Kjellberg L, Wang Z, Wiklund F, Edlund K, Angstr M T, Lenner P, Sj Berg I, Hallmans G, Wallin K L, Sapp M, Schiller J, Wadell G, M Hlck C G, Dillner J
J Gen Virol. 1999 Feb;80 ( Pt 2):391-398. doi: 10.1099/0022-1317-80-2-391.
Sexual history is an established risk determinant for cervical neoplasia. It is not clear if human papillomavirus (HPV) exposure entirely explains the sexual behaviour-related risk or if other sexually transmitted agents may act as cofactors for HPV in carcinogenesis. The aim of this study was to elucidate whether HPV exposure or HPV persistence explains the sexual history-related risk of high-grade cervical intraepithelial neoplasia (CIN) using a population-based case-control study of most of the 254 women referred to colposcopy in the Vasterbotten county in Sweden because of an abnormal cervical smear during October 1993 to December 1995 and 320 age-matched women from the general population. The women were interviewed for sexual history and tested for presence of serum antibodies to HPV-16, -18 and -33 as well as for presence of HPV DNA in cervical brush samples. HPV-16, -18 and -33 seropositivity was specific for the corresponding type of HPV DNA, dependent on the lifetime sexual history and associated with a two- to threefold increased risk of CIN 3. There was no sexual history-related risk of CIN among HPV-seropositive women and adjustment for HPV DNA presence explained the sexual history-related risk of CIN. In conclusion, HPV exposure appeared to explain the sexual history-related risk of high-grade CIN.
性史是宫颈癌变的一个既定风险决定因素。目前尚不清楚人乳头瘤病毒（HPV）暴露是否能完全解释与性行为相关的风险，或者其他性传播病原体是否可能在致癌过程中作为HPV的辅助因子。本研究的目的是通过一项基于人群的病例对照研究，阐明HPV暴露或HPV持续感染是否能解释与性史相关的高级别宫颈上皮内瘤变（CIN）风险。该研究纳入了1993年10月至1995年12月期间因宫颈涂片异常而转诊至瑞典韦斯特博滕县进行阴道镜检查的254名女性中的大多数，以及320名来自普通人群的年龄匹配女性。对这些女性进行了性史访谈，并检测了她们血清中针对HPV-16、-18和-33的抗体以及宫颈刷样本中HPV DNA的存在情况。HPV-16、-18和-33血清阳性对相应类型的HPV DNA具有特异性，取决于终生性史，并与CIN 3风险增加两到三倍相关。HPV血清阳性女性中不存在与性史相关的CIN风险，对HPV DNA存在情况进行调整后解释了与性史相关的CIN风险。总之，HPV暴露似乎可以解释与性史相关的高级别CIN风险。
