Luostarinen T, Lehtinen M, Bjørge T, Abeler V, Hakama M, Hallmans G, Jellum E, Koskela P, Lenner P, Lie A K, Paavonen J, Pukkala E, Saikku P, Sigstad E, Thoresen S, Youngman L D, Dillner J, Hakulinen T
Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Box 169, FIN-00171 Helsinki, Finland.
Eur J Cancer. 2004 May;40(7):1058-65. doi: 10.1016/j.ejca.2003.11.032.
This case-control study based in Nordic serum banks evaluated the joint effects of infections with genital human papillomavirus (HPV) types, and Chlamydia trachomatis in the aetiology of cervical squamous cell carcinoma. Through a linkage with the cancer registries, 144 cases were identified and 420 controls matched to them. Exposure to past infections was defined by the presence of specific IgG antibodies. The odds ratio (OR) for the second-order interaction of HPV16, HPV6/11 and C. trachomatis was small (1.0) compared to the expected multiplicative OR, 57, and the additive OR, 11. The interactions were not materially different among HPV16 DNA-positive squamous cell carcinomas. When HPV16 was replaced with HPV18/33 in the analysis of second-order interactions with HPV6/11 and C. trachomatis, there was no evidence of interaction, the joint effect being close to the expected additive OR. Possible explanations for the observed antagonism include misclassification, selection bias or a true biological phenomenon with HPV6/11 and C. trachomatis exposures antagonizing the carcinogenic effects of HPV16.
这项基于北欧血清库的病例对照研究评估了生殖道人乳头瘤病毒（HPV）各型感染与沙眼衣原体感染在宫颈鳞状细胞癌病因学中的联合作用。通过与癌症登记处的联动，确定了144例病例，并为其匹配了420名对照。既往感染的暴露情况通过特定IgG抗体的存在来定义。与预期的相乘比值比57和相加比值比11相比，HPV16、HPV6/11和沙眼衣原体二阶相互作用的比值比（OR）较小（1.0）。在HPV16 DNA阳性的鳞状细胞癌中，相互作用没有实质性差异。在与HPV6/11和沙眼衣原体的二阶相互作用分析中，当用HPV18/33替代HPV16时，没有相互作用的证据，联合效应接近预期的相加比值比。观察到的拮抗作用的可能解释包括错误分类、选择偏倚或一种真实的生物学现象，即HPV6/11和沙眼衣原体暴露拮抗HPV16的致癌作用。
