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JAMA:美HPV感染相关癌症发病率逐年上升

  1. HPV感染
  2. 口咽部
  3. 鳞状细胞癌

来源:生物谷 2012-11-18 23:12

人乳头瘤病毒是一种属于乳多空病毒科的乳头瘤空泡病毒A属,是球形DNA病毒,能引起人体皮肤黏膜的鳞状上皮增殖。表现为寻常疣、生殖器疣(尖锐湿疣)等症状,口咽部人乳头瘤病毒(HPV)的感染与口咽鳞状细胞癌密切相关。如今,HPV感染越来越引起人们的关注。

人乳头瘤病毒是一种属于乳多空病毒科的乳头瘤空泡病毒A属,是球形DNA病毒,能引起人体皮肤黏膜的鳞状上皮增殖。表现为寻常疣、生殖器疣(尖锐湿疣)等症状,口咽部人乳头瘤病毒(HPV)的感染与口咽鳞状细胞癌密切相关。如今,HPV感染越来越引起人们的关注。

1月26日,国际权威杂志JAMA上刊登的一篇论文证实:美国人口咽部感染HPV的发病率在持续上升,14岁至69岁的人群中,有6.9%的人口腔感染了HPV。

在美国,虽然口咽部鳞状细胞癌的发病率已有所下降,但来自美国俄亥俄州立大学的研究人员发现与HPV感染相关的口咽部鳞状细胞癌的发病率却逐年增加。

研究人员调查了年龄在14岁至69岁之间的5,501受访者的性行为,同时对这些人的口腔做了30秒的冲洗,并进行HPV DNA聚合酶链反应和特异性杂交实验。

结果是,在5,501受访者中,6.9%的人口腔感染HPV。并且口腔HPV感染率按年龄呈双峰模式,即30至34岁出现一个小高峰,60岁至64时出现一个大高峰。

另外,男性口腔HPV感染率高于女性(分别是10.1%和3.6%),有过性生活的人感染率高于没有过性生活的人(分别是7.5%与0.9%)。多变量分析结果显示,口腔感染HPV的风险与年龄、性别、性伴侣的数目等因素有关。(生物谷 Bioon.com)

Prevalence of Oral HPV Infection in the United States, 2009-2010

Maura L. Gillison, MD, PhD;Tatevik Broutian, MS;Robert K. L. Pickard, EdM, et al.

Context Human papillomavirus (HPV) infection is the principal cause of a distinct form of oropharyngeal squamous cell carcinoma that is increasing in incidence among men in the United States. However, little is known about the epidemiology of oral HPV infection.

Objective To determine the prevalence of oral HPV infection in the United States.

Design, Setting, and Participants A cross-sectional study was conducted as part of the National Health and Nutrition Examination Survey (NHANES) 2009-2010, a statistically representative sample of the civilian noninstitutionalized US population. Men and women aged 14 to 69 years examined at mobile examination centers were eligible. Participants (N = 5579) provided a 30-second oral rinse and gargle with mouthwash. For detection of HPV types, DNA purified from oral exfoliated cells was evaluated by polymerase chain reaction and type-specific hybridization. Demographic and behavioral data were obtained by standardized interview. Statistical analyses used NHANES sample weights to provide weighted prevalence estimates for the US population.

Main Outcome Measures Prevalence of oral HPV infection.

Results The prevalence of oral HPV infection among men and women aged 14 to 69 years was 6.9% (95% CI, 5.7%-8.3%) and of HPV type 16 was 1.0% (95% CI, 0.7%-1.3%). Oral HPV infection followed a bimodal pattern with respect to age, with peak prevalence among individuals aged 30 to 34 years (7.3%; 95% CI, 4.6%-11.4%) and 60 to 64 years (11.4%; 95% CI, 8.5%-15.1%). Men had a significantly higher prevalence than women for any oral HPV infection (10.1% [95% CI, 8.3%-12.3%] vs 3.6% [95% CI, 2.6%-5.0%], P < .001; unadjusted prevalence ratio [PR], 2.80 [95% CI, 2.02-3.88]). Infection was less common among those without vs those with a history of any type of sexual contact (0.9% [95% CI, 0.4%-1.8%] vs 7.5% [95% CI, 6.1%-9.1%], P < .001; PR, 8.69 [95% CI, 3.91-19.31]) and increased with number of sexual partners (P < .001 for trend) and cigarettes smoked per day (P < .001 for trend). Associations with age, sex, number of sexual partners, and current number of cigarettes smoked per day were independently associated with oral HPV infection in multivariable models.

Conclusion Among men and women aged 14 to 69 years in the United States, the overall prevalence of oral HPV infection was 6.9%, and the prevalence was higher among men than among women.

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