Human papillomavirus and cancer:: the epidemiological evidence
Human papillomavirus and cancer:: the epidemiological evidence
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DOI：
10.1016/s1386-6532(00)00125-6
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发表时间：
2000-10-01
影响因子：
8.8
通讯作者：
Muñoz, N
中科院分区：
文献类型：
--
作者：
Muñoz, N
目的：总结国际癌症研究中心对人乳头瘤病毒与宫颈癌的研究。结果：第一项是国际浸润性宫颈癌(ICC)HPV分型患病率调查，共进行了22年。国家。总体而言，在1000例经组织学证实的ICC中，使用GP5+/GP6+或E7引物也显示99.7%的人乳头瘤病毒DNA阳性，表明HPV是宫颈癌的必要原因。HPV16型(53%)、HPV18型(15%)、HPV45型(9%)、HPV31型(6%)、HPV33型(3%)。HPV16型是所有地理区域中最常见的类型，其次是HPV18型，在东南亚特别常见。第二组研究包括在13个国家进行的病例对照研究。其中包括约2000例病例和2000例对照。阳性，对任何HPV DNA产生的合并优势比(OR)为70。鳞状细胞癌(OR=74)和腺癌(OR=50)、HPV16和18以及不太常见的HPV类型之间的关联同样强烈。我们的结果表明，除了HPV16和18之外，HPV31、33、35、45、51、52、58和59现在可以被认为是致癌的。第三组研究旨在确定普通人群中随机的、按年龄分层(按5岁，15-19岁至65岁以上)亚样本(1100名妇女)的HPV DNA流行率。在一些国家(哥斯达黎加、墨西哥、哥伦比亚)发现了两个年龄高峰(59岁)，但没有在所有国家(阿根廷)发现。第二个高峰是否是由于病毒重新激活、筛查的差异或代表出生队列效应仍有待确定。普通人群中最常见的HPV类型(HPV16、18、45、31、58、33、35)的分布与宫颈癌病例的分布相似。结论：我们的研究提供了最可靠的流行病学证据，得出结论：HPV不仅是全球宫颈癌的中心原因，而且是必要的原因。(C)2000年，爱思唯尔科学公司出版。
Objective: Summary of the studies carried out by the IARC on HPV and cervical cancer is presented. Results: the first one was the international prevalence survey of HPV types in invasive cervical cancer (ICC) conducted in up to 22. countries. Overall, 99.7% of 1000 cases with histologically confirmed ICC were also shown to be HPV DNA positive using the GP5 + /GP6 + or E7 primers, indicating that HPV is a necessary cause of cervical cancer. The most prevalent HPV types were HPV 16 (53%), HPV 18 (15%), HPV 45 (9%), HPV 31 (6%) and HPV 33 (3%). HPV 16 was the most common type in all geographical regions, followed by HPV 18 that was particularly, common in South-East Asia. The second set of studies included case-control studies carried out in 13 countries. They included about 2000 cases and 2000 controls. Positivity, for any HPV DNA yielded a pooled odds ratio (OR) of 70. The association was equally strong for both squamous cell (OR = 74) and adenocarcinoma (OR = 50) and for HPV 16 and 18 as well as for the less common HPV types. Our results indicate that in addition to HPV 16 and 18, HPV 31, 33, 35, 45, 51, 52, 58 and 59 now can be considered as carcinogenic. The third group of studies is aimed to determine the HPV DNA prevalence in random, age-stratified (by 5 years, 15-19 to 65+) subsamples (1100 women) of the general population. Two age-peaks (59 years), have been found in some countries (Costa-Rica, Mexico, Colombia) but not in all (Argentina). Whether the second peak is due to viral reactivation, variations in screening or represents a birth-cohort effect remains to be determined. The distribution of the most prevalent HPV types in the general population (HPV 16, 18, 45, 31, 58, 33, 35) resembles that for cervical cancer cases. Conclusions: our studies provide the most solid epidemiological evidence, to conclude that HPV is not only the central cause of cervical cancer worldwide but also a necessary cause. (C) 2000 Published by Elsevier Science B.V.