Zhang Z F, Graham S, Yu S Z, Marshall J, Zielezny M, Chen Y X, Sun M, Tang S L, Liao C S, Xu J L
Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA.
Ann Epidemiol. 1995 Jul;5(4):325-32. doi: 10.1016/1047-2797(94)00101-x.
The relationship between Trichomonas vaginalis infection and cervical cancer was investigated prospectively in a cohort of 16,797 women aged 25 years or more who were followed from 1974 to 1985 within the framework of a cervical screening program in Jingan, China. Personal interviews were conducted by trained interviewers when the women first entered the screening program. At initial screening, 421 (2.51%) women had a positive cytologic diagnosis of T. vaginalis infection. Ninety-nine incident cases of pathologically confirmed squamous cell carcinoma were identified from the cohort, with a total of 140,018 person-years of observation. T. vaginalis infection was found to contribute to the risk of cervical cancer, as determined by crude estimates and after adjustment for potential confounding effects. In a multiple proportional hazards model, the relative risk for cervical cancer was 3.3 (95% confidence interval: 1.5 to 7.4) among women with T. vaginalis infection. Furthermore, in the multivariate analysis, increased risk of cervical cancer was associated with the following factors: number of extramarital sexual partners of both the subjects and their spouses, cigarette smoking, and irregular menstruation. Having a large number of negative Pap smears was associated with lower risk. This study suggests that there might be an association between T. vaginalis infection and the risk of cervical cancer, but only 4 to 5% of cervical cancer in Chinese women may be attributable to T. vaginalis infection.
在中国上海静安区的一项宫颈癌筛查项目框架内，对16797名年龄在25岁及以上的女性进行了前瞻性研究，以调查阴道毛滴虫感染与宫颈癌之间的关系。这些女性于1974年至1985年期间被随访。当女性首次进入筛查项目时，由经过培训的访谈员进行个人访谈。在初次筛查时，421名（2.51%）女性的阴道毛滴虫感染细胞学诊断呈阳性。从该队列中确定了99例经病理证实的鳞状细胞癌新发病例，总观察人年数为140018人年。通过粗略估计以及在对潜在混杂效应进行调整后发现，阴道毛滴虫感染会增加患宫颈癌的风险。在多比例风险模型中，阴道毛滴虫感染女性患宫颈癌的相对风险为3.3（95%置信区间：1.5至7.4）。此外，在多变量分析中，患宫颈癌风险增加与以下因素有关：受试者及其配偶的婚外性伴侣数量、吸烟和月经不调。多次巴氏涂片检查结果为阴性与较低风险相关。这项研究表明，阴道毛滴虫感染与宫颈癌风险之间可能存在关联，但中国女性中只有4%至5%的宫颈癌可能归因于阴道毛滴虫感染。
