Zhang Z F, Begg C B
Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY 10021.
Int J Epidemiol. 1994 Aug;23(4):682-90. doi: 10.1093/ije/23.4.682.
We conducted this combined analysis of available data from studies with information on this issue to clarify the association between Trichomonas vaginalis infection and cervical neoplasia.
We performed MEDLINE searches (1966-1993) using the key words and phrases 'trichomonas vaginitis' and 'neoplasms, cervix' for articles published in English, and searched citations of the articles obtained from MEDLINE: A total of 24 articles (two cohort studies and 22 case-control) were included in this data analysis. In the analysis, the studies were evaluated for heterogeneity using Breslow-Day tests for homogeneity of the odds ratios and of rate ratios. If the odds ratios from studies are heterogeneous, it is not appropriate to combine them using the Mantel-Haenszel method. Also, publication bias was evaluated by assessing the association between the observed effect size and the variance of the effect size using a rank correlation test.
The combined summary relative risk for the two cohort studies was 1.93 (95% confidence interval: 1.22-2.65) indicating an approximate doubling of the risk of cervical neoplasia in the presence of T. vaginalis infection. The attributable risks among exposed subjects and among the source population were 47.4% and 2.1% respectively. Results of the 22 retrospective studies were much less consistent. However, most of them demonstrated a significant positive association.
This combined analysis suggests that there is an association between T. vaginalis and the risk of cervical neoplasia, but that such infections account for only 2% of cervical neoplasia.
我们对有关该问题的研究中的可用数据进行了综合分析，以阐明阴道毛滴虫感染与宫颈肿瘤形成之间的关联。
我们使用关键词“滴虫性阴道炎”和“肿瘤，宫颈”对1966年至1993年发表在英文期刊上的文章进行了MEDLINE检索，并检索了从MEDLINE获得的文章的参考文献：共有24篇文章（两项队列研究和22项病例对照研究）纳入该数据分析。在分析中，使用Breslow-Day检验评估研究中比值比和率比的同质性，以评估研究的异质性。如果研究中的比值比是异质的，则使用Mantel-Haenszel方法合并它们是不合适的。此外，通过使用秩相关检验评估观察到的效应大小与效应大小的方差之间的关联来评估发表偏倚。
两项队列研究的合并总结相对风险为1.93（95%置信区间：1.22 - 2.65），表明在存在阴道毛滴虫感染的情况下，宫颈肿瘤形成风险大约增加一倍。暴露组和源人群中的归因风险分别为47.4%和2.1%。22项回顾性研究的结果一致性较差。然而，其中大多数显示出显著的正相关。
这项综合分析表明，阴道毛滴虫与宫颈肿瘤形成风险之间存在关联，但此类感染仅占宫颈肿瘤形成的2%。
