持続的なヒトパピローマウイルス感染症は,子宮頸部内皮内腫瘍症の予測因子である
N F Schlecht1, S Kulaga, J Robitaille
1Department of Oncology, McGill University, 546 Pine Ave W, Montreal, Quebec, Canada H2W1S6. eduardo.franco@mcgill.ca
JAMA
|January 5, 2002
まとめ
持続的なヒトパピローマウイルス (HPV) 感染症,特にHPVタイプ16または18は,子宮頸がんの前駆体である状内皮損傷 (SIL) を発症するリスクを大幅に高めます.
科学分野:
- 腫瘍学 腫瘍学
- ウイルス学 ウイルス学 ウイルス学
- エピデミオロジー エピデミオロジー
背景:
- ヒトパピローマウイルス (HPV) 感染症は子宮頸がんの主な原因です.
- HPVと子宮頸がんを関連付けるほとんどの証拠は,遡及的な研究から得られています.
- 累積的または持続的なHPV被曝の動態に関するデータは限られている.
研究 の 目的:
- 持続的なHPV感染と子宮頸部腫瘍形成のリスクとの関連性を評価する.
- 特定の腫瘍性HPV型が病変の発生に及ぼす影響を評価する.
主な方法:
- 1993年から2000年まで,ブラジルのサンパウロで縦断研究が行われました.
- 初期の細胞学的病変のない1611人の女性を繰り返しHPV検査と細胞学で追跡した.
- 子宮頸部のサンプルをHPVとPapanicolaouの細胞学について,最初は4カ月ごとに,その後は年に2回,分析した.
主要な成果:
- 状内皮損傷 (SIL) の発生率は,HPV感染が持続している女性では著しく高かった.
- 16型または18型HPVの感染が持続している女性は,SILsのリスクが著しく上昇したことを示しました.
- 発生性SILの相対リスク (RR) は,がん性HPV感染が持続する場合は10.19,高度SILの場合11.67でした.
結論:
- 持続的なHPV感染とSILの発生率の間に強い相関関係があります.
- 16型および18型HPV感染は,子宮頸部新生病のリスクが特に高いことを示しています.
- 縦断的なデータは,子宮頸がんの発症における持続性HPVの重要な役割を果たしていることを確認しています.
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