Human papillomavirus infection in women with and without cervical cancer in Nepal
Human papillomavirus infection in women with and without cervical cancer in Nepal
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DOI：
10.1007/s10552-009-9467-z
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发表时间：
2010-03-01
影响因子：
2.3
通讯作者：
Franceschi, Silvia
中科院分区：
文献类型：
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作者：
Sherpa, Ang Tshering Lama;Clifford, Gary M.;Franceschi, Silvia
目的宫颈癌是尼泊尔妇女最常见的恶性肿瘤。人乳头瘤病毒(HPV)流行的流行病学资料为制定合理的预防措施提供了依据。方法从尼泊尔巴拉特布尔普通人群中采集932例15~59岁已婚妇女的宫颈标本，以及61例当地诊断的浸润性宫颈癌(ICC)标本。结果在普通人群中，HPV总感染率为8.6%，高危型感染率为6.1%。异常巴氏涂片的发生率为3.6%，其中包括5例高度鳞状上皮内病变。居住在贫民窟、受教育程度较低、女性一生中有3个性伴侣、丈夫有婚外情与HPV阳性显著相关。在所有年龄组中，HPV患病率相对稳定。HPV16型是最常见的类型，在普通人群(1.9%)和54名HPV阳性ICC女性(68.5%)中都是如此。ICC人群中HPV18例(22.2%)和45例(5.6%)也较常见。结论尼泊尔HPV感染负担中等，低于印度和中国等许多地区。在尼泊尔，大约80%的宫颈癌理论上可以通过HPV16/18疫苗预防。与此同时，应鼓励筛查和治疗方法，以克服在召回筛查阳性结果的妇女时遇到的困难。
Objectives Cervical cancer is the most common malignancy among Nepalese women. Rational prevention measures are informed by epidemiological data on human papillomavirus (HPV) prevalence.Methods Cervical specimens were obtained from 932 married women aged 15-59 years from the general population of Bharatpur, Nepal, as well as from 61 locally diagnosed invasive cervical cancers (ICC). HPV was detected using a GP5+/6+ PCR-based assay.Results Among the general population, the overall prevalence of HPV was 8.6% (6.1% for high-risk types). Prevalence of abnormal Pap smears was 3.6%, including five high-grade squamous intraepithelial lesions. Residence in slum housing, lower education level, >= 3 sexual partners in a woman's lifetime, and husband's extramarital affairs were significantly associated with HPV positivity. HPV prevalence was relatively constant across all age groups. HPV16 was the most common type, both among the general population (1.9%) and among 54 women with HPV-positive ICC (68.5%). HPV18 (22.2%) and 45 (5.6%) were also common in ICC.Conclusions Nepal has an intermediate burden of HPV infection, lower than many areas in India and China. Approximately 80% of cervical cancer in Nepal is theoretically preventable by HPV16/18 vaccines. In the meantime, screen-and-treat approaches should be encouraged to overcome difficulties that were encountered to recall women with screening-positive findings.