RELATIONSHIP OF CIN III AND HUMAN PAPILLOMA VIRUS

这是一个修订后的建议，继续进行病例对照研究，以测试 假设感染人乳头瘤病毒（HPV）与 宫颈上皮内瘤变III（CIN）的风险增加 III/原位癌）。此外，本研究将调查 存在和可能涉及其他性传播感染 病原体（如HSV-II、CMV和衣原体）和其他暴露（包括 吸烟、避孕和营养）。 这项以人群为基础的病例对照研究将继续确定和 采访活检证实为CIN III的妇女，她们是这三个地区的居民。 华盛顿西部的城市县，45岁或以下， 团体健康合作社（GHC），美国最大的HMO之一， States.控制妇女的相同年龄和县的居住将是 通过GHC的招生档案随机抽取并进行访谈。所有 病例的既往细胞学标本（巴氏涂片）和宫颈活检 将通过以下方式收集和评价HPV类型的存在： 聚合酶链反应（PCR）。将采集血样 从病例和对照组中，分析既往暴露于 性传播病毒感染 这项研究最初获得批准，并资助了为期两年的试验阶段， 一个计划项目赠款（CA 42792）对HPV的一部分。这一订正提案 解决了评审员对使用PCR方法测量的担忧 子宫颈抹片检查中HPV的存在。自成立以来，PCR已成为 被认为是流行病学中测量HPV最敏感的方法 研究，是唯一的方法，可用于研究，如这一点， 依赖于档案标本，如巴氏涂片。

This is a revised proposal to continue a case-control study to test the hypothesis that infection with human papilloma virus (HPV) is related to an increased risk of cervical intraepithelial neoplasia III (CIN III/carcinoma-in-situ). In addition, this study will investigate the presence and possible involvement of other sexually transmitted infectious agents (such as HSV-II, CMV, and chlamydia) and other exposures (including smoking, contraceptive use, and nutrition). This population-based case-control study will continue to identify and interview women with biopsy-proven CIN III who are residents of the three urban counties of western Washington, 45 years old or less, and enrolled in Group Health Cooperative (GHC), one of the largest HMOs in the United States. Control women of the same ages and counties of residence will be randomly selected through enrollment files of GHC and interviewed. All previous cytologic specimens (Pap smears) and cervical biopsies of cases and controls will be collected and evaluated for presence of HPV types by means of Polymerase Chain Reaction (PCR). Blood samples will be collected from both cases and controls and analyzed for evidence of prior exposure to sexually transmitted viral infections. This study was initially approved and funded for a two-year pilot phase as part of a program project grant (CA 42792) on HPV. This revised proposal addresses concerns by reviewers about the use of the PCR method to measure the presence of HPV in Pap smears. Since its inception, the PCR has become recognized as the most sensitive method of measuring HPV in epidemiologic studies and is the ONLY method available for studies such as this which rely on archival specimens, such as Pap smears.