Li Ni, Dai Min
Cancer Hospital & Institute, Chinese Academy of Medical Sciences, National Office for Cancer Prevention and Control, Beijing 100021, China.
Zhonghua Yu Fang Yi Xue Za Zhi. 2010 May;44(5):423-6.
To investigate the prevalence of multiple infections of human papillomavirus (HPV) and its relationship with cervical neoplasia among Chinese women in urban areas.
A population-based cross-sectional study was performed among 1712 women (1027 in Shenzhen, Guangdong province and 685 in Shenyang, Liaoning province, respectively) aged 15 - 59 years in China. One community was chosen by cluster sampling in each city. Exfoliated cervical cell was collected and HPV types were detected.
The total HPV prevalence of multiple infections was 4.73% (81/1712). There was no significant difference of HPV infection between two cities (Shenzhen vs Shenyang: 4.38% (45/1027) vs 5.26% (36/685); chi(2) = 0.70, P = 0.404). Among all multiple infections, HPV16-related infection was the most common one, accounting for 23.46% (19/81), followed by HPV52 and 58 (19.75% for each, 16/81). HPV prevalence of multiple infections were 3.42% (55/1606), 17.39% (12/69) and 37.84% (14/37) among the women with normal cervix, low-grade lesion and high-grade lesion, respectively. The HPV prevalence of multiple infections increased with the severity of cervical neoplasia (Z = 9.38, P = 0.01). The risk of high-grade lesion increased more dramatically among the women with multiple infections than single infections (adjusted OR = 96.61, 95%CI: 32.07 - 291.06 vs adjusted OR = 34.60, 95%CI: 12.59 - 95.02 for multiple and single infections, respectively). However, the risk of low-grade lesion increased relatively similarly among the women with the multiple and single infections (OR = 15.00, 95%CI: 6.89 - 32.65 vs OR = 12.04, 95%CI: 6.88 - 21.08 for multiple and single infections, respectively). Multiple-sexual-partner was the key risk factor for multiple infection of HPV (OR = 2.04, 95%CI: 1.19 - 3.49).
Multiple infections may play a higher role than single infection in the development of cervical neoplasia. Multiple HPV infections could be introduced into the strategy for cervical cancer prevention as a possible biomarker.
调查中国城市女性中人类乳头瘤病毒（HPV）多重感染的患病率及其与宫颈肿瘤形成的关系。
在中国对1712名年龄在15 - 59岁的女性（分别为广东省深圳市1027名和辽宁省沈阳市685名）进行了一项基于人群的横断面研究。每个城市通过整群抽样选择一个社区。收集宫颈脱落细胞并检测HPV类型。
多重感染的HPV总患病率为4.73%（81/1712）。两个城市之间的HPV感染无显著差异（深圳与沈阳：4.38%（45/1027）对5.26%（36/685）；χ² = 0.70，P = 0.404）。在所有多重感染中，HPV16相关感染最为常见，占23.46%（19/81），其次是HPV52和58（各占19.75%，16/81）。宫颈正常、低度病变和高度病变的女性中，多重感染的HPV患病率分别为3.42%（55/1606）、17.39%（12/69）和37.84%（14/37）。多重感染的HPV患病率随宫颈肿瘤形成的严重程度增加而升高（Z = 9.38，P = 0.01）。与单一感染的女性相比，多重感染的女性发生高度病变的风险增加更为显著（调整后的OR = 96.61，95%CI：32.07 - 291.06，而多重感染和单一感染的调整后OR分别为34.60，95%CI：12.59 - 95.02）。然而，多重感染和单一感染的女性发生低度病变的风险增加相对相似（多重感染和单一感染的OR分别为15.00，95%CI：6.89 - 32.65和OR = 12.04，95%CI：6.88 - 21.08）。多个性伴侣是HPV多重感染的关键危险因素（OR = 2.04，95%CI：1.19 - 3.49）。
在宫颈肿瘤形成过程中，多重感染可能比单一感染起更大作用。多重HPV感染可作为一种可能的生物标志物纳入宫颈癌预防策略。
