Circumcision and human papillomavirus infection in men: A site-specific comparison
Circumcision and human papillomavirus infection in men: A site-specific comparison
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DOI：
10.1086/528379
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发表时间：
2008-03-15
影响因子：
6.4
通讯作者：
Goodman, M. T.
中科院分区：
文献类型：
--
作者：
Hernandez, B. Y.;Wilkens, L. R.;Goodman, M. T.
背景。缺乏包皮环切术已被确定为男性生殖器人乳头瘤病毒（HPV）感染的危险因素，尽管这种关联尚未得到一致的支持。从379名成年男性（主要是异性恋）中收集HPV检测标本。HPV在龟头、阴茎和冠状沟、阴茎干、阴囊、精液和尿液中的患病率与包皮环切术状态进行了比较。总体而言，HPV DNA在精液中的患病率从6%到阴茎轴中的52%不等。未行包皮环切术的男性（46%）比行包皮环切术的男性（29%）的任何HPV感染的患病率都高（优势比[OR]， 1.96[95%可信区间{CI}， 1.02 - 3.75]，根据人口统计学特征和性史进行调整）。未行包皮环切术的男性患致癌HPV感染（校正OR， 2.51 [95% CI, 1.11- 5.69]）和多种HPV感染（校正OR， 3.56 [95% CI, 1.50 - 8.50]）的风险也增加。在未割包皮的男性中，HPV在包皮中的患病率（44%）与在龟头/冠中的患病率相当，并且在两个部位之间观察到类型特异性阳性（kappa = 0.52）。未割包皮的男性感染HPV的风险增加，包括致癌的HPV，特别是在龟头/冠上，可能是因为它靠近包皮，而包皮可能特别容易感染。
Background. Lack of circumcision has been identified as a risk factor for male genital human papillomavirus (HPV) infection, although this association has not been consistently supported.Methods. Specimens for HPV testing were collected from a cohort of 379 (primarily heterosexual) adult males. HPV prevalence in the glans penis and coronal sulcus, penile shaft, scrotum, semen, and urine was compared by circumcision status.Results. Overall, HPV DNA prevalence ranged from 6% in semen to 52% in the penile shaft. The prevalence of any HPV infection in the glans/corona was significantly higher in uncircumcised men (46%) than in circumcised men (29%) (odds ratio [ OR], 1.96 [ 95% confidence interval {CI}, 1.02 - 3.75], adjusted for demographic characteristics and sexual history). Uncircumcised men also had an increased risk of oncogenic HPV infection (adjusted OR, 2.51 [ 95% CI, 1.11- 5.69]) and infection with multiple HPV types (adjusted OR, 3.56 [ 95% CI, 1.50 - 8.50]). Among uncircumcised men, HPV prevalence in the foreskin (44%) was comparable to that in the glans/ corona, and type- specific positivity was observed between the 2 sites (kappa = 0.52).Conclusions. Uncircumcised men have an increased risk of HPV infection, including with oncogenic HPV, specifically localized to the glans/corona, possibly because of its proximity to the foreskin, which may be particularly vulnerable to infection.