Paez C, Konno R, Yaegashi N, Matsunaga G, Araujo I, Corral F, Sato S, Yajima A
Department of Obstetrics and Gynecology, Tohoku University School of Medicine, Sendai, Japan.
Tohoku J Exp Med. 1996 Nov;180(3):261-72. doi: 10.1620/tjem.180.261.
Cervical cancer is about 6 times more frequent in Ecuador than in Japan. We investigated the association between infection by the human papillomavirus (HPV) and the genesis of cervical cancer in specimens of lesions of the cervical epithelium obtained from patients in Ecuador and Japan. We also examined the results of HPV DNA detection and typing by the polymerase chain reaction (PCR) performed under the same technical conditions in areas with differing rates of cervical cancer. Purified tissue DNA from paraffin-embedded samples was amplified by PCR with universal and type-specific primers. HPV DNA was detected in 8 (20%) of 40 normal cervical epithelial samples from Ecuadorian patients, 19 (45%) of 42 low-grade squamous intraepithelial lesions (LSIL), 16 (50%) of 32 high-grade squamous intraepithelial lesions (HSIL), and 38 (81%) of 47 invasive squamous cell carcinomas (SCC) compared with 3 (10%) of 30 normal cervical specimens from Japanese patients, 107 (51%) of 210 HSILs, and 45 (71%) of 63 SCCs. The prevalence of HPV types 16 and 18 rose significantly with increasing histological grade (p < 0.05). The prevalence of HPV DNA decreased with increasing age in both Ecuadorian and Japanese patients. The detection rate and type-specific distribution of HPV DNA were not correlated with geographic location. Findings suggest that risk factors associated with poverty and underdevelopment may influence the prevalence of HPV infection and the sequence of events after HPV infection culminating in cervical cancer. These factors may help to explain the differing geographic distribution of this disease.
宫颈癌在厄瓜多尔的发病率比在日本高约6倍。我们调查了从厄瓜多尔和日本患者获取的宫颈上皮病变标本中人类乳头瘤病毒（HPV）感染与宫颈癌发生之间的关联。我们还在宫颈癌发病率不同的地区，检查了在相同技术条件下通过聚合酶链反应（PCR）进行的HPV DNA检测和分型结果。用通用引物和型特异性引物通过PCR扩增石蜡包埋样本中的纯化组织DNA。在厄瓜多尔患者的40份正常宫颈上皮样本中，有8份（20%）检测到HPV DNA；42份低级别鳞状上皮内病变（LSIL）中有19份（45%）；32份高级别鳞状上皮内病变（HSIL）中有16份（50%）；47份浸润性鳞状细胞癌（SCC）中有38份（81%）。相比之下，在日本患者的30份正常宫颈标本中有3份（10%）；210份HSIL中有107份（51%）；63份SCC中有45份（71%）检测到HPV DNA。HPV 16型和18型的患病率随组织学分级增加而显著上升（p<0.05）。在厄瓜多尔和日本患者中，HPV DNA的患病率均随年龄增长而下降。HPV DNA的检测率和型特异性分布与地理位置无关。研究结果表明，与贫困和不发达相关的风险因素可能会影响HPV感染的患病率以及HPV感染后最终导致宫颈癌的一系列事件。这些因素可能有助于解释这种疾病在地理分布上的差异。
