Human papillomavirus and risk factors for cervical cancer in Chennai, India:: A case-control study
Human papillomavirus and risk factors for cervical cancer in Chennai, India:: A case-control study
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DOI：
10.1002/ijc.11350
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发表时间：
2003-10-20
影响因子：
6.4
通讯作者：
Herrero, R
中科院分区：
文献类型：
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作者：
Franceschi, S;Rajkumar, T;Herrero, R
为了评估人乳头瘤病毒（HPV）和其他危险因素在侵袭性宫颈癌（ICC）病因学中的作用，我们在印度南部钦奈进行了一项基于医院的病例对照研究。共纳入205例ICC病例（包括12例腺癌）和213例频率年龄匹配的对照妇女。采用聚合酶链反应法对宫颈细胞中的HPV DNA进行检测。比值比（ORs）和相应的95%置信区间（Cls）通过无条件多元逻辑回归模型计算。除1例外，所有ICC病例和27.7%的对照女性（OR = 498）均检测到HPV感染。发现了23种不同的HPV类型。无论是病例还是对照组，HPV 16都是最常见的类型，其次是HPV 18和33。ICC与HPV 18和HPV 16相关类型的相关性强于与HPV 16相关类型的相关性。多重HPV感染没有显示出比单一感染更高的ICC OR。除HPV感染外，高胎次（4胎比小于或等于2胎的OR = 7.3）、女性报告丈夫婚外性关系（OR = 10.0）和早期绝经（OR = 45岁= 4.2）与ICC显著相关，这也是在限制HPV阳性病例和对照组的分析后得出的结论。卫生条件差与对照组妇女中HPV感染风险增加有关，但与HPV阳性妇女中ICC风险无关。针对HPV 16和18的疫苗可能对研究区域超过四分之三的ICC有效。(C) 2003 Wiley-Liss, Inc。
To evaluate the role of human papillomavirus (HPV) and other risk factors in the aetiology of invasive cervical carcinoma (ICC), we conducted a hospital-based case-control study in Chennai, Southern India. A total of 205 ICC cases (including 12 adenocarcinomas) and 213 frequency age-matched control women were included. HPV DNA in cervical cells was evaluated by means of a polymerase chain-reaction assay. Odds ratios (ORs) and corresponding 95% confidence intervals (Cls) were computed by means of unconditional multiple logistic regression models. HPV infection was detected in all but one ICC cases and in 27.7% of control women (OR = 498). Twenty-three different HPV types were found. HPV 16 was the most common type in either cases or controls, followed by HPV 18 and 33. The association of ICC with HPV 18 and HPV 16-associated types was somewhat stronger than the one with HPV 16. Multiple HPV infections did not show a higher OR for ICC than single infections. Other than HPV infection, high parity (OR for >4 vs. less than or equal to2 births = 7.3), a woman's report of her husband's extramarital sexual relationships (OR = 10.0) and early menopause (OR for = 45 years = 4.2) were significantly associated with ICC, also after restricting the analysis to HPV-positive cases and controls. Poor hygienic conditions were associated with an increased risk of HPV infection among control women but not with ICC risk among HPV-positive women. A vaccine against HPV 16 and 18 may be effective in more than three-quarters of ICC in the study area. (C) 2003 Wiley-Liss, Inc.