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ヒトパピローマウイルス18型と,急速に進行する子宮頸内皮内腫瘍症
Ciaran B J Woodman1, Stuart Collins, Terry P Rollason
1Centre for Cancer Epidemiology, University of Manchester, Withington, M20 4QL, Manchester, UK. ciaran.woodman@cce.man.ac.uk
Lancet (London, England)
|January 9, 2003
まとめ
ヒトパピローマウイルス18型 (HPV-18) 感染症は子宮頸がんと関連しているが,高度の子宮頸内膜内腫瘍 (CIN) でその過小評価は,疾患の重症度を過小評価して,潜在的にスクリーニングの有効性に影響を与える可能性がある.
科学分野:
- 婦人科腫瘍学 婦人科腫瘍学
- ウイルス学 ウイルス学 ウイルス学
- 公衆衛生は公衆衛生である.
背景:
- 18型ヒトパピローマウイルス (HPV-18) は,子宮頸がん,特にアデノカルシノーマの重要な原因です.
- 逆説的にHPV-18は,HPV-16.0と比較して,高度の子宮頸内膜内腫瘍症 (CIN) で検出されていない.
- 子宮頸部腫瘍の進行におけるHPV-18の役割を理解するために,縦断的な研究が必要である.
研究 の 目的:
- 発生したHPV-18およびHPV-16感染症の後の細胞学的異常の発生を調査するために.
- HPV-18に関連した子宮頸部疾患が,HPV-16.1と比較して,侵襲前段階を通して異なって進行するかどうかを判断する.
主な方法:
- 1075人の若い女性 (15~19歳) を対象とした縦断的な研究で,出血時の細胞質が正常で,HPVの状態は正常であった.
- 定期的な6ヶ月のフォローアップには,細胞学的およびウイルス学的サンプル収集が含まれていました.
- 分析は,HPV-18およびHPV-16感染後の細胞学的異常への相対的なリスクと時間に焦点を当てました.
主要な成果:
- HPV-18感染は,境界性核異常のリスク2.06,軽度性硬化症のリスク3.11の増加を示した.
- HPV-16感染は,境界性異常のリスクが1.99%,軽度の硬化症のリスクが4.76と増加しました.
- 細胞学的異常までの時間は,HPV-18とHPV-16の両方の感染症に類似しており,HPV-18は,HPV-16 (2.85) と比較して,中等重度の/重度のディスカリオシス (0.80) のリスクが低いことを示しました.
結論:
- 発見は,HPV-18に関連した疾患が急速に進行するという仮説に異議を唱え,高度のCINでその過小評価を説明しています.
- HPV-18感染後の細胞学的変化は,潜在的子宮頸疾患の実際の重症度を過小評価する可能性があります.
- この過小評価は,HPV-18に関連するがんを検出する子宮頸がんスクリーニングプログラムの有効性を低下させる可能性があります.
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