Multiple Human Papillomavirus Infections among Chinese Women with and without Cervical Abnormalities: A Population-Based Multi-Center Cross-Sectional Study.
Multiple Human Papillomavirus Infections among Chinese Women with and without Cervical Abnormalities: A Population-Based Multi-Center Cross-Sectional Study.
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中国妇女中有多种人类乳头瘤病毒感染有或没有宫颈异常：一项基于人群的多中心横断面研究。
DOI：
10.3389/fonc.2011.00038
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发表时间：
2011
影响因子：
4.7
通讯作者：
Dai M
中科院分区：
文献类型：
--
作者：
Li N;Yang L;Zhang K;Zhang Y;Zheng T;Dai M
背景：尽管近年来关于人乳头状瘤病毒(HPV)和宫颈癌流行病学的研究有所增加，但HPV多发性感染的情况仍然不清楚，尤其是在中国女性中。2004-2005年间，中国医学科学院肿瘤研究所、中国医学科学院附属医院(CIHCAMS)和国际癌症研究机构(IARC)开展了一系列以人群为基础的HPV患病率调查。在这些调查的基础上，我们评估了中国女性多重HPV感染的患病率和危险因素，并探讨了其与宫颈异常的关系。方法：对来自三个研究中心的2374名妇女进行了细胞学检查，并将HPV结果纳入分析范围。用基于GP5+/6+聚合酶链式反应的酶免疫分析方法检测44种HPV类型。采用非条件Logistic回归模型对HPV多重感染对宫颈病变的影响及其影响因素进行调整。组间差异通过基于q检验的异质性检验进行评估。结果：在2 374例中国妇女中发现111例HPV多重感染，感染率为5.2 8%(95%CI = 3.86~5.6 0%)，占全部阳性妇女的2 8.98%(95%CI = 2 4.49~33.81%)。调整年龄组、研究地区和性伴数目后，高龄女性(≥45 ；校正OR = 1.5 2，95%CI = 1.0 2~2.2 7)和有3个以上性伴的女性(校正OR = 2.10，95%CI = 1.0 5~4.17)发生多发性HPV感染的风险显著增加。我们还发现，多个HPV感染的高级别病变的风险显著高于低级别病变(P异质性 = 0.044)，但与单一HPV感染相比没有显著差异(P异质性 = 0.108)。结论：多发性HPV感染，尤其是高危型HPV感染，可能是公共宫颈癌预防或临床意义的重要指标。
Background: Despite an increase in the number of studies conducted in recent years on human papillomavirus (HPV) and cervical cancer epidemiology, the profile of multiple HPV infections remain obscure, particularly among Chinese women. During 2004–2005, a series of population-based HPV prevalence surveys were performed by Cancer Institute and Hospital of Chinese Academy of Medical Sciences (CIHCAMS) and International Agency for Research on Cancer (IARC). Based on these surveys, we evaluated the prevalence and risk factors of multiple HPV infections, and explored its association with cervical abnormalities among Chinese women. Methods: A total of 2374 women from three study centers underwent gynecological examinations with valid cytology and their HPV results were included in the analysis. Forty-four HPV types were detected using the GP5+/6+ PCR-based enzyme immunoassay. An unconditional logistic regression model was used to evaluate the effect of multiple HPV infections on cervical lesions and its risk factors adjusting for confounders. The between-groups difference was evaluated by a heterogeneity test based on the Q test. Results: One hundred and eleven women of multiple HPV infections was found among 2374 Chinese women with a prevalence of 5.28% (95% CI = 3.86–5.60%), which attributed to 28.98% (95% CI = 24.49–33.81%) of all of the 383 HPV-positive women. A significantly increased risk of multiple HPV infections was found in the older women (≥45 years; adjusted OR = 1.52, 95% CI = 1.02–2.27) and those having more than three sexual partners (adjusted OR = 2.10, 95% CI = 1.05–4.17) after adjustment for age-group, study area, and number of sexual partner. We also found that the risk of high-grade lesions was significantly higher than that of low-grade lesions with the multiple HPV infections (Pheterogeneity = 0.044), but not as significantly with the single HPV infection (Pheterogeneity = 0.108). Conclusion: Multiple HPV Infections, especially with high-risk HPV types, may be a substantial indicator either for public cervical cancer prevention or clinical implications.