接觸傳染致病，至於是哪部分的皮膚呢？

就是上面有提到過的那些既平坦又潮濕的皮膚表面：陰道、口等，或藉由肛交而傳染。

並不會經由血液或體液傳染。經由(多人)性交則會傳染地相當快。

如果沒有性交的話就比較不會經由生殖器接觸而致病，

但偶爾還是會發生，因為藉由口交或是手接觸到生殖器而傳染的例子還是有的。

如果是媽媽懷孕生小孩其實也不太會傳染，但還是有機會發生，這樣生出來的寶寶就會在呼吸道長疣。

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.

幾乎只要是所有有從事性交活動的男生女生一生當中多少多會得到人類乳突病毒，就算你只有單一性伴侶也會。

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.

那高危險因子有那些呢？

女生的高危險因子如下：

1.有多重性伴侶

2.你的伴侶有多重性伴侶

3.小於25歲

4.16歲以下就開始從事性交活動

5.你的伴侶沒有割包皮，因為沒割包皮的男生比較容易感染人類乳突病毒，然後傳染給女性。

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.

男生的高危險因子如下：

1.有多重性伴侶

2.沒有割包皮(但原因尚不明確，而且就算割了包皮也不保證你都不會感染)

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：那得到人類乳突病毒該怎麼處理治療呢???

Q: The treatments of HPV.

很抱歉要告訴你一個壞消息，對於病毒本身並沒有治療方法。

但就像之前有提到的，我們自身的免疫系統在2年內會主動擊退病毒。

即使不能針對人類乳突病毒這個東西去治療，但卻可以對於受到人類乳突病毒感染的病變細胞/產生的症狀來下手。

比如說如果感染到人類乳突病毒長出生殖器濕疣，那這個症狀是可以治療的，

像其他子宮頸癌、肛門癌、生殖器癌症等也都是有治療方法的。

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：如何預防感染人類乳突病毒???

Q: The preventions of HPV.

有的，現在有出人類乳突病毒疫苗可以施打，

一種用來預防編號16及18的人類乳突病毒衍生成子宮頸癌，預防率約70%；

另一種則用來預防編號6及11的人類乳突病毒衍生成生殖器濕疣，預防率達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.

其實在從事性交活動前就必須施打了，之後則在6個月內施打完3劑疫苗會最有效果。

不過疫苗的效期可以持續多久並沒有有效的實驗根據證實，

但最新的研究指出疫苗的保護力並不會隨著時間流逝而下降。

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.

那有些人就會問男生有沒有需要打疫苗啊？

要喔…男生施打的話則可以預防某種型態的人類乳突病毒進展成肛門濕疣及生殖器濕疣，

但是不是施打疫苗就能避免把人類乳突病毒傳染給性伴侶或會導致喉癌的另一種病毒型態，這就無法獲得證實了。

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).

國內子宮頸癌預防疫苗”嘉喜”已獲得衛生署覈准上市，

此疫苗針對感染人類乳突病毒第6、11、16、18型的病人提供65~70%的保護效力。

須在半年內接種3劑，費用約1萬元需要自費，以沒有性經驗的女性施打最有效，

已罹患子宮頸癌、切除子宮、正感染人類乳突病毒及50歲以上婦女則不適合接種。

雖然疫苗可以提高保護力，但安全性行為加上抹片篩檢還是不能少喔。

如果有施打疫苗的相關問題其實都可以掛號門診向醫生諮詢…

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.

希望這些資訊能讓大家更瞭解菜花這東西…

各位女性同胞們也要記得定期做子宮抹片篩檢喔…

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

多喫菜美如花…

但不要種菜花…

參考資料

Reference

1. Human Papilloma Virus (HPV)