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宫颈和肛门管同时存在癌前病变或癌症的女性中 HPV 的肛门患病率:横断面研究。

Anal prevalence of HPV in women with pre-malignant lesion or cancer in the cervix and anal canal simultaneously: cross-sectional study.

机构信息

Department of Lower Genital Tract Pathology, Instituto de Medicina Integral Professor Fernando Figueira (IMIP), Recife, PE, Brazil.

Department of Fetal Medicine and Ultrasonography, Instituto de Medicina Integral Professor Fernando Figueira (IMIP), Recife, PE, Brazil.

出版信息

Int J Gynaecol Obstet. 2019 Nov;147(2):225-232. doi: 10.1002/ijgo.12933. Epub 2019 Aug 12.

Abstract

OBJECTIVE

To determine the prevalence of anal HPV genotypes and associated factors in women with pre-malignant lesion or cancer in the cervix and anal canal.

METHODS

A prospective, cross-sectional study analyzed DNA samples taken from women with cervical pre-malignant lesions or cancer to identify anal HPV by polymerase chain reaction (PCR). The prevalence of high-risk HPV (HR-HPV) in women with intraepithelial neoplasia and anal cancer was calculated; sociodemographic and clinical risk factors were identified using multivariate analysis.

RESULTS

A total of 152 patients were included (mean age 37.8 ± 10.01 years), of whom 101 (66.4%) had anal HR-HPV. Fourteen different anal HPV types were identified. HPV 16 and 18 were found in 30 (52.6%) anal high-grade squamous intraepithelial lesions (HSIL), and HPV 31 and 33 in 21 (36.8%) lesions. In the logistic regression analysis, the factors that remained associated with HR-HPV types were: an anal histopathology report of HSIL or invasive carcinoma (odds ratio [OR] 8.96, 95% confidence interval [CI] 3.40-23.57; P<0.0001) and alcohol consumption (OR 2.20, 95% CI 1.01-4.80; P=0.04).

CONCLUSION

Prevalence of HR-HPV is high in the anal canal of women with cervical and anal pre-malignant lesions simultaneously or cancer of the cervix and/or anal canal. HPV 16, 31, 33, and 18 were the four major genotypes identified.

摘要

目的

确定宫颈和肛门管同时存在癌前病变或癌症的女性中肛门 HPV 基因型的流行情况及其相关因素。

方法

一项前瞻性、横断面研究分析了来自宫颈癌前病变或癌症女性的 DNA 样本,通过聚合酶链反应(PCR)鉴定肛门 HPV。计算了上皮内瘤变和肛门癌女性中高危型 HPV(HR-HPV)的流行率;使用多变量分析确定社会人口统计学和临床危险因素。

结果

共纳入 152 例患者(平均年龄 37.8±10.01 岁),其中 101 例(66.4%)有肛门 HR-HPV。共鉴定出 14 种不同的肛门 HPV 类型。HPV 16 和 18 存在于 30 例(52.6%)肛门高级别鳞状上皮内病变(HSIL)中,HPV 31 和 33 存在于 21 例(36.8%)病变中。在逻辑回归分析中,与 HR-HPV 类型相关的因素仍然是:肛门组织病理学报告为 HSIL 或浸润性癌(比值比 [OR] 8.96,95%置信区间 [CI] 3.40-23.57;P<0.0001)和饮酒(OR 2.20,95% CI 1.01-4.80;P=0.04)。

结论

宫颈和肛门同时存在癌前病变或宫颈癌和/或肛门癌的女性肛门管中 HR-HPV 的流行率较高。HPV 16、31、33 和 18 是鉴定出的四种主要基因型。

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