Pei R X, Wu C H, Yan J X, Ding L, Song L, Lyu Y J, Wang J, Liu H, Meng D, Qi Z, Hao M, Wang J T
Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan 030001, China.
Department of Obstetrics and Gynecology, Second Hospital of Shanxi Medical University, Taiyuan 030001, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2021 Nov 10;42(11):2060-2065. doi: 10.3760/cma.j.cn112338-20210406-00278.
To investigate the effects of polycyclic aromatic hydrocarbons (PAHs) exposure on the prognosis of high risk human papillomavirus (HR-HPV) infection. In this prospective study, 564 patients with low-grade cervical intraepithelial neoplasia confirmed by pathology were selected from the natural cohort population established by our research group in Shanxi province in 2014. Based on the baseline data of demographic characteristics and factors related to HPV infection, the concentrations of 1-hydroxypyrene in urine samples of the patients were determined by high performance liquid chromatography to define the exposure level of PAHs. At baseline survey and follow-up after 24 months, flow-through hybridization was used to detect HPV infection types, and to evaluate the prognosis of HR-HPV (persistent infection, negative conversion, positive conversion and persistent negative status). Of the 564 subjects, 483 completed the follow-up, with a follow-up rate of 85.6% (483/564). Among them, the persistent infection rate was 52.4% (75/143), the persistent homotype infection rate was 35.7% (51/143), the negative conversion rate was 47.6% (68/143), the positive conversion rate was 19.7% (67/340), and the persistent negative rate was 80.3% (273/340). The follow-up results showed that the persistent infection rate (a3.22, 95%: 1.85-5.62) and positive conversion rate (a=2.84, 95%: 1.64-4.94) of HR-HPV in high PAHs exposure group were higher than those in low PAHs exposure group, while the persistent negative rate (a0.55, 95% : 0.43-0.70) of HR-HPV in high PAHs exposure group were lower than those in low PAHs exposure group. Based on restrictive cubic spline analysis, the results showed that the effects of PAHs exposure on persistent HR-HPV infection and persistent homotype infection showed an ascending linear dose-response relationship, while on HR-HPV positive conversion and persistent negative status showed an ascending and declining nonlinear dose-response relationship respectively (<0.01). High PAHs exposure could promote persistent HR-HPV infection and persistent homotypic infection. Reducing PAHs exposure might conducive to HR-HPV continuous negative maintenance. Active prevention and control of PAHs exposure is of great significance to prevent HR-HPV infection and persistent infection.
探讨多环芳烃（PAHs）暴露对高危型人乳头瘤病毒（HR-HPV）感染预后的影响。在这项前瞻性研究中，从2014年我们研究团队在山西省建立的自然队列人群中选取了564例经病理确诊的低级别宫颈上皮内瘤变患者。根据人口统计学特征和HPV感染相关因素的基线数据，采用高效液相色谱法测定患者尿液样本中1-羟基芘的浓度，以确定PAHs的暴露水平。在基线调查和24个月后的随访中，采用导流杂交法检测HPV感染类型，并评估HR-HPV的预后（持续感染、转阴、转阳和持续阴性状态）。564名受试者中，483名完成了随访，随访率为85.6%（483/564）。其中，持续感染率为52.4%（75/143），持续同型感染率为35.7%（51/143），转阴率为47.6%（68/143），转阳率为19.7%（67/340），持续阴性率为80.3%（273/340）。随访结果显示，高PAHs暴露组HR-HPV的持续感染率（a=3.22，95%：1.85-5.62）和转阳率（a=2.84，95%：1.64-4.94）高于低PAHs暴露组，而高PAHs暴露组HR-HPV的持续阴性率（a=0.55，95%：0.43-0.70）低于低PAHs暴露组。基于限制性立方样条分析，结果显示PAHs暴露对HR-HPV持续感染和持续同型感染的影响呈上升线性剂量反应关系，而对HR-HPV转阳和持续阴性状态的影响分别呈上升和下降的非线性剂量反应关系（P<0.01）。高PAHs暴露可促进HR-HPV持续感染和持续同型感染。减少PAHs暴露可能有助于HR-HPV持续阴性维持。积极防控PAHs暴露对预防HR-HPV感染和持续感染具有重要意义。
