Zhang Jianjun, Orang'o Omenge, Tonui Philip, Tong Yan, Maina Titus, Kiptoo Stephen, Muthoka Katpen, Groopman John, Smith Joshua, Madeen Erin, Ermel Aaron, Loehrer Patrick, Brown Darron R
Department of Epidemiology, Fairbanks School of Public Health, Indiana University, Indianapolis, IN, USA.
Department of Reproductive Health, Moi University, Eldoret, Kenya.
Open Forum Infect Dis. 2019 Sep 2;6(9). doi: 10.1093/ofid/ofz354.
Cervical cancer is common in Kenyan women. Cofactors in addition to infection with oncogenic human papillomavirus (HPV) are likely to be important in causing cervical cancer, as only a small percentage of HPV-infected women will develop this malignancy. Kenyan women are exposed to dietary aflatoxin, a potent carcinogen and immunosuppressive agent, which may be such a co-factor.
Demographics, behavioral data, plasma, and cervical swabs were collected from 88 HIV-uninfected Kenyan women without cervical dysplasia. HPV detection was compared between women with or without plasma AFB1-lys and evaluated in relation to AFB1-lys concentration.
Valid HPV testing results were available for 86 women (mean age 34.0 years); 49 women (57.0%) had AFB1-lys detected and 37 (43.0%) had none. AFB1-lys detection was not associated with age, being married, having more than secondary school education, home ownership, living at a walking distance to health care ≥60 minutes, number of lifetime sex partners, or age of first sex. AFB1-lys detection and plasma concentrations were associated with detection of oncogenic HPV types.
AFB1-lys-positivity and higher plasma AFB1-lys concentrations were associated with higher risk of oncogenic HPV detection in cervical samples from Kenya women. Further studies are needed to determine if aflatoxin interacts with HPV in a synergistic manner to increase the risk of cervical cancer.
宫颈癌在肯尼亚女性中很常见。除感染致癌性人乳头瘤病毒(HPV)外,其他辅助因素在宫颈癌的发生中可能也很重要,因为只有一小部分感染HPV的女性会患上这种恶性肿瘤。肯尼亚女性接触膳食黄曲霉毒素,这是一种强效致癌物和免疫抑制剂,可能就是这样一种辅助因素。
从88名未感染HIV、无宫颈发育异常的肯尼亚女性中收集人口统计学、行为数据、血浆和宫颈拭子。比较有或无血浆AFB1-赖氨酸的女性之间的HPV检测情况,并根据AFB1-赖氨酸浓度进行评估。
86名女性(平均年龄34.0岁)获得了有效的HPV检测结果;49名女性(57.0%)检测到AFB1-赖氨酸,37名(43.0%)未检测到。AFB1-赖氨酸检测与年龄、已婚、受过高中以上教育、拥有住房、居住距离医疗保健机构步行时间≥60分钟、终身性伴侣数量或首次性行为年龄无关。AFB1-赖氨酸检测和血浆浓度与致癌性HPV类型的检测有关。
AFB1-赖氨酸阳性和较高的血浆AFB1-赖氨酸浓度与肯尼亚女性宫颈样本中致癌性HPV检测的较高风险相关。需要进一步研究以确定黄曲霉毒素是否与HPV以协同方式相互作用,从而增加宫颈癌风险。