Ruharo Eye Hospital, Uganda.
Int J Cancer. 2010 Jul 15;127(2):427-32. doi: 10.1002/ijc.25040.
HIV increases the risk of OSSN. Here we investigate other factors in a case-control study from Uganda with 318 cases (48 CIN I, 66 CIN II, 81 CIN III and 123 with invasive disease) and 762 controls. Initial analyses were stratified by HIV serostatus (204 cases and 202 controls were HIV seropositive), but since findings were similar in infected and uninfected people, the combined results are presented here. The risk of OSSN increased with increasing time spent in direct sunlight (p(trend) = 0.003, adjusted for age, sex, residential district and HIV serostatus): compared to those who reported spending up to 1 hr a day in direct sunlight, the risk was 1.7 (95% Confidence Interval [CI] 1.2-2.4) in those reporting 2-4-hr exposure and 1.8 (95% CI 1.1-3.1) in those reporting 5+ hr. The risk was also increased among people reporting a previous injury to the affected eye (OR 2.4, 95% CI 1.2-4.5). Pinguecula in the nasal quadrant of the unaffected eye were evident on clinical examination for 98% of cases (293/300) and for 91% of the same quadrant in the right eye (246/271) of controls (OR = 6.4, 95% CI 2.5-16.1). We confirm associations with exposure to solar ultraviolet radiation and with the presence of pinguecula and report a role for previous ocular trauma in the aetiology of OSSN. We did not identify any additional factors that point to an underlying infectious cause, although this is an area of on-going research.
HIV 会增加 OSSN 的风险。在这里，我们对来自乌干达的一项病例对照研究中的 318 例病例（48 例 CIN I、66 例 CIN II、81 例 CIN III 和 123 例侵袭性疾病）和 762 例对照进行了其他因素的研究。最初的分析按 HIV 血清状态分层（204 例病例和 202 例对照为 HIV 血清阳性），但由于感染和未感染人群的发现相似，因此这里呈现的是合并结果。OSSN 的风险随着直接暴露在阳光下的时间增加而增加（p(trend) = 0.003，调整年龄、性别、居住地区和 HIV 血清状态后）：与每天报告暴露在阳光下 1 小时的人相比，报告暴露在 2-4 小时的风险为 1.7（95%置信区间 [CI] 1.2-2.4），报告暴露在 5 小时以上的风险为 1.8（95% CI 1.1-3.1）。在报告之前对受影响的眼睛有过受伤的人群中，风险也增加（OR 2.4，95% CI 1.2-4.5）。在受影响的眼睛的鼻象限中，98%的病例（300 例中的 293 例）和 91%的对照组同一象限（271 例中的 246 例）有临床可见的鼻侧象限的翼状胬肉（OR = 6.4，95% CI 2.5-16.1）。我们证实了与暴露于太阳紫外线辐射以及翼状胬肉的存在有关，并报告了眼部外伤在 OSSN 发病机制中的作用。我们没有发现任何其他指向潜在感染原因的因素，尽管这是一个正在进行的研究领域。
