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包皮环切术对阴茎癌的强大保护作用。

The Strong Protective Effect of Circumcision against Cancer of the Penis.

作者信息

Morris Brian J, Gray Ronald H, Castellsague Xavier, Bosch F Xavier, Halperin Daniel T, Waskett Jake H, Hankins Catherine A

机构信息

School of Medical Sciences and Bosch Institute, Sydney Medical School, The University of Sydney, Sydney, NSW 2006, Australia.

出版信息

Adv Urol. 2011;2011:812368. doi: 10.1155/2011/812368. Epub 2011 May 22.


DOI:10.1155/2011/812368
PMID:21687572
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3113366/
Abstract

Male circumcision protects against cancer of the penis, the invasive form of which is a devastating disease confined almost exclusively to uncircumcised men. Major etiological factors are phimosis, balanitis, and high-risk types of human papillomavirus (HPV), which are more prevalent in the glans penis and coronal sulcus covered by the foreskin, as well as on the penile shaft, of uncircumcised men. Circumcised men clear HPV infections more quickly. Phimosis (a constricted foreskin opening impeding the passage of urine) is confined to uncircumcised men, in whom balanitis (affecting 10%) is more common than in circumcised men. Each is strongly associated with risk of penile cancer. These findings have led to calls for promotion of male circumcision, especially in infancy, to help reduce the global burden of penile cancer. Even more relevant globally is protection from cervical cancer, which is 10-times more common, being much higher in women with uncircumcised male partners. Male circumcision also provides indirect protection against various other infections in women, along with direct protection for men from a number of genital tract infections, including HIV. Given that adverse consequences of medical male circumcision, especially when performed in infancy, are rare, this simple prophylactic procedure should be promoted.

摘要

男性包皮环切术可预防阴茎癌,阴茎癌的侵袭性形式是一种几乎仅见于未行包皮环切术男性的毁灭性疾病。主要病因包括包茎、龟头炎以及高危型人乳头瘤病毒(HPV),这些在未行包皮环切术男性被包皮覆盖的阴茎头和冠状沟以及阴茎体上更为普遍。行包皮环切术的男性清除HPV感染的速度更快。包茎(包皮开口狭窄阻碍尿液通过)仅见于未行包皮环切术的男性,其中龟头炎(发生率为10%)在未行包皮环切术男性中比在已行包皮环切术男性中更为常见。两者均与阴茎癌风险密切相关。这些发现促使人们呼吁推广男性包皮环切术,尤其是在婴儿期,以帮助减轻全球阴茎癌负担。在全球范围内更具相关性的是预防宫颈癌,宫颈癌的发病率是阴茎癌的10倍,在有未行包皮环切术男性伴侣的女性中发病率更高。男性包皮环切术还能为女性提供针对其他各种感染的间接保护,同时为男性提供针对包括艾滋病毒在内的多种生殖道感染的直接保护。鉴于医学上的男性包皮环切术,尤其是在婴儿期进行时,不良后果很少见,这种简单的预防性手术应该得到推广。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1bb2/3113366/79ffe89d7dc0/AU2011-812368.004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1bb2/3113366/a9339072c8f1/AU2011-812368.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1bb2/3113366/b8307a9c6813/AU2011-812368.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1bb2/3113366/f4275a0c8162/AU2011-812368.003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1bb2/3113366/79ffe89d7dc0/AU2011-812368.004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1bb2/3113366/a9339072c8f1/AU2011-812368.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1bb2/3113366/b8307a9c6813/AU2011-812368.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1bb2/3113366/f4275a0c8162/AU2011-812368.003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1bb2/3113366/79ffe89d7dc0/AU2011-812368.004.jpg

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[6]
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[8]
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[9]
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[10]
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本文引用的文献

[1]
Male circumcision and anatomic sites of penile high-risk human papillomavirus in Rakai, Uganda.

Int J Cancer. 2011-4-1

[2]
Lichen sclerosus in boys.

Dtsch Arztebl Int. 2011-1-28

[3]
Effect of circumcision of HIV-negative men on transmission of human papillomavirus to HIV-negative women: a randomised trial in Rakai, Uganda.

Lancet. 2011-1-6

[4]
HIV-1 transmission in the male genital tract.

Am J Reprod Immunol. 2010-11-28

[5]
A modeling framework for the analysis of HPV incidence and persistence: a semi-parametric approach for clustered binary longitudinal data analysis.

Stat Med. 2010-12-10

[6]
Penile cancer--prevention and premalignant conditions.

Urology. 2010-8

[7]
Epidemiology and natural history of penile cancer.

Urology. 2010-8

[8]
Human papillomavirus infection in couples with female low-grade intraepithelial cervical lesion.

Eur J Obstet Gynecol Reprod Biol. 2010-6-19

[9]
Within 1 h, HIV-1 uses viral synapses to enter efficiently the inner, but not outer, foreskin mucosa and engages Langerhans-T cell conjugates.

Mucosal Immunol. 2010-6-23

[10]
Current understanding of the mechanism of HPV infection.

Gynecol Oncol. 2010-6

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