Giuliano Anna R, Nielson Carrie M, Flores Roberto, Dunne Eileen F, Abrahamsen Martha, Papenfuss Mary R, Markowitz Lauri E, Smith Danelle, Harris Robin B
H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, 33612, USA.
J Infect Dis. 2007 Oct 15;196(8):1146-52. doi: 10.1086/521629. Epub 2007 Sep 17.
Background. Human papillomavirus (HPV) infection in men contributes to infection and cervical disease in women as well as to disease in men. This study aimed to determine the optimal anatomic site(s) for HPV detection in heterosexual men.Methods. A cross-sectional study of HPV infection was conducted in 463 men from 2003 to 2006. Urethral, glans penis/coronal sulcus, penile shaft/prepuce, scrotal, perianal, anal canal, semen, and urine samples were obtained. Samples were analyzed for sample adequacy and HPV DNA by polymerase chain reaction and genotyping. To determine the optimal sites for estimating HPV prevalence, site-specific prevalences were calculated and compared with the overall prevalence. Sites and combinations of sites were excluded until a recalculated prevalence was reduced by <5% from the overall prevalence.Results. The overall prevalence of HPV was 65.4%. HPV detection was highest at the penile shaft (49.9% for the full cohort and 47.9% for the subcohort of men with complete sampling), followed by the glans penis/coronal sulcus (35.8% and 32.8%) and scrotum (34.2% and 32.8%). Detection was lowest in urethra (10.1% and 10.2%) and semen (5.3% and 4.8%) samples. Exclusion of urethra, semen, and either perianal, scrotal, or anal samples resulted in a <5% reduction in prevalence.Conclusions. At a minimum, the penile shaft and the glans penis/coronal sulcus should be sampled in heterosexual men. A scrotal, perianal, or anal sample should also be included for optimal HPV detection.
背景。男性感染人乳头瘤病毒（HPV）会导致女性感染及宫颈疾病，同时也会引发男性自身疾病。本研究旨在确定异性恋男性中检测HPV的最佳解剖部位。
方法。2003年至2006年对463名男性进行了HPV感染的横断面研究。采集了尿道、阴茎头/冠状沟、阴茎体/包皮、阴囊、肛周、肛管、精液和尿液样本。通过聚合酶链反应和基因分型分析样本的充足性和HPV DNA。为确定估计HPV流行率的最佳部位，计算了各部位特异性流行率并与总体流行率进行比较。排除各部位及部位组合，直至重新计算的流行率比总体流行率降低<5%。
结果。HPV总体流行率为65.4%。HPV检测率在阴茎体最高（全队列中为49.9%，完整采样的男性亚队列中为47.9%），其次是阴茎头/冠状沟（35.8%和32.8%）和阴囊（34.2%和32.8%）。尿道（10.1%和10.2%）和精液（5.3%和4.8%）样本中的检测率最低。排除尿道、精液以及肛周、阴囊或肛管样本之一后，流行率降低<5%。
结论。对于异性恋男性，至少应采集阴茎体和阴茎头/冠状沟样本。为实现最佳HPV检测，还应采集阴囊、肛周或肛管样本。
