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

王铭; 丁玲; 刘学智; 刘春亮; 李俐; 吕元婧; 王金桃

Abstract

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].Chinese journal of Epidemiology,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

Received:October 17, 2017

DOI：10.3760/cma.j.issn.0254-6450.2018.05.026

KeyWord: 宫颈上皮内瘤变多环芳烃高危型人乳头瘤病毒交互效应

English Key Word: Cervical intraepithelial neoplasia Polycyclic aromatic hydrocarbons High risk human papillomavirus Interaction

FundProject: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

Author Name	Affiliation	E-mail
Wang Ming	Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan 030001, China
Ding Ling	Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan 030001, China
Liu Xuezhi	Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan 030001, China
Liu Chunliang	Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan 030001, China
Li Li	Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan 030001, China
Lyu Yuanjing	Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan 030001, China
Wang Jintao	Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan 030001, China	wangjt59@163.com

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Abstract:

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。

English Abstract:

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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