204.2 📚 國考版

204.2.0.1 必背 — HPV Types

  • Low-risk: 6, 11 → genital warts + RRP
  • High-risk: 16, 18 → ~ 70% cervical cancer; also 31, 33, 45, 52, 58

204.2.0.2 必背 — Diseases

  • Cervical cancer (HPV essentially necessary)
  • Anal cancer (MSM, HIV+, women)
  • Oropharyngeal cancer (tonsil + base of tongue, HPV-16, rising)
  • Vulvar / vaginal / penile cancers
  • Genital warts (6, 11)
  • RRP (6, 11)

204.2.0.3 必背 — Gardasil 9 (9vHPV)

  • Types 6, 11, 16, 18, 31, 33, 45, 52, 58
  • 9-14 yr: 2-dose series
  • 15-26 yr: 3-dose series
  • 27-45 yr: shared decision

  • 95% efficacy

204.2.0.4 必背 — Cervical Screening (USPSTF + ACS 2024)

Age Approach
21-24 Cytology q3y
25-65 HPV primary q5y (preferred); HPV + cytology q5y; cytology q3y
≥ 65 with adequate prior Discontinue
HIV / immunocompromise More frequent

204.2.0.5 必背 — E6 + E7 Oncogenes

  • E6 degrades p53
  • E7 inactivates Rb
  • High-risk HPV strain E6/E7 → cancer

204.2.0.6 必背 — Cervical Cancer Treatment

  • Pembrolizumab + chemotherapy for advanced (KEYNOTE-826)
  • Chemoradiation locally advanced
  • Surgery early stage

204.2.0.7 必背 — ANCHOR Study (2024)

  • HIV+ AIN 2-3 treatment reduces anal cancer
  • Established standard of care

204.2.0.8 必背 — Pregnancy + HPV

  • Pregnancy doesn’t activate HPV
  • Genital warts can persist / proliferate during pregnancy (estrogen)
  • Vaginal delivery generally OK (rare perinatal RRP)
  • Cervical screening as per algorithm