High-risk human papilloma virus infection and cervical neoplasm in female inflammatory bowel disease patients: a cross-sectional study
High-risk human papilloma virus infection and cervical neoplasm in female inflammatory bowel disease patients: a cross-sectional study
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DOI：
10.1093/gastro/goy053
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发表时间：
2019-10-01
影响因子：
3.6
通讯作者：
Gao, Xiang
中科院分区：
文献类型：
--
作者：
Li, Miao;Yang, Qing-Fan;Gao, Xiang
背景和目的：本横断面研究调查了女性炎症性肠病（IBD）患者中高危人乳头瘤病毒（HPV）感染（尤其是16型和18型）以及宫颈肿瘤的患病率和危险因素。方法：2014年7月至2017年1月，性活跃的中国女性IBD患者（21-60岁）和年龄匹配的对照者接受了宫颈ThinPrep细胞学检测（TCT）和高危人群HPV-DNA检测，并完成宫颈癌和HPV认知调查问卷。宫颈不典型增生分为宫颈上皮内瘤变（CIN）1、2和3。结果：124例IBD患者（30例溃疡性结肠炎和94例克罗恩病）中，17例（13.7%）患有高危HPV，其中9例（7.3%）患有HPV 16/18感染，4例（3.2%）患有宫颈CIN（3例CIN 3，1例CIN） 1）通过病理学。在 372 名对照者中，33 名（8.9%）患有高危 HPV，只有 1 名（0.3%）患有 HPV 16 感染。宫颈 TCT 在一名对照中检测到意义不明的非典型鳞状细胞；没有对照出现 CIN。 IBD患者的HPV 16/18感染率和CIN患病率均显着高于对照组（P均<0.001）。服用甲氨蝶呤 [P = 0.005，优势比（95% 置信区间）4.76 (1.471-15.402)] 或两种以上免疫抑制剂 [P = 0.013，优势比（95% 置信区间）3.64 (1.255-10.562)] 的患者 HPV 感染率较高。硫嘌呤、类固醇、英夫利昔单抗和疾病行为/部位与 HPV 感染无关。只有29.3%的患者接受过宫颈癌筛查。对HPV感染和HPV相关宫颈癌的认识较差（28.2%）。结论：女性IBD患者高危型HPV感染和宫颈肿瘤的风险增加，这可能与免疫抑制剂有关。建议进行教育并定期进行 HPV-DNA 检测和 TCT 随访，特别是对于中国女性 IBD 患者。
Background and aim: This cross-sectional study investigated the prevalence and risk factors of high-risk human papilloma virus (HPV) infection, especially types 16 and 18, and cervical neoplasia in female Inflammatory bowel disease (IBD) patients.Methods: From July 2014 to January 2017, sexually active, female, Chinese IBD patients (21-60 years) and age-matched controls underwent cervical ThinPrep cytology testing (TCT) and high-risk HPV-DNA detection, and completed questionnaires about awareness of cervical cancer and HPV. Cervical dysplasia was categorized as cervical intraepithelial neoplasia (CIN) 1, 2 and 3.Results: Of 124 IBD patients (30 ulcerative colitis and 94 Crohn's disease), 17 (13.7%) had high-risk HPV among whom 9 (7.3%) had HPV 16/18 infection and 4 (3.2%) had cervical CIN (3 CIN 3, 1 CIN 1) by pathology. Among 372 controls, 33 (8.9%) had high-risk HPV and only 1 (0.3%) had HPV 16 infection. Cervical TCT detected atypical squamous cells of unknown significance in one control; no control had CIN. The HPV 16/18 infection rate and CIN prevalence were significantly higher in IBD patients than controls (both P < 0.001). The HPV-infection rate was higher in patients administered methotrexate [P = 0.005, odds ratio (95% confidence interval) 4.76 (1.471-15.402)] or more than two immunosuppressants [P = 0.013, odds ratio (95% confidence interval) 3.64 (1.255-10.562)]. Thiopurine, steroid, infliximab and disease behavior/location were not associated with HPV infection. Only 29.3% of patients had undergone cervical-cancer screening. Awareness of HPV infection and HPV-related cervical cancer was poor (28.2%).Conclusions: Female IBD patients are at increased risk of high-risk HPV infection and cervical neoplasia, which may be associated with immunosuppressants. Education and routine follow-up with HPV-DNA testing and TCT are recommended, especially in female Chinese IBD patients.