Lehtinen Matti, Koskela Pentti, Jellum Egil, Bloigu Aini, Anttila Tarja, Hallmans Göran, Luukkaala Tiina, Thoresen Steinar, Youngman Linda, Dillner Joakim, Hakama Matti
School of Public Health, University of Tampere, Finland.
Am J Epidemiol. 2002 Oct 15;156(8):687-92. doi: 10.1093/aje/kwf098.
Human papillomaviruses (HPVs) play the major role in cervical carcinogenesis. The authors reevaluated the role of herpes simplex virus type 2 (HSV-2) in this multistage process by conducting a longitudinal, nested case-control study using 1974-1993 data and comparing the results with those from a meta-analysis of studies. A Nordic cohort of 550,000 women was followed up for an average of 5 years, after which 178 cervical carcinoma cases and 527 controls were identified. HSV-2; HPV-16, HPV-18, and HPV-33; and Chlamydia trachomatis antibodies were determined at baseline by HSV-2 glycoprotein gG-2 and HPV virus-like-particle enzyme immunoassays and by using the microimmunofluorescence method. The relative risk of cervical carcinoma was calculated by conditional logistic regression. Longitudinal studies on HSV-2 and cervical neoplasia were identified through MEDLINE (National Library of Medicine, Bethesda, Maryland), and weighted mean relative risks were calculated. Smoking (relative risk = 1.6, 95% confidence interval (CI): 1.1, 2.3) and HPV-16/HPV-18/HPV-33 (relative risk = 2.9, 95% CI: 1.9, 4.3) were both associated with cervical carcinoma. The smoking- and HPV-16/HPV-18/HPV-33-adjusted relative risks for HSV-2 were 1.0 (95% CI: 0.6, 1.7) and 0.7 (95% CI: 0.3, 1.6), respectively, for HPV seropositives. In the meta-analysis, the relative risk for HSV-2 was 0.9 (95% CI: 0.6, 1.3). In both sets of data, HSV-2 did not play a role in cervical carcinogenesis.
人乳头瘤病毒（HPV）在宫颈癌发生过程中起主要作用。作者通过开展一项纵向巢式病例对照研究，利用1974 - 1993年的数据，并将结果与研究的荟萃分析结果进行比较，重新评估了2型单纯疱疹病毒（HSV - 2）在这一多阶段过程中的作用。对北欧的55万名女性队列进行了平均5年的随访，之后确定了178例宫颈癌病例和527名对照。通过HSV - 2糖蛋白gG - 2和HPV病毒样颗粒酶免疫测定以及微免疫荧光法在基线时测定HSV - 2、HPV - 16、HPV - 18和HPV - 33以及沙眼衣原体抗体。通过条件逻辑回归计算宫颈癌的相对风险。通过医学文献数据库（美国国立医学图书馆，马里兰州贝塞斯达）检索关于HSV - 2和宫颈肿瘤形成的纵向研究，并计算加权平均相对风险。吸烟（相对风险 = 1.6，95%置信区间（CI）：1.1，2.3）和HPV - 16/HPV - 18/HPV - 33（相对风险 = 2.9，95% CI：1.9，4.3）均与宫颈癌相关。对于HPV血清阳性者，经吸烟和HPV - 16/HPV - 18/HPV - 33调整后的HSV - 2相对风险分别为1.0（95% CI：0.6，1.7）和0.7（95% CI：0.3，1.6）。在荟萃分析中，HSV - 2的相对风险为0.9（95% CI：0.6，1.3）。在这两组数据中，HSV - 2在宫颈癌发生过程中均未发挥作用。
