Sudenga Staci L, Torres B Nelson, Fulp William J, Silva Roberto, Villa Luisa L, Lazcano-Ponce Eduardo, Ingles Donna J, Stoler Mark, Messina Jane L, Abrahamsen Martha, Baggio Maria Luiza, Salmeron Jorge, Quiterio Manuel, Giuliano Anna R
Center for Infection Research on Cancer, Moffitt Cancer Center & Research Institute, Tampa, FL.
Centro de Referencia de Treinamento em DST e Aids, São Paulo, Brazil.
Int J Cancer. 2017 Jan 15;140(2):337-345. doi: 10.1002/ijc.30452. Epub 2016 Oct 20.
The purpose of this study was to assess whether the incidence of histopathologically confirmed condyloma and penile intraepithelial neoplasia (PeIN) and rates of genital HPV infection progression to these lesions differs by country (Brazil, Mexico and the U.S.). At each visit, lesions were biopsied and were categorized by pathologic diagnoses. The Linear Array genotyping method was used to identify HPV genotypes from genital swabs, while the INNO-LiPA HPV Genotyping Extra method was used for tissue specimens. Age-specific analyses were conducted for lesion incidence by country, with Kaplan-Meier estimation of cumulative incidence. The proportion of HPV infections that progressed to condyloma and PeIN, the median time to lesion development and the incidence rates were estimated by country. When comparing demographic and sexual characteristics across the three countries, sexual orientation (p = 0.008) and lifetime number of female sexual partners (p < 0.0001) were differentially associated with lesion incidence in the three countries. Condyloma incidence in Brazil and the U.S. decreased with age, while incidence remained constant across the lifespan in Mexico. There were no differences by country and age for PeIN incidence. HPV types 6 and 11 were the most common types to progress to condyloma and HPV types 16, 6 and 11 were the most common types to progress to PeIN in all three countries. The continuous risk of condyloma and PeIN across all age groups and countries in this study emphasizes the need to ensure that strong HPV immunity, such as that obtained through vaccination, is maintained across the lifespan of men.
本研究的目的是评估经组织病理学确诊的尖锐湿疣和阴茎上皮内瘤变（PeIN）的发病率，以及生殖器HPV感染进展为这些病变的比率在不同国家（巴西、墨西哥和美国）是否存在差异。每次就诊时，对病变进行活检并根据病理诊断进行分类。采用线性阵列基因分型方法从生殖器拭子中鉴定HPV基因型，而采用INNO-LiPA HPV基因分型额外方法对组织标本进行检测。按国家对病变发病率进行年龄特异性分析，采用Kaplan-Meier法估计累积发病率。按国家估计进展为尖锐湿疣和PeIN的HPV感染比例、病变发展的中位时间和发病率。在比较三个国家的人口统计学和性特征时，性取向（p = 0.008）和女性性伴侣的终生数量（p < 0.0001）与三个国家的病变发病率存在差异关联。巴西和美国的尖锐湿疣发病率随年龄下降，而墨西哥的发病率在整个生命周期中保持不变。PeIN发病率在国家和年龄方面没有差异。在所有三个国家，HPV 6型和11型是进展为尖锐湿疣最常见的类型，HPV 16、6和11型是进展为PeIN最常见的类型。本研究中所有年龄组和国家尖锐湿疣和PeIN的持续风险强调了确保男性在整个生命周期中维持强大的HPV免疫力（如通过接种疫苗获得的免疫力）的必要性。
