Risk factors for cervical cancer in Thailand:: A case-control study
Risk factors for cervical cancer in Thailand:: A case-control study
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DOI：
10.1093/jnci/90.1.50
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发表时间：
1998-01-07
期刊：
影响因子：
--
通讯作者：
Walboomers, JMM
中科院分区：
文献类型：
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作者：
Chichareon, S;Herrero, R;Walboomers, JMM
背景资料：人乳头瘤病毒（HPV）16型和18型与宫颈癌的病因学密切相关，但其他HPV类型的致癌性证据有限，以往的研究结果还没有明确定义HPV感染发展为高级别前体和癌症的辅助因子。我们在泰国Hat-Yai进行了一项以医院为基础的浸润性宫颈癌病例对照研究，以调查HPV感染及其流行病学辅助因子的相关风险。共有338例鳞状细胞癌患者，39例腺癌/腺鳞癌患者和261例对照受试者被纳入研究，并接受采访以获得关于宫颈癌危险因素的信息，通过聚合酶链反应测定宫颈脱落细胞或冷冻活检标本中HPV DNA的存在，结果：95%的鳞状细胞癌患者、90%的腺癌/腺鳞癌患者和16%的对照组中检测到HPV DNA。鳞状细胞癌患者中最常见的HPV类型为16型在腺癌/腺鳞癌患者中，最常见的HPV类型为18型（18%）、58型（3%）、52型（3%）和31型（2%）。在调整HPV及其相互混杂效应后，与两种组织学类型风险相关的危险因素是有限的教育，增加性伴侣数量，性病史，以及自上次巴氏涂片检查以来的间隔（即，结论：宫颈癌的新的预防策略需要考虑多种HPV类型。
Background: Human papillomaviruses (HPV) types 16 and 18 are clearly involved in the etiology of cervical cancer, but the evidence for the carcinogenicity of other HPV types is limited, Cofactors involved in the progression from infection with HPV to high-grade precursors and cancer have not been clearly defined by the results of previous studies, Methods: We conducted a hospital-based, case-control study of invasive cervical cancer to investigate risk in relation to HPV infection and its epidemiologic cofactors in Hat-Yai, Thailand, A total of 338 patients with squamous cell carcinoma, 39 patients with adenocarcinoma/adenosquamous carcinoma, and 261 control subjects were included in the study and were interviewed to obtain information with regard to cervical cancer risk factors, HPV DNA presence in cervical exfoliated cells or frozen biopsy specimens was determined by a polymerase chain reaction assay, Results: HPV DNA was detected in 95% of patients with squamous cell carcinoma, 90% of those with adenocarcinoma/adenosquamous carcinoma, and 16% of control subjects, For patients with squamous cell carcinoma, the most common types of HPV found were type 16 (60% of the positives), type 18 (18%), type 58 (3%), type 52 (3%), and type 31 (2%), For patients with adenocarcinoma/adenosquamous carcinoma, the most common HPV types found were type 18 (60% of the positives), type 16 (37%), and type 45 (3%), The risk factors that remained associated with risk of both histologic types after adjustment for HPV and their mutual confounding effects were limited education, increasing number of sexual partners, history of venereal diseases, and interval since last Pap smear (i.e., cytologic) test, Among patients with squamous cell carcinoma, some association with smoking was also observed, Conclusion: New preventive strategies for cervical cancer will require the consideration of multiple HPV types.