人类白细胞抗原I类和II类等位基因与宫颈肿瘤风险：来自哥斯达黎加一项基于人群研究的结果

Human leukocyte antigen class I and II alleles and risk of cervical neoplasia: results from a population-based study in Costa Rica.

作者信息

Wang S S, Wheeler C M, Hildesheim A, Schiffman M, Herrero R, Bratti M C, Sherman M E, Alfaro M, Hutchinson M L, Morales J, Lorincz A, Burk R D, Carrington M, Erlich H A, Apple R J

机构信息

Interdisciplinary Studies Section, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD 20892-7234, USA.

出版信息

J Infect Dis. 2001 Nov 15;184(10):1310-4. doi: 10.1086/324209. Epub 2001 Oct 29.

DOI:10.1086/324209

PMID:11679920

Abstract

To examine human leukocyte antigen (HLA) involvement in the development of all grades of cervical neoplasia, a nested case-control study of 10,077 women in Guanacaste, Costa Rica, was conducted. Participants had invasive cervical cancer, high-grade squamous intraepithelial lesions (HSILs; n=166), or low-grade squamous intraepithelial lesions (LSILs); were positive for human papillomavirus (HPV) with no evidence of cervical neoplasia (n=320); or were HPV negative with no evidence of cervical neoplasia but with a history of high-risk sexual behavior (n=173). Compared with women who were HPV negative, women with HLA-DRB11301 were associated with decreased risk for cancer/HSILs (odds ratio [OR], 0.4; 95% confidence interval [CI], 0.2-0.7) and for LSILs/HPV (OR, 0.6; 95% CI, 0.3-0.9). Women with both HLA-B07 and HLA-DQB1*0302 had an 8.2-fold increased risk for cancer/HSILs (95% CI, 1.8-37.2) and a 5.3-fold increased risk for LSILs/HPV (95% CI, 1.2-23.7). These results support the hypothesis that multiple risk alleles are needed in order to increase risk for cervical neoplasia, but a single protective allele may be sufficient for protection.

摘要

为研究人类白细胞抗原（HLA）在各级宫颈肿瘤发生发展中的作用，在哥斯达黎加瓜纳卡斯特省对10077名女性进行了一项巢式病例对照研究。参与者包括浸润性宫颈癌、高级别鳞状上皮内病变（HSIL；n = 166）或低级别鳞状上皮内病变（LSIL）患者；人乳头瘤病毒（HPV）检测呈阳性但无宫颈肿瘤证据者（n = 320）；或HPV检测呈阴性、无宫颈肿瘤证据但有高危性行为史者（n = 173）。与HPV阴性的女性相比，携带HLA - DRB11301的女性患癌/HSIL的风险降低（比值比[OR]，0.4；95%置信区间[CI]，0.2 - 0.7），患LSIL/HPV的风险也降低（OR，0.6；95% CI，0.3 - 0.9）。同时携带HLA - B07和HLA - DQB1*0302的女性患癌/HSIL的风险增加8.2倍（95% CI，1.8 - 37.2），患LSIL/HPV的风险增加5.3倍（95% CI，1.2 - 23.7）。这些结果支持了这样一种假设，即增加宫颈肿瘤风险需要多个风险等位基因，但单个保护性等位基因可能足以提供保护。