CIN2+患者高危型HPV感染情况及治疗方法分析

目的研究宫颈上皮内瘤变(CIN)2级及以上(CIN2+)患者高危型人乳头瘤病毒(HPV)持续感染的可能因素和治疗方法。方法249例CIN2+合并高危型HPV感染患者接受环形电切术(LEEP)治疗,依据术后1年高危型HPV检测是否转阴分为术后转阴组(n=160)和持续感染组(n=89),依据治疗方式将89例持续感染组患者分为对照组(n=41)和联合组(n=48)。对照组患者接受重组人干扰素α2b阴道泡腾片治疗,联合组患者在此基础上联合保妇康栓治疗。比较术后转阴组和持续感染组患者术前高危型HPV分型及持续感染的相关因素,以及对照组和联合组患者药物治疗后高危型HPV转阴情况。结果持续感染组患者术前多重感染率为24.72%,高于术后转阴组的21.88%,但差异无统计学意义(P﹥0.05)。持续感染组和术后转阴组患者高危型HPV亚型均以HPV16和HPV58为主。持续感染组和术后转阴组CIN2+患者切缘情况、性伴侣人数、避孕方式、人工流产次数和CIN分级情况比较,差异均有统计学意义(P﹤0.01)。治疗后,联合组患者高危型HPV感染转阴率为79.17%,高于对照组患者的58.54%,差异有统计学意义(P﹤0.05)。结论应加强对有不健康性行为史、宫颈锥切术切缘阳性、高级别CIN患者的术后随访,预防高危型HPV的持续感染,发现持续感染应及时行抗病毒治疗。保妇康栓联合重组人干扰素α2b阴道泡腾片可能使接受LEEP手术的CIN2+合并HPV持续感染的患者获益。     

人乳头状瘤病毒感染及病毒载量与宫颈病变的相关性研究

目的：研究高危型人乳头状瘤病毒感染及病毒载量与宫颈病变的关系。方法：对774例研究对象采用第二代杂交捕获试验（HC—Ⅱ）进行宫颈脱落细胞的HPV-DNA定量检测。分析不同程度宫颈病变的HPV感染情况,并根据HPV病毒载量将所有检测对象分为四组,阴性（RLU／CO〈1．0）、低载量（1．0≤RLU／CO〈10）、中载量（10≤RLU／CO〈100）、高载量（RLU／CO≥100）,采用非条件多项式logistic回归分析病毒载量与宫颈病变级别的关系。结果：在检测的774例研究对象中,对照组、宫颈上皮内瘤变（cervical intraepithelial neoplasia,CIN）Ⅰ、CINⅡ、CINⅢ和浸润性宫颈癌患者的HPV感染率分别为21．29％、82．35％、80．00％、90．16％和86．67％。对照组高危型HPV感染率明显低于CIN和浸润性宫颈癌患者,差异有统计学意义,P〈0．01;HPV阳性者患CIN的风险是阴性者的24．96倍（95％CI：13．20～47．18）,患浸润性宫颈癌的风险是HPV阴性者的24．03倍（95％CI：12．01～48．09）。在不同级别宫颈病变中,CINI组的低病毒载量患者占11．67％,高载量占41．18％,OR值为23．84（95％CI：5．96～95．33）,P〈0．001;而在CINⅢ组中62．30％的患者呈高病毒载量,OR值达64．70（95％CI：25．98～161．20）,P〈0．001。结论：高危型HPV感染与CIN和浸润性宫颈癌的发生密切相关;宫颈高危型HPV病毒载量是影响宫颈病变严重程度的危险因素。     

年轻女性宫颈人乳头瘤病毒感染亚型与宫颈病变的调查

目的：探讨年轻女性（年龄25~35岁）人乳头瘤病毒（HPV）感染亚型与宫颈病变的特点。方法采集1273例患者宫颈上皮细胞标本,采用PCR-反向点杂交法对其进行21种HPV分型的检测。结果1273例年轻女性患者,HPV阳性有130例,检出率为10.2%;单一型感染为115例,包括高危型感染105例,感染率为91.3%,低危型感染10例,感染率为8.7%;最常见高危型是HPV16,共35例,其次为HPV58,共17例;HPV16感染导致宫颈高级别上皮内瘤变10例,低级别上皮内瘤变11例;高危HPV阳性患者,宫颈活检证实为鳞状细胞癌的病例2例,均是HPV16感染。结论年轻女性HPV阳性检出率较高,以单一型感染和高危型感染为主,高危型HPV感染与宫颈高级别上皮内瘤变和宫颈癌的发生密切相关,其中HPV16亚型是导致年轻女性宫颈癌的主要原因。     

人乳头瘤病毒与宫颈病变的相关性研究

目的探讨宫颈病变与HPVDNA基因型感染的关系。方法导流杂交基因分型技术检测HPVDNA。结果炎症、CINI、CINII、CINIII及宫颈癌中HPV感染率分别为62．24％、67．64％、91．67％、96．87％、96．00％;宫颈病变中6种最常见的HPV基因型为16、18、52、58、33、31。炎症、CINI、CINII、CINIII及宫颈癌患者多重感染率分别为19。0％、35．8％、45．9％、54．9％、60．8％、70．2％。结论随宫颈病变程度加重HPV感染率增加,宫颈病变中6种最常见HPV基因型为16、18、52、58、33、31。多重HPV感染可能促进宫颈癌的发生。     

宫颈高级别病变与HPV感染型别分析

目的探讨HPV在宫颈高级别病变中的感染率及感染型别。方法采用导流杂交法分别检测CINII～Ⅲ30例和宫颈癌患者160例HPV基因型别,比较HPV感染与宫颈病变的关系。结果CINⅡ～III和宫颈癌患者HPV感染率均为90％,且以单型别感染为主,分别为70．37％（19／27）、81．94％（118／144）;在CIN II～Ⅲ中HPV58型、52型感染居多,宫颈癌则以HPV16型、18型感染最常见;无论宫颈鳞癌还是宫颈腺癌,以HPV16型检出率最高。结论HPV16型、18型是宫颈癌的主要致病型,不同病理类型并无HPV型别上的差异;宫颈上皮高级别内瘤变则以HPV58型、52型感染为主;对HPV58型、52型感染者应重视随访。     

人乳头瘤病毒感染亚型与宫颈病变的关系

目的探讨HPV感染与宫颈病变发生的关系。方法将病理检查确诊宫颈有病变的187例患者分为3组:慢性炎症组(n=41)、宫颈上皮瘤变(CIN)组(n=62)和宫颈癌组(n=84)。采用人乳头瘤病毒核酸扩增分型技术对患者宫颈脱落细胞样本作HPV基因分型检测,分析HPV感染状况及HPV基因型在各组疾病中的分布。结果 1187例患者中共检出HPV阳性者136例,阳性率为72.72%(136/187),其中高危型HPV感染阳性率为95.58%(130/136)。在被测的21个HPV亚型中最常见的6个类型依次为16型(46.32%、63/136),58型(21.32%、29/136),52型(15.44%、21/136),18型(12.50%、17/136),33型(9.56%、13/136),31型(8.09%、11/136),未检测出44型、43型及6型。2慢性炎症组HPV阳性率为14.63%(6/41);CIN组HPV阳性率为85.48%(53/62)、其中CINⅠ组、CINⅡ组、CINⅢ组中HPV感染率分别为62.50%(10/16)、90.47%(19/21)、96.00%(24/25);宫颈癌组HPV阳性率91.67%(77/84)。CIN及宫颈癌组HPV阳性率均高于炎症组,而CINⅡ~CINⅢ组及宫颈癌组HPV阳性率又明显高于CINⅠ组。3组阳性表达率差异有统计学意义(P<0.05)。3HPV阳性者中单一感染率为67.65(92/136),多重感染率为32.35%(44/136),其中以双重感染为主,占79.55%(35/44)。4HPV感染患者年龄以30~59岁最高,但各年龄段HPV感染检出率比较无统计学差异(P>0.05)。5慢性炎症组、CIN组和宫颈癌组的16型感染率分别为16.67%(1/6)、47.16%(25/53)、48.05%(37/77)。CIN组和宫颈癌组的16型感染率高于慢性炎症组,差异具有统计学意义(P<0.05)。结论 HPV感染与宫颈病变发生、发展密切相关,HPV基因分型诊断对宫颈病变高危人群的筛查、预防、临床诊断、治疗可提供重要的理论依据。     

江西地区妇女宫颈癌患者人乳头瘤病毒(HPV)感染各亚型分布特点

目的分析江西地区妇女宫颈癌患者人乳头瘤状病毒(human papillomavirus,HPV)感染分布情况及主要型别,为江西地区临床防治宫颈癌、研制适合该地区的预防性HPV疫苗提供理论依据。方法收集经病理确诊的941例宫颈癌患者治疗前宫颈脱落细胞,采用人乳头瘤病毒核酸扩增分型检测试剂盒方法,进行HPV分型检测。结果 941例宫颈癌患者中有780例HPV阳性,阳性率为82.9%,其中,单纯感染率为67.5%,混合感染率为15.4%,单纯高危感染率为66.6%。HPV16感染率最高为54.8%,宫颈癌中其他高危型的感染率从高到低依次为HPV58、18、52、31、33、39、53、45、51、68、59、66、56、35,未发现单纯HPV56感染。低危HPV型中HPV81型感染率最高为1.7%,其他低危型感染率从高到低依次为HPV44、6、42、11,未检测出低危型HPV43,且低危型HPV44仅存在于混合感染中。随着年龄增加,高危HPV16感染率呈逐渐下降趋势,差异有统计学意义(P=0.001,<0.05)。年龄≤50岁,HPV16感染率为59.5%,高于年龄>50岁HPV16感染率(50.7%),差异有统计学意义(P=0.007,<0.05)。年龄≤50岁HPV58感染率为6.7%,低于年龄>50岁HPV58感染率(11.7%),差异有统计学意义(P=0.019,<0.05)。而HPV亚型18、52、31分布均无差异。结论江西地区妇女宫颈癌患者中以HPV16、58、18、52感染为主要型别,HPV16感染是年轻宫颈癌的主要致病因素。混合感染并不增加宫颈癌的发生率。     

新疆维吾尔族女性HPV感染状况及其分布特征研究

目的了解新疆维吾尔族女性HPV感染及其分布特征,为今后宫颈癌防治提供策略。方法采用横断面研究,于2006年在新疆于田县以整群抽样的方法选择年龄16-59岁、有性生活的维吾尔族女性约1000人行宫颈癌危险因素问卷调查和宫颈脱落细胞HPVDNA检测。所有女性均按年龄分层人组,先由调查员进行一对一的问卷调查,后由医师进行宫颈脱落细胞采样。将收集到的样本采用第2代杂交捕获（hc2）试验进行HPVDNA检测。样本中检出的HPVDNA≥1．0pg／mL即为感染阳性。结果共纳入883名新疆维吾尔族女性,平均年龄为36．26±10．10岁。其高危型HPV和低危型HPV感染率分别为7．25％和1．59％,总体HPV感染率为8．27％,明显低于中国汉族女性（16．1％）。HPV感染率在有2个以上性伴侣的女性中明显较高（X^2=5．254,P=0．022）,但是在以下人群中无统计学差异：不同的年龄、教育和收入水平、初次性生活年龄及丈夫婚前、婚后有或无其他性伴侣。结论新疆维吾尔族女性HPV感染率明显低于中国汉族女性。其HPV感染可能与种族有一定关系,并受到性行为因素的影响。     

女性下生殖道HPV感染与宫颈上皮内瘤变及宫颈癌关系的病理研究

目的：探讨女性下生殖道高危型人乳头状瘤病毒（high risk human papillomavirus,HR－HPV）感染与宫颈上皮内瘤变（cervical intraepithelial neoplasia,CIN）及宫颈癌的关系。方法：选择2013年2月－2015年4月我院收治的236例CIN及宫颈癌患者为观察组,进行下生殖道HPV（人乳头状瘤病毒）检测,分析CIN及宫颈癌与HPV感染的关系,并与对照组有宫颈炎但无CIN及宫颈癌的126例患者进行对比研究。结果：HR－HPV感染率随着患者CIN 的严重程度而升高,宫颈癌的HR－HPV感染率最高为91．89％,明显高于对照组差异具有统计学意义（P＜0．05）。HR－HPV双重感染率以及HR－HPV多重感染率与单一HR－HPV患者的病毒感染率相比较高,差异具有统计学意义（P＜0．05）。且患者随着病情的加重,单型、双重、多重HR－HPV感染率从CINⅠ期、CINⅡ期、CINⅢ期呈递增趋势。结论：HR－HPV感染及HR－HPV多重感染是导致宫颈上皮内瘤变及宫颈癌发生的重要诱因,对高危型 HPV 病毒的持续感染,及时的诊断并予以有效的治疗,能够阻滞癌前病变的发展,对于预防宫颈上皮内瘤变及宫颈癌,降低宫颈癌的死亡率具有重要临床意义。     

人类乳头状瘤病毒与宫颈糜烂癌变的相关性研究

目的：探讨人类乳头状瘤病毒与宫颈糜烂和癌变的相互关系。方法：阴道镜下对116例宫颈糜烂患者、12例宫颈癌患者及36例正常妇女宫颈，分别钳取活组织；用聚合酶链反应，对活组织进行HPV公共引物及HPV16、HPV18型特异引物检测。结果：宫颈糜烂患者HPV阳性率为29．31％，正常妇女宫颈HPV阳性率仅11．11％（P＜0．05），宫颈颗粒型或乳突型糜烂与宫颈癌强相关（OR＝5．56％CI＝1．21－25．459）。“高危”HPV－DNA检出率随宫颈鳞柱上皮异位程度增加而升高。结论：宫颈糜烂癌变的病因可能与持续感染“高危”HPVs有关。     

高危型HPV分型和p16蛋白表达在宫颈病变诊断中的临床意义

目的:了解HPV高危型阳性的高级别鳞状上皮内瘤变(high-grade squamous intraepithelial lesion，HSIL)（CIN II-III）、慢性炎症及宫颈癌中HPV感染分型的不同分型和p16在不同组织中的表达情况，并分析其与HPV的相关性。方法:收集海南省人民医院就诊的海南籍宫颈疾病患者，其中包括HPV高危型阳性的HSIL患者100例、HPV高危型阳性慢性宫颈炎和宫颈癌患者各25例和HPV阴性慢性宫颈炎25例，收集宫颈病理组织，进行HPV分型和p16蛋白表达检测。结果:HPV高危型阳性宫颈病变中，检测出全部13种高危型亚型，主要为HPV16（16.67%）、HPV52（15.33%）、HPV58（12.67%）、HPV31（12.0%），不同宫颈病变HPV分型结果具有高度统一性，差异不具有统计学意义（P=0.999）；HPV阴性慢性宫颈炎症组织、HPV高危型阳性慢性宫颈炎症组织、HSIL组织、宫颈癌组织中p16蛋白表达阳性率分别为12.0%、72.0%、84.0%、100.0%，不同宫颈病变p16蛋白表达差异具有统计学意义（P＜0.001），随着宫颈病变的进展，p16蛋白表达逐渐增加，p16蛋白表达与宫颈病变的恶性程度具有正相关性。结论:海南籍宫颈病变患者其高危型HPV感染分型分布与目前研究一致，随着宫颈疾病进展加重， p16蛋白表达增加，HPV分型和p16蛋白联合检测对于诊断不同宫颈疾病具有重要价值。     

An association of cervical inflammation with high-grade cervical neoplasia in women infected with oncogenic human papillomavirus (HPV).

Previous reports of genital conditions, such as nonspecific genital infection/sore or vaginal discharge associated with cervical cancer (L. A. Brinton et al., J. Natl. Cancer Inst. (Bethesda), 79: 23-30, 1987; C. J. Jones et al., Cancer Res., 50: 3657-3662, 1990), suggest a possible link between either genital tract inflammation or changes in bacteria flora consistent with bacterial vaginosis (BV) and cervical cancer. To test whether changes in vaginal bacterial flora or the degree of cervical inflammation are associated with women having a human papillomavirus (HPV) infection or with women infected with oncogenic HPV having high-grade cervical lesions (high-grade squamous intraepithelial lesions or cancer), we conducted a case-control study of women <50 years old enrolled in the Costa Rican natural history study of HPV and cervical neoplasia. To test whether BV and inflammation were associated with HPV DNA positivity, Analysis 1 was restricted to women with no or mild (low-grade or equivocal) cytological abnormalities, and the degree of inflammation and Nugent score (a measure of BV) were compared between women infected (n = 220) and not infected (n = 130) with HPV. To test whether BV and inflammation were associated with high-grade lesions, Analysis 2 was restricted to women infected with oncogenic HPV, and the degree of inflammation and Nugent score were compared between women with (n = 95) and without (n = 158) high-grade cervical lesions. In Analysis 1, BV and cervical inflammation were not associated with HPV infection. In Analysis 2, BV was not associated with high-grade lesions. However, we found a marginally significant positive trend of increasing cervical inflammation associated with high-grade lesions in oncogenic HPV-infected women, (P(trend) = 0.05). Overt cervicitis was associated with a 1.9-fold increase in risk of high-grade lesions (95% confidence interval, 0.90-4.1). The results of this study suggest that cervical inflammation may be associated with high-grade lesions and may be a cofactor for high-grade cervical lesions in women infected with oncogenic HPV.     

Risk factors associated with genital warts in HIV-positive Brazilian women

AIMS AND BACKGROUND: In Brazil, the female population has been increasingly infected with human immunodeficiency virus (HIV), and uterine cervix carcinoma now represents the second highest cause of mortality. Although HIV infection among women is associated with an increased prevalence of cervical cancer precursors, the co-infection with human papillomavirus (HPV) is considered to be a necessary but not sufficient factor to induce genital lesions. This study was conducted to identify risk factors associated with the history of genital warts among HIV-positive women. METHODS: A comparative cross-sectional evaluation was applied to 141 HIV-positive women. All patients were submitted to colposcopy, smear cytology, directed biopsy, and HPV-DNA detection. The chi-square, Fisher's exact test, and the odds ratio (OR, 95%; confidence interval, CI) were used to evaluate associations between history of genital warts and risk factors. RESULTS: A history of genital warts presented associations with: a) age at first sexual intercourse < or = 17 years (OR, 0.42; CI, 0.16-1.11); b) history of genital warts in sex partners (OR, 11.39; CI, 4.21-30.76), especially with recurrent episodes (OR, 6.60; CI, 2.69-16.12); c) drug addiction (OR, 2.38; CI, 1.09-5.19), especially in crack users (OR, 5.34; CI, 1.64-17.41); d) cervical HPV infection (OR, 2.75; CI 1.09-6.90); e) cervical infection caused by only one HPV type (OR, 2.77; CI 1.06-7.20); f) perianal HPV infection (OR, 2.30; CI, 0.70-7.56), associated with negative results for undetermined risk HPV (OR, 8.41; P = 0.04); and g) no antiretroviral therapy (OR, 3.41; P = 0.07). CONCLUSIONS: Evaluation of behavioral risk factors associated with a genital wart history is an important tool to prevent and reduce persistent HPV infection, and consequently genital cancer precursors in HIV infected women.     

Genital human papilloma virus infection in males. A clinico-pathologic study.

From March 1987 to December 1988, 402 male sexual partners of 317 women with human papilloma virus (HPV) infection of the lower genital tract and 85 with HPV-associated cervical and/or vulvar intraepithelial neoplasia (CIN and/or VIN) were submitted to clinical examination and peniscopy. The latter was performed at a 6-15 X magnification after a 3 min exposure to 5% acetic acid solution. Visible lesions were biopsied. Thirty-one patients had clinical evidence of HPV infection in the glans, penile shaft or urethra, and 222 had peniscopic evidence of subclinical aceto-white lesions. Of 31 patients with clinical lesions, 11 showed also aceto-white subclinical lesions. Of 253 peniscopically positive males, 237 were biopsied and 191 of these were histologically ascertained. Three patients had penile intraepithelial neoplasia, one with clinical appearance of a Buschke-L?wenstein tumor. The incidence of HPV infection in male sexual partners of women affected by HPV infection of the lower genital tract associated or not with intraepithelial neoplasia is lower than expected. However, clinically negative males should not be considered disease free; in fact, 12 patients, negative at the first examination, showed histological evidence of HPV infection at subsequent controls. Therefore, follow-up of at least 6 months should be allowed to identify HPV bearing males. The reported low frequency of HPV infection may be due to the fact that the males may harbour the virus in the urethra, prostate or seminal vesicles or penis without any clinical evidence of disease. Although research for HPV-DNA in intraurethral and penile scraping material might be useful for diagnosis, peniscopy with a 5% acetic acid application remains the clinical test for evaluating HPV infection in males. The importance of peniscopy should be viewed with respect to the prevention of infection or reinfection of the female sexual partners, in addition to the specific diagnostic purpose in male patients.     

高危型HPV感染在宫颈癌前病变、宫颈癌中的临床意义

目的:分析高危型HPV感染在宫颈癌前病变、宫颈癌发生和发展中的关系,为宫颈病变的筛查和HPV疫苗的选择提供理论依据。方法:选择来我院妇科肿瘤中心就诊的1 197例患者作为研究对象,根据病理检查结果将病例分为慢性宫颈炎组（212例）、LSIL组（142例）、HSIL组（484例）和宫颈癌组（359例）,检测各组高危型HPV感染的情况,分析不同组HPV的阳性率及HPV亚型的分布。结果:慢性宫颈炎组 HPV 感染阳性率为9.43%,LSIL组为78.87%,HSIL组为92.15%,宫颈癌组为97.77%,各组间阳性率两两比较差异有统计学意义（P<0.001）。各组中,高危HPV单一感染率均大于多重感染率,差异有统计学意义（P<0.001）。慢性宫颈炎组以HPV52、HPV16、HPV58为主要亚型（阳性率分别为 3.77%、2.83%和 1.41%）,LSIL组以HPV52、HPV16、HPV58为主要亚型（阳性率分别为 23.94%、21.13%和 16.90%）,HSIL组以HPV16、HPV52、HPV58为主要亚型（阳性率分别为33.06%、29.34%和 19.42%）,宫颈癌组以HPV16、HPV58、HPV52为主要亚型（阳性率分别为 65.18%、20.89%和 10.86%）。本地区HSIL及宫颈癌人群感染率最高的5种亚型是HPV16、HPV18、HPV33、HPV52、HPV58。结论:宫颈病变程度越严重,HPV阳性率越高,不同程度宫颈病变HPV感染的亚型分布有差异。高危型HPV检测对本地区宫颈病变的早期筛查及HPV疫苗的接种有重要的指导意义。     

Sexual behavior, condom use, and human papillomavirus: pooled analysis of the IARC human papillomavirus prevalence surveys.

Human papillomavirus (HPV) is a sexually transmitted infection but it is unclear whether differences in transmission efficacy exist between individual HPV types. Information on sexual behavior was collected from 11 areas in four continents among population-based, age-stratified random samples of women of ages > or = 15 years. HPV testing was done using PCR-based enzyme immunoassay. Unconditional logistic regression was used to estimate odds ratios (OR) of being HPV positive and corresponding 95% confidence intervals (95% CI). Variables were analyzed categorically. When more than two groups were compared, floating confidence intervals were estimated by treating ORs as floating absolute risks. A total of 11,337 women (mean age, 41.9 years) were available. We confirmed that lifetime number of sexual partners is associated with HPV positivity (OR for > or = 2 versus 1, 1.86; 95% CI, 1.63-2.11) but the association was not a linear one for HPV18, 31, and 33 (i.e., no clear increase for > or = 3 versus 2 sexual partners). Women who had multiple-type infection and high-risk HPV type infection reported a statistically nonsignificant higher number of sexual partners than women who had single-type and low-risk type infections, respectively. Early age at sexual debut was not significantly related to HPV positivity. Husband's extramarital sexual relationships were associated with an OR of 1.45 (95% CI, 1.24-1.70) for HPV positivity in their wives after adjustment for age and lifetime number of women's sexual partners. We did not observe a significant association with condom use. Our study showed an effect of both women's and their husbands' sexual behavior on HPV positivity. Furthermore, it suggests some differences in the pattern of the association between sexual behavior and different HPV types.     

A Correlative Analysis of Cervical Lesions in Patients with Vulva Condyloma Acuminatum

T here are at least 40 subtypes of human papillomavirus (HPV) re- lated to infections and diseases of the female lower genital tract, including 13 definitely high-risk subtypes and 5 low-risk subtypes. In- fections by high-risk subtypes are associated wit…     

Co-Risk Factors for HPV Infection in Northeastern Thai Women with Cervical Carcinoma

HPV infection is the main cause of cervical cancer; however, factors that promote and maintain HPV infection ‍are still unclear. This study was designed to search for factors responsible for the HPV infection in Northeastern ‍Thai women. A total of 190 volunteers with a normal histopathologic appearance of cervix as controls (n=100) and ‍with squamous cell cervical carcinoma (SCCA) (n=90) were the subjects. Variables of risk factors including sexual ‍behaviors, history of reproduction, history of sexually transmitted diseases and smoking were conducted with selfreport ‍and direct interview. Number of sexual partners and smoking history increased the likelihood of high-risk ‍HPV infection. Multiple sexual partners showed significantly higher 3.94-fold risk for HPV infection (95% CI = ‍1.82-8.82, p-value<0.001). Smoking history of partner increased the risk for HPV infection 3.03-fold (95%CI=1.42- ‍6.58, p-value< 0.002). After OR were adjusted, significant difference was still observed in the number of sexual ‍partners (p-value <0.0001) and smoking history of the partner (p-value<0.005). To decrease the incidence of cervical ‍cancer, we should prevent HPV dissemination and be on the alert for having multiple sexual partners and a partner’ ‍s smoking habit, which must be included in our public health planning.     

Selected Risk Factors,Human Papillomavirus Infection and the P53 Codon 72 Polymorphism in Patients with Squamous Intraepithelial Lesions in Northeastern Thailand

Risk factors for cervical squamous intraepithelial lesions (SIL) including human papillomavirus (HPV) infection ‍and the p53 codon 72 polymorphism were investigated in a case-control study with 103 cases and 105 controls in ‍Northeastern Thailand. Increased risk for SIL was observed for age at menarche (odds ratio (OR) = 2.2; p<0.005), ‍age at the first sexual intercourse (OR=2.4; p<0.05), number of sexual partners (OR=2.7; p<0.005) and partners’ ‍smoking history (OR=2.3-3.2; p<0.01). Prevalence of malignant type of HPV infection in the control and SIL groups ‍was 18.1% and 60.2%, respectively. HPV infection significantly increased risk for SIL 6.8-fold (p<0.001). HPV-16 ‍infection was the commonest (31 out of 62 carriers) in SIL patients and highly associated with risk. The p53 codon 72 ‍polymorphism was not identified as a genetic risk for SIL in this study, as demonstrated in Thai cervical cancer. ‍Therefore, to prevent cervical neoplasia or HPV infection, inclusion of knowledge on sexual behavior and effects of ‍smoking into public health programs is important and, at the same time, a nation-wide screening scheme for cervical ‍abnormalities including HPV-typing is a high priority in Thailand.