Brisson J, Morin C, Fortier M, Roy M, Bouchard C, Leclerc J, Christen A, Guimont C, Penault F, Meisels A
Department of Social and Preventive Medicine, Laval University, Quebec, Canada.
Am J Epidemiol. 1994 Oct 15;140(8):700-10. doi: 10.1093/oxfordjournals.aje.a117318.
This case-control study assesses relations of human papillomavirus (HPV) type 16 infection, sexual history, cigarette smoking, and oral contraceptive use to low- and high-grade cervical intraepithelial neoplasia (CIN). A total of 548 high-grade and 338 low-grade CIN cases and 612 controls were identified among women seen at a colposcopy clinic in Quebec, Quebec, Canada, in 1988-1989. Interviews, colposcopy, cervical scrapings, and colposcopically directed biopsies were performed. One pathologist reviewed all histologic slides. Southern blot techniques were used to assay specimens for HPV 16 DNA. Lifetime number of sexual partners was related to low- and high-grade CIN. Presence of HPV 16 DNA was associated with a 8.7-fold (95% confidence interval 5.1-15.0) elevation in estimated relative risk of high-grade CIN. Relative risk of high-grade CIN increased with amount of HPV 16 DNA (p < 0.0001). Estimated relative risk of high-grade CIN in current cigarette smokers was 2.4 (95% confidence interval 1.8-3.2) compared with never smokers and increased with number of pack-years of exposure (p < 0.0001). Long-term (6 years or more) users of oral contraceptives had an estimated relative risk of high-grade CIN of 1.9 (95% confidence interval 1.1-3.3) compared with those who never used such contraceptives. In contrast, presence of HPV 16 DNA, cigarette smoking, and oral contraceptive use showed little or no relation to low-grade CIN. Risk factors for low- and high-grade CIN may differ substantially.
这项病例对照研究评估了16型人乳头瘤病毒（HPV）感染、性史、吸烟及口服避孕药的使用与低度和高度宫颈上皮内瘤变（CIN）之间的关系。1988年至1989年期间，在加拿大魁北克省一家阴道镜诊所就诊的女性中，共识别出548例高度CIN病例、338例低度CIN病例以及612名对照。研究人员进行了访谈、阴道镜检查、宫颈刮片及阴道镜引导下活检。由一名病理学家复查所有组织学切片。采用Southern印迹技术检测标本中的HPV 16 DNA。性伴侣的终生数量与低度和高度CIN相关。HPV 16 DNA的存在与高度CIN估计相对风险升高8.7倍（95%可信区间5.1 - 15.0）相关。高度CIN的相对风险随HPV 16 DNA数量增加而升高（p < 0.0001）。与从不吸烟者相比，当前吸烟者患高度CIN的估计相对风险为2.4（95%可信区间1.8 - 3.2），且随暴露的包年数增加而升高（p < 0.0001）。与从未使用过此类避孕药的女性相比，长期（6年或更长时间）使用口服避孕药的女性患高度CIN的估计相对风险为1.9（95%可信区间1.1 - 3.3）。相比之下，HPV 16 DNA的存在、吸烟及口服避孕药的使用与低度CIN几乎没有关系。低度和高度CIN的危险因素可能有很大差异。
