HUMAN PAPILLOMAVIRUS INFECTION OF THE CERVIX - RELATIVE RISK ASSOCIATIONS OF 15 COMMON ANOGENITAL TYPES
HUMAN PAPILLOMAVIRUS INFECTION OF THE CERVIX - RELATIVE RISK ASSOCIATIONS OF 15 COMMON ANOGENITAL TYPES
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DOI：
10.1097/00006250-199203000-00002
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发表时间：
1992-03-01
影响因子：
7.2
通讯作者：
KURMAN, RJ
中科院分区：
文献类型：
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作者：
LORINCZ, AT;REID, R;KURMAN, RJ
在1982-1989年期间，2627名妇女被纳入8项研究，分析人乳头瘤病毒（HPV）感染与宫颈肿瘤的关系。随后，每个人被指定为病例或对照，每个宫颈样本通过低严格性Southern印迹杂交重新筛选HPV DNA。阳性样品在高严格性下用HPV 6/11、16、18、31、33、35、42、43、44、45、51、52、56和（在大多数情况下）58的特异性探针重新测试。大多数病例（153例癌症，261例高级别和377例低级别鳞状上皮内病变）进行了靶向或锥状活检;所有270例边缘性宫颈炎受试者和1566例正常对照中超过85%的人进行了细胞学检查加阴道镜检查/细胞学检查。进行HPV检测的科学家对临床诊断不知情。在79.3%的确诊宫颈疾病妇女（627/791）、23.7%的临界宫颈炎患者（64/270）和6.4%的正常人（101/1566）标本中检测到人乳头瘤病毒DNA。诊断谱中每个点的比值比图形分析定义了四个类别：1）“低风险”（HPV 6/11、42、43和44），存在于20.2%（76/377）低度病变，但在所有153例癌症中均未发现; 2）“中等风险”（HPV 31、33、35、51、52和58），检出率为23.8%（62/261）高度鳞状上皮内病变，但仅10.5%（16/153）癌症; 3）“高危/HPV 16”，与47.1%的高度上皮内病变相关（123/261）和癌症（72/153）;和4）“高风险/HPV 18”（HPV 18、45和56），在26.8%（41/153）的浸润性癌中发现，但仅6.5%（17/261）的高级别上皮内病变中发现。致癌HPV类型的存在赋予发生高级别病变的相对风险为65.1-235.7，侵袭性癌症的相对风险为31.1-296.1。
During the years 1982-1989, 2627 women were recruited into eight studies analyzing the relationship between human papillomavirus (HPV) infection and cervical neoplasia. Subsequently, each individual was assigned as either a case or control, and each cervical sample was rescreened for HPV DNA by low-stringency Southern blot hybridization. Positive samples were retested at high stringency with specific probes for HPVs 6/11, 16, 18, 31, 33, 35, 42, 43, 44, 45, 51, 52, 56, and (in most instances) 58. Most cases (153 cancers, 261 high-grade and 377 low-grade squamous intraepithelial lesions) had target or cone biopsies; all 270 borderline atypia subjects and more than 85% of the 1566 normal controls had cytology plus colposcopy/cytology. Scientists performing HPV testing were masked to the clinical diagnoses. Human papillomavirus DNA was detected in 79.3% of specimens from women with definite cervical disease (627 of 791), in 23.7% of borderline atypia subjects (64 of 270), and in 6.4% of normal subjects (101 of 1566). Graphic analysis of odds ratios at each point in the diagnostic spectrum defined four categories: 1) "low risk" (HPVs 6/11, 42, 43, and 44), present in 20.2% (76 of 377) of low-grade lesions but absent in all 153 cancers; 2) "intermediate risk" (HPVs 31, 33, 35, 51, 52, and 58), detected in 23.8% (62 of 261) of high-grade squamous intraepithelial lesions but only 10.5% (16 of 153) of cancers; 3) "high risk/HPV 16," associated with 47.1% of both high-grade intraepithelial lesions (123 of 261) and cancers (72 of 153); and 4) "high risk/HPV 18" (HPVs 18, 45, and 56), found in 26.8% (41 of 153) of invasive carcinomas but only 6.5% (17 of 261) of high-grade intraepithelial lesions. The presence of an oncogenic HPV type conferred relative risks ranging at 65.1-235.7 for the occurrence of a high-grade lesion and 31.1-296.1 for an invasive cancer.