[山西省岢岚县人乳头瘤病毒感染与宫颈癌相关性研究]

[Study of the association between human papillomavirus infection and cervical cancer in Xianguan county, Shanxi province].

作者信息

Zhao F, Li N, Ma J

机构信息

Department of Epidemiology, Cancer Institute/Hospital, Chinese Academy of Medical Sciences, Beijing 100021, China.

出版信息

Zhonghua Liu Xing Bing Xue Za Zhi. 2001 Oct;22(5):375-8.

PMID:11769697

Abstract

OBJECTIVE

To investigate human papillomavirus (HPV) prevalence in the high incidence areas of cervical cancer in Shanxi and to study the association between HPV infection and cervical cancer.

METHODS

Cells exfoliated from cervix (collected by clinician) and from vagina (collected by subject herself) of 1997 women aged 35-45 from Xiangyuan county, Shanxi province were analyzed blindly by Hybrid Capture Assay (HC-II), which could detect 13 HPV types of high-risk. Unconditional logistics regression model was used to analyze the relation between HPV and cervical cancer/cervical intraepithelial neoplasia (CIN). Kappa coefficient was used to compare the agreement of the two tests.

RESULTS

HPV DNA detection rate in the population was 20.8% while HPV infection rates increased with the seriousness of cervical lesions (chi 2 = 444.04, P = 0.000). Rates of the two groups (35-39 and 40-45) had no significant difference (20.9%: 20.6%, chi 2 = 0.03, P = 0.86). Unconditional logistic regression analysis showed, when comparing with the normal subjects, the risk odds ratio of HPV infection with cervical cancer/high grade CIN and low grade CIN were 254.2 and 26.4 respectively, with attributable risk proportions (ARP) 98.1% and 83.6% respectively. The sensitivity of self-collected vaginal swabs assayed for HPV DNA was lower than that of clinician-collected cervical samples assayed for HPV DNA (84%: 98%, chi 2 = 5.92, P = 0.015). No significant difference in specificity was seen between them (86%: 85%, chi 2 = 0.00, P = 0.997) and there was fair agreement between the two tests (kappa = 0.74).

CONCLUSION

High-risk HPV infection in female genital tract was the major risk factor of cervical cancer and CIN in the areas. Prevention and control of cervical cancer should be focused on avoiding HPV infection, screening women for HPV infection and monitoring population infected by high-risk HPV. Self-collected vaginal swabs assayed for HPV DNA seemed a more practical method in primary screening for cervical cancer.

摘要

目的

调查山西省宫颈癌高发地区人乳头瘤病毒（HPV）的感染情况，研究HPV感染与宫颈癌的关系。

方法

对山西省襄垣县1997名35 - 45岁女性的宫颈脱落细胞（由临床医生采集）和阴道脱落细胞（由受试者本人采集）采用杂交捕获法（HC-II）进行盲法检测，该方法可检测13种高危型HPV。采用非条件logistic回归模型分析HPV与宫颈癌/宫颈上皮内瘤变（CIN）的关系。用Kappa系数比较两种检测方法的一致性。

结果

人群中HPV DNA检测率为20.8%，且HPV感染率随宫颈病变严重程度增加而升高（χ² = 444.04，P = 0.000）。两组（35 - 39岁和40 - 45岁）感染率无显著差异（20.9%: 20.6%，χ² = 0.03，P = 0.86）。非条件logistic回归分析显示，与正常受试者相比，HPV感染导致宫颈癌/高级别CIN和低级别CIN的风险比分别为254.2和26.4，归因危险度百分比（ARP）分别为98.1%和83.6%。自行采集阴道拭子检测HPV DNA的敏感性低于临床医生采集宫颈样本检测HPV DNA的敏感性（84%: 98%，χ² = 5.92，P = 0.015）。两者特异性无显著差异（86%: 85%，χ² = 0.00，P = 0.997），两种检测方法一致性较好（kappa = 0.74）。