Ragin Camille, Edwards Robert, Larkins-Pettigrew Margaret, Taioli Emanuela, Eckstein Stacy, Thurman Natalie, Bloome Jessica, Markovic Nina
Cancer Prevention and Control Program, Fox Chase Cancer Center, PA 19111, USA.
Int J Mol Sci. 2011;12(6):3928-40. doi: 10.3390/ijms12063928. Epub 2011 Jun 10.
Human Papillomavirus (HPV) is the main risk factor for cervical cancers and is associated with close to 36% of oropharyngeal cancers. There is increasing evidence that oral HPV transmission is related to sexual behavior but to our knowledge studies that involve women who have sex with women have not been performed. We examined the prevalence of oral HPV according to sexual behavior among a population-based sample of 118 women and have made some inferences of possible predictors of oral HPV infection. Women were categorized as heterosexual (history of vaginal sex and/or oral sex with males only, n = 75), bisexual (history of vaginal sex and oral sex with females, n = 32) and other (no history of vaginal sex but oral sex with females [homosexuals], virgins and women with incomplete sexual exposure data, n = 11) The prevalence of oral HPV infection was 12/118 (10.2%) for the overall study population and was not significantly different between heterosexual and bisexual women (10.7% (8/75) vs. 12.5% (4/32), p = 0.784). There was no oral HPV detected among homosexual women, virgins or among women where sexual exposure was unknown. Never smokers were more likely to be oral HPV+ compared to former smokers (Adjusted Odds Ratio (Adj OR) = 0.1, 95% CI, 0.0-1.1) and there was no difference in risk between never smokers and current smokers (Adj OR = 0.7, 95% CI, 0.1-4.6). Twenty-five percent (3/12) of oral HPV+ women had a history of HPV and/or genital warts compared to 9% (10/106) of oral HPV-women (p = 0.104). For the women with a history of vaginal sex (n = 110), oral HPV status was statistically significantly different according to oral sex exposure (p = 0.039). A higher proportion of oral HPV-positive women reported that they had no history of oral sex exposure compared to oral HPV-negative women (4/12, 33% vs. 7/98, 8%). The prevalence of cervical HPV infection did not vary between heterosexuals and bisexuals (35.7% (25/70) vs. 35.5% (11/31), p-value 0.411) and for all other women the cervical HPV prevalence was significantly lower (11.1%, 1/9). Our study suggests that smoking and sexual behavior involving males rather than female partners may be possible predictors of oral HPV infection in women. Further studies with larger sample size are needed to confirm these findings.
人乳头瘤病毒（HPV）是宫颈癌的主要危险因素，约36%的口咽癌与之相关。越来越多的证据表明，口腔HPV传播与性行为有关，但据我们所知，尚未有针对与女性发生性行为的女性开展的研究。我们在一个基于人群的118名女性样本中，根据性行为情况研究了口腔HPV的患病率，并对口腔HPV感染的可能预测因素进行了一些推断。女性被分为异性恋者（仅与男性有阴道性交和/或口交史，n = 75）、双性恋者（与女性有阴道性交和口交史，n = 32）和其他（无阴道性交史但与女性有口交史[同性恋者]、处女以及性行为暴露数据不完整的女性，n = 11）。整个研究人群中口腔HPV感染的患病率为12/118（10.2%），异性恋和双性恋女性之间无显著差异（10.7%（8/75）对12.5%（4/32），p = 0.784）。在同性恋女性、处女或性行为暴露情况不明的女性中未检测到口腔HPV。与既往吸烟者相比，从不吸烟者更有可能感染口腔HPV（调整优势比（Adj OR）= 0.1，95%置信区间，0.0 - 1.1），从不吸烟者和当前吸烟者之间的风险无差异（Adj OR = 0.7，95%置信区间，0.1 - 4.6）。感染口腔HPV的女性中有25%（3/12）有HPV和/或尖锐湿疣病史，而未感染口腔HPV的女性中这一比例为9%（10/106）（p = 0.104）。对于有阴道性交史的女性（n = 110），根据口交暴露情况，口腔HPV状态在统计学上有显著差异（p = 0.039）。与未感染口腔HPV的女性相比，感染口腔HPV的女性中报告无口交暴露史的比例更高（4/12，33%对7/98，8%）。异性恋者和双性恋者中宫颈HPV感染的患病率无差异（35.7%（25/70）对35.5%（11/31），p值0.411），所有其他女性的宫颈HPV患病率显著更低（11.1%，1/9）。我们的研究表明，吸烟以及涉及男性而非女性伴侣的性行为可能是女性口腔HPV感染的潜在预测因素。需要进一步开展更大样本量的研究来证实这些发现。
