No evidence for synergy between human papillomavirus genotypes for the risk of high-grade squamous intraepithelial lesions in a large population-based study.
No evidence for synergy between human papillomavirus genotypes for the risk of high-grade squamous intraepithelial lesions in a large population-based study.
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在一项基于大规模人群的研究中，没有证据表明人乳头瘤病毒基因型之间对高级鳞状上皮内病变风险有协同作用。
DOI：
10.1093/infdis/jit577
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发表时间：
2014
期刊：
影响因子：
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通讯作者：
NewMexicoHPVPapRegistrySteeringCommittee
中科院分区：
文献类型：
--
作者：
Wentzensen,Nicolas;Nason,Martha;Schiffman,Mark;Dodd,Lori;Hunt,WilliamC;Wheeler,CosetteM;NewMexicoHPVPapRegistrySteeringCommittee
背景：多种人乳头瘤病毒（HPV）基因型可能独立或协同与高度鳞状上皮内病变（HSIL）风险相关。方法：对居住在新墨西哥州的59 664例宫颈细胞学标本进行分层抽样，评估细胞学异常和HPV基因型。我们计算了单一HPV基因型感染妇女发生HSIL的危险性，以及多种HPV基因型感染妇女发生HSIL的危险性。结果：观察到的HSIL危险性最高的HPV-16（0.036），其次是HPV-33（0.028），HPV-58（0.024）和HPV-18（0.022）。对于大多数类型，我们观察到感染多种致癌HPV类型的女性发生HSIL的风险更大。相比之下，与仅感染HPV-16的女性相比，感染HPV-16和其他类型的女性发生HSIL的风险相似。我们观察到，与感染单一类型的妇女相比，感染多种类型的妇女发生HSIL的风险增加但趋于稳定，风险比为1.5（95%置信区间[CI]，1.2-1.8），1.7（95% CI，1.3-2.4）和1.4（95% CI，0.83-2.5）对于感染2、3和≥4种基因型的女性，结论：在迄今为止最大的基于人群的HPV基因型和细胞学结果的研究中，我们没有看到HPV类型对感染多种类型的女性HSIL风险的加和效应。
Background.Multiple human papillomavirus (HPV) genotypes may be independently or synergistically associated with risk of high-grade squamous intraepithelial lesions (HSILs). We evaluated the risk of HSIL in women concomitantly infected with multiple HPV genotypes.Methods.A population-based stratified sample of 59 664 cervical cytology specimens from women residing in New Mexico were evaluated for cytologic abnormalities and HPV genotypes. We calculated the risk of HSIL in women infected with a single HPV genotype and the risk in those infected with multiple HPV genotypes.Results.The highest risk of HSIL was observed for HPV-16 (0.036), followed by HPV-33 (0.028), HPV-58 (0.024), and HPV-18 (0.022). For most types, we observed a greater risk of HSIL in women infected with multiple carcinogenic HPV types. In contrast, the risk of HSIL was similar in women infected with HPV-16 and other types, compared with women infected with HPV-16 only. We observed an increased but plateauing risk of HSIL in women infected with multiple types, compared with those infected with a single type, with risk ratios of 1.5 (95% confidence interval [CI], 1.2–1.8), 1.7 (95% CI, 1.3–2.4), and 1.4 (95% CI, 0.83–2.5) for women infected with 2, 3, and ≥4 genotypes, respectively.Conclusions.In the largest population-based study of HPV genotypes and cytologic outcomes so far, we did not see more than additive effects of HPV types on the risk of HSIL in women infected with multiple types.