文章摘要
王铭,丁玲,刘学智,刘春亮,李俐,吕元婧,王金桃.多环芳烃与高危型人乳头瘤病毒感染在宫颈上皮内瘤变中的作用及其交互效应[J].中华流行病学杂志,2018,39(5):673-677
多环芳烃与高危型人乳头瘤病毒感染在宫颈上皮内瘤变中的作用及其交互效应
Interaction between polycyclic aromatic hydrocarbons and high risk human papillomavirus infection on cervical intraepithelial neoplasia
收稿日期:2017-10-17  出版日期:2018-05-24
DOI:10.3760/cma.j.issn.0254-6450.2018.05.026
中文关键词: 宫颈上皮内瘤变  多环芳烃  高危型人乳头瘤病毒  交互效应
英文关键词: Cervical intraepithelial neoplasia  Polycyclic aromatic hydrocarbons  High risk human papillomavirus  Interaction
基金项目:国家自然科学基金(81473060,81273157,30872166);国家卫生和计划生育委员会公益性行业科研专项(201402010);山西省优势和特色重点学科建设项目
作者单位E-mail
王铭 030001 太原, 山西医科大学公共卫生学院流行病学教研室  
丁玲 030001 太原, 山西医科大学公共卫生学院流行病学教研室  
刘学智 030001 太原, 山西医科大学公共卫生学院流行病学教研室  
刘春亮 030001 太原, 山西医科大学公共卫生学院流行病学教研室  
李俐 030001 太原, 山西医科大学公共卫生学院流行病学教研室  
吕元婧 030001 太原, 山西医科大学公共卫生学院流行病学教研室  
王金桃 030001 太原, 山西医科大学公共卫生学院流行病学教研室 wangjt59@163.com 
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中文摘要:
      目的 探讨多环芳烃(PAHs)与高危型人乳头瘤病毒(HR-HPV)感染在宫颈上皮内瘤变发生发展过程中的作用及其交互效应。方法 从建立的自然人群队列中选取2014年6-12月经病理学确诊的正常宫颈(NC)妇女208例,低度宫颈上皮内瘤变(CIN Ⅰ)患者154例,高度宫颈上皮内瘤变(CIN Ⅱ/Ⅲ)患者124例为研究对象。采用高效液相色谱法检测其尿中1-羟基芘(1-OHP)的浓度(反映PAHs内暴露情况),应用导流杂交技术检测HPV感染状态及感染类型。利用SPSS 22.0软件进行资料的χ2检验、χ2趋势检验、Kruskal-Wallis H检验、Nemenyi秩和检验、Spearman秩相关分析,采用相加模型评价两因素间交互作用。结果 NC、CIN Ⅰ、CIN Ⅱ/Ⅲ组HR-HPV感染率分别为27.9%、37.0%、58.9%,尿1-OHP浓度(μmol/molCr)分别为0.07±0.09、0.11±0.10、0.17±0.15。随着宫颈病变程度的加重,HR-HPV感染率(趋势检验χ2=29.89,P<0.001)和PAHs高暴露率(趋势检验χ2=27.94,P<0.001)均逐渐升高。HR-HPV感染与尿中1-OHP浓度呈正相关(r=0.680,P<0.001)。CIN Ⅱ/Ⅲ组中HR-HPV感染与PAHs高暴露存在正相加交互作用,而在CIN Ⅰ组中未发现存在类似交互作用。结论 HR-HPV感染和PAHs高暴露均可增加宫颈上皮内瘤变的患病风险,两者在高度宫颈上皮内瘤变发生发展中存在协同作用。
英文摘要:
      Objective To evaluate the effects of polycyclic aromatic hydrocarbons (PAHs)and high risk human papillomavirus (HR-HPV) infection and their interaction on the progression of cervical intraepithelial neoplasia. Methods A total of 486 patients, including 208 women with normal cervix (NC), 154 patients with low-grade cervical intraepithelial neoplasm (CINⅠ), 124 patients with high-grade cervical intraepithelial neoplasm (CINⅡ/Ⅲ), were selected from the cervical lesions cohort from June to December, 2014. HR-HPV was detected by using flow-through hybridization technology and the urine concentration of 1-hydroxypyrene (1-OHP) was detected with high performance liquid chromatography. By using software SPSS 22.0, the χ2 test, trend χ2 test, Kruskal-Wallis H test, Nemenyi rank test and Spearman rank correlation analysis were performed. And the interaction effects were evaluated by additive model. Results The HR-HPV infection rates in NC, CINⅠ and CINⅡ/Ⅲ groups were 27.9%, 37.0% and 58.9%, respectively. The urine concentrations of 1-OHP (μmol/molCr) were 0.07±0.09, 0.11±0.10 and 0.17±0.15, respectively. With increasing severity of the cervical lesions, the HR-HPV infection rate gradually increased (trend χ2=29.89, P<0.001) and the high exposure rate of PAHs gradually increased (trend χ2=27.94, P<0.001). HR-HPV infection was positively correlated with 1-OHP exposure (r=0.680, P<0.001). There was a positive additive interaction between HPV infection and PAHs exposure in CIN Ⅱ/Ⅲ group, but it was not found in CIN Ⅰ group. Conclusion Both HR-HPV infection and high exposure of PAHs might increase the risk of cervical intraepithelial neoplasm, and might have a synergistic effect on the progression of high-grade cervical intraepithelial neoplasia.
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