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中国北方河南省林州市 2007 年至 2009 年高发地区食管和宫颈癌中人乳头瘤病毒感染的流行情况。

Prevalence of human papillomavirus infection in esophageal and cervical cancers in the high incidence area for the two diseases from 2007 to 2009 in Linzhou of Henan Province, Northern China.

机构信息

Henan Medical Genetics Institute, People's Hospital of Zhengzhou University (Henan Provincial People's Hospital), Zhengzhou, 450003, Henan, China.

出版信息

Arch Virol. 2014 Jun;159(6):1393-401. doi: 10.1007/s00705-013-1943-9. Epub 2014 Jan 3.

Abstract

The etiological role of human papillomavirus (HPV) in cervical cancer has been well established. However, it is inconclusive whether HPV plays the same role in esophageal carcinogenesis. In this study, we detected HPV infection in 145 frozen esophageal tissues, including 30 normal epithelium (ENOR), 37 dysplasia (DYS) and 78 invasive squamous cell carcinoma (ESCC), and in 143 frozen cervical tissues composed of 30 normal epithelium (CNOR), 38 intraepithelial neoplasia (CIN) and 75 invasive squamous cell carcinoma (CSCC). The patients and symptom-free subjects enrolled in this study were from a high-incidence area for both ESCC and CSCC, Linzhou City, Northern China, from 2007 to 2009. The HPV infection analysis was conducted by using an HPV GenoArray Test Kit. We found that the high-risk HPV types accounted for more than 90 % of the HPV-positive lesions of esophagus and cervix tissues. The prevalence of high-risk HPV types increased significantly during the progression of both esophageal and cervical carcinogenesis (positive rate in esophageal tissues: 33 % ENOR, 70 % in DYS and 69 % in ESCC; positive rate in cervical tissues: 27 % in CNOR, 82 % in CIN and 88 % in CSCC; P < 0.001, respectively). Infection with the high-risk HPV types increased the risk for both DYS and ESCC by 4-fold (DYS vs. ENOR: OR = 4.73, 95 %CI = 1.68-13.32; ESCC vs. ENOR: OR = 4.50, 95 %CI = 1.83-11.05) and increased the risk for both CIN and CSCC by 12-fold and 20-fold (CIN vs. CNOR: OR = 12.18, 95 %CI = 3.85-38.55; CSCC vs. CNOR: OR = 20.17, 95 %CI = 6.93-58.65), respectively. The prevalence of high-risk types in ESCC patients was lower than that in CSCC patients (P = 0.005) and was significantly associated with the degree of ESCC tumor infiltration (P = 0.001). HPV 16 was the most prevalent subtype in both esophageal and cervical tissues. Single HPV infection increased significantly along with the progression of ESCC and maintained a high level in cervical tissues, regardless of whether they were CNOR or CSCC tissues. Our results showed that infection with HPV, especially the high-risk types, was positively associated with both esophageal and cervical cancers, suggesting that HPV also plays a role in the etiology of ESCC in the high-incidence area.

摘要

人乳头瘤病毒(HPV)在宫颈癌中的病因作用已得到充分证实。然而,HPV 是否在食管癌的发生中起相同作用尚不确定。在这项研究中,我们检测了 145 份冷冻食管组织(包括 30 份正常上皮组织[ENOR]、37 份发育不良[DYS]和 78 份浸润性鳞状细胞癌[ESCC])和 143 份冷冻宫颈组织(包括 30 份正常上皮组织[CNOR]、38 份上皮内瘤变[CIN]和 75 份浸润性鳞状细胞癌[CSCC])中的 HPV 感染。本研究中的患者和无症状受试者均来自中国北方高发区的食管癌和宫颈癌高发区林州市,时间为 2007 年至 2009 年。采用 HPV GenoArray 检测试剂盒进行 HPV 感染分析。我们发现高危型 HPV 占食管和宫颈组织 HPV 阳性病变的 90%以上。高危型 HPV 类型的流行率在食管和宫颈癌的发生过程中显著增加(食管组织中的阳性率:33%ENOR,70%DYS 和 69%ESCC;宫颈组织中的阳性率:27%CNOR,82%CIN 和 88%CSCC;P<0.001)。高危型 HPV 感染使 DYS 和 ESCC 的发病风险增加了 4 倍(DYS 与 ENOR 相比:OR=4.73,95%CI=1.68-13.32;ESCC 与 ENOR 相比:OR=4.50,95%CI=1.83-11.05),使 CIN 和 CSCC 的发病风险分别增加了 12 倍和 20 倍(CIN 与 CNOR 相比:OR=12.18,95%CI=3.85-38.55;CSCC 与 CNOR 相比:OR=20.17,95%CI=6.93-58.65)。ESCC 患者高危型 HPV 感染的流行率低于 CSCC 患者(P=0.005),且与 ESCC 肿瘤浸润程度显著相关(P=0.001)。HPV16 是食管和宫颈组织中最常见的亚型。无论是否为 CNOR 或 CSCC 组织,单一 HPV 感染均随 ESCC 的进展显著增加,并在宫颈组织中保持较高水平。我们的结果表明,HPV 感染,尤其是高危型 HPV 感染,与食管和宫颈癌均密切相关,提示 HPV 也在该高发区 ESCC 的病因学中起作用。

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