Bosch F X, Muñoz N, de Sanjosé S, Navarro C, Moreo P, Ascunce N, Gonzalez L C, Tafur L, Gili M, Larrañaga I
International Agency for Research on Cancer, Lyon, France.
Cancer Epidemiol Biomarkers Prev. 1993 Sep-Oct;2(5):415-22.
A case-control study of 525 cases of cervical intraepithelial neoplasia grade III (CIN III) and 512 controls was conducted in Spain and Colombia between 1985 and 1988 to assess the role of human papillomavirus (HPV) in the etiology of CIN III. HPV DNA in cytological scrapes from the cervix was assessed by Virapap and by polymerase chain reaction (PCR) based on the L1 consensus primers. A subsample of 268 specimens was also tested for HPV DNA using Southern hybridization. In Spain, the PCR-based prevalences of HPV DNA were 70.7% among cases and 4.7% among controls. Odds ratio (OR) and 95% confidence interval (numbers in parentheses) for HPV DNA were 56.9 (24.8-130.6). In Columbia HPV DNA was detected by PCR in 63.2% of the cases and in 10.5% of the controls. The OR was 15.5 (8.2-29.4). The estimated fractions of CIN III attributable to HPV were 72.4% in Spain and 60.3% in Colombia. HPV 16 was the predominant viral type and showed the strongest association with CIN III; in Spain the OR was 295.5 (44.8-1946.4) and in Colombia the OR was 27.1 (10.6-69.5). HPV DNA of unknown type was frequent in HPV-positive cases (18.3% in Spain and 38.0% in Colombia) and controls (66.7% in Spain and 47.4% in Colombia). The comparison of results from Virapap and PCR indicated that PCR is the method of choice for epidemiological studies. These data strongly support the hypothesis of the viral origin of CIN III, the common etiology of CIN III and invasive cervical cancer, and the causal nature of the association between HPV and CIN III.
1985年至1988年间，在西班牙和哥伦比亚对525例宫颈上皮内瘤变III级（CIN III）病例和512名对照进行了一项病例对照研究，以评估人乳头瘤病毒（HPV）在CIN III病因学中的作用。通过Virapap以及基于L1共有引物的聚合酶链反应（PCR）对宫颈细胞学刮片中的HPV DNA进行评估。还使用Southern杂交对268个标本的子样本进行了HPV DNA检测。在西班牙，基于PCR的HPV DNA患病率在病例中为70.7%，在对照中为4.7%。HPV DNA的优势比（OR）和95%置信区间（括号内数字）为56.9（24.8 - 130.6）。在哥伦比亚，通过PCR在63.2%的病例和10.5%的对照中检测到HPV DNA。OR为15.5（8.2 - 29.4）。西班牙归因于HPV的CIN III估计比例为72.4%，哥伦比亚为60.3%。HPV 16是主要的病毒类型，与CIN III的关联最强；在西班牙OR为295.5（44.8 - 1946.4），在哥伦比亚OR为27.1（10.6 - 69.5）。未知类型的HPV DNA在HPV阳性病例（西班牙为18.3%，哥伦比亚为38.0%）和对照（西班牙为66.7%，哥伦比亚为47.4%）中很常见。Virapap和PCR结果的比较表明，PCR是流行病学研究的首选方法。这些数据有力地支持了CIN III的病毒起源假说、CIN III和浸润性宫颈癌的共同病因以及HPV与CIN III之间关联的因果性质。
