Age-related changes of the cervix influence human papillomavirus type distribution
Age-related changes of the cervix influence human papillomavirus type distribution
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DOI：
10.1158/0008-5472.can-05-3066
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发表时间：
2006-01-15
期刊：
影响因子：
11.2
通讯作者：
Burk, RD
中科院分区：
文献类型：
--
作者：
Castle, PE;Jeronimo, J;Burk, RD
大约有15种类型的人乳头瘤病毒(HPV)导致几乎所有的宫颈癌，而其他类型的HPV与癌症无关。我们感兴趣的是，一些非致癌类型与致癌类型在对宫颈转移区的亲和力上是否不同，几乎所有HPV诱导的癌症都发生在宫颈转移区。为了检验这种可能性，我们对参加瓜纳卡斯特人群研究的8,374名没有宫颈癌前病变和癌症的妇女的宫颈样本进行了检测，以检测>；40 HPV类型。我们比较了主要致癌的、包括HPV16在内的主要致癌的Alpha 9和遗传上不同类型的Alpha 3/Alpha 15的HPV型(例如，HPV71)的年龄组特异性流行情况，后者是非致癌的，在子宫切除妇女的阴道标本中很常见。我们将各组的HPV检测与宫颈鳞状上皮和阴道鳞状上皮与宫颈管内柱状上皮连接的位置相关联。模型评估了暴露的柱状上皮量(异位)和年龄对阿尔法9或阿尔法3/阿尔法15型存在的独立影响。阿尔法9型的患病率在最年轻的女性中达到峰值(7.6%)，在中年女性中下降，然后在老年女性中略有上升。相比之下，Alpha3/Alpha15型的患病率(7.6%)倾向于保持不变或随年龄增长而增加。随着柱状上皮暴露的增加，α9感染的检测增加(P趋势和t；0.0005)，而α3/α15感染的检测减少(P趋势和t；0.0005)。与阿尔法9感染相比，年龄较大和宫颈异位减少独立地与阿尔法3/阿尔法15感染呈正相关。这些模式需要在其他研究和人群中得到证实。我们认为，这些遗传上不同的HPV类型组可能在组织偏好上有所不同，这可能是导致它们致癌潜力差异的原因之一。
Approximately 15 human papillomavirus (HPV) types cause virtually all cervical cancer whereas other HPV types are unrelated to cancer. We were interested in whether some noncarcinogenic types differ from carcinogenic in their affinity for the cervical transformation zone, where nearly all HPV-induced cancers occur. To examine this possibility, we tested cervical specimens from 8,374 women without cervical precancer and cancer participating in a population-based study in Guanacaste for > 40 HPV types using PCR. We compared age-group specific prevalences of HPV types of the alpha 9 species, which are mainly carcinogenic and include HPV16, to the genetically distinct types of the alpha 3/alpha 15 species (e.g., HPV71), which are noncarcinogenic and common in vaginal specimens from hysterectomized women. We related HPV detection of each group to the location of the junction between the squamous epithelium of the ectocervix and vagina and the columnar epithelium of the endocervical canal. Models evaluated the independent effects of amount of exposed columnar epithelium (ectopy) and age on the presence of alpha 9 or alpha 3/alpha 15 types. Prevalence of alpha 9 types (7.6%) peaked in the youngest women, declined in middle-aged women, and then increased slightly in older women. By contrast, prevalence of alpha 3/alpha 15 types (7.6%) tended to remain invariant or to increase with increasing age. Detection of alpha 9 infections increased (P-trend < 0.0005) but alpha 3/alpha 15 infections decreased (Ptrend < 0.0005) with increasing exposure of the columnar epithelia. Older age and decreasing cervical ectopy were independently positively associated with having an alpha 3/alpha 15 infection compared with having an alpha 9 infection. These patterns need to be confirmed in other studies and populations. We suggest that these genetically distinct groups of HPV types may differ in tissue preferences, which may contribute to their differences in carcinogenic potential.