Gynaecological infections as risk determinants of subsequent cervical neoplasia
Gynaecological infections as risk determinants of subsequent cervical neoplasia
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DOI：
10.1080/028418600431003
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发表时间：
2000-01-01
期刊：
影响因子：
3.1
通讯作者：
Hakama, M
中科院分区：
文献类型：
--
作者：
Viikki, M;Pukkala, E;Hakama, M
进行了一项纵向队列研究，以确定除人乳头瘤病毒（HPV）外的妇科感染是否也与随后宫颈肿瘤风险增加有关。这项研究包括19114名妇女参加了有组织的大规模筛查在芬兰在1985年至1990年与细胞学检测HPV，放线菌，单纯疱疹，阴道毛滴虫，或酵母。通过与全国癌症登记处的联系，对这些妇女随后的浸润前病变和浸润性癌症进行了跟踪，直到1994年底。标准化发病率比（SIR）与整个芬兰的参考率和95%的置信区间（CI）进行了估计。阴道毛滴虫和HPV与宫颈癌的高相对风险相关，SIR分别为6.4（CI 3.7-10，浸润前病变和浸润性癌合并）和SIR 5.5（CI 4.2-7.2，浸润前病变和浸润性癌合并）。单纯疱疹很少被检测到，但观察到最高和统计学上最显著的点估计值（SIR 12，CI 2.4-34，浸润前病变和浸润性癌合并）。放线菌和酵母菌都与宫颈癌风险显著增加无关。这些结果均不能被其他感染的混杂效应所解释。我们的研究结果，基于前瞻性设计，使我们提出，阴道毛滴虫和单纯疱疹病毒也是宫颈肿瘤的预测因子。
A longitudinal cohort study was carried out to determine whether gynaecological infections other than human papillomavirus (HPV) are also related to the subsequent increased risk of cervical neoplasia. The study comprised 19114 women attending the organized mass screening in Finland in 1985-1990 with cytologically detected HPV, Actinomyces, herpes simplex, Trichomonas vaginalis, or yeast. The women were followed-up for subsequent preinvasive lesions and invasive cancers until the end of 1994 by linkage to the nation-wide Cancer Registry. Standardized incidence ratios (SIR) with rates for the whole of Finland as reference and 95% confidence intervals (CI) were estimated. Trichomonas vaginalis and HPV were associated with a high relative risk of cervical cancer, SIR 6.4 (CI 3.7-10, preinvasive lesion and invasive cancer combined) and SIR 5.5 (CI 4.2-7.2, preinvasive lesion and invasive cancer combined), respectively. Herpes simplex was rarely detected, but the highest and statistically most significant point estimate was observed (SIR 12, CI 2.4-34, preinvasive lesion and invasive cancer combined). Neither Actinomyces nor yeast was associated with a significantly increased risk of cervical cancer. None of these results could be accounted for by the confounding effect of the other infections. Our results, based on a prospective design, lead us to propose that Trichomonas vaginalis and herpes simplex virus are also predictors for cervical neoplasia.