宫颈细胞学异常妇女多环芳烃暴露与人乳头瘤病毒感染的关系

Associations between polycyclic aromatic hydrocarbon exposure and human papillomavirus infection in women with abnormal cervical cytology

目的探讨宫颈细胞学异常妇女多环芳烃(polycyclic aromatic hydrocarbons,PAHs)暴露与人乳头瘤病毒(human papillomavirus,HPV)感染的关系。方法选取课题组建立的自然人群队列中宫颈细胞学异常的2285名妇女为研究对象,利用队列基线资料进行横断面研究。在收集研究对象基线资料的同时,进行宫颈脱落细胞HPV分型检测和尿液1-羟基芘(1-hydropyrene,1-OHP)浓度的测定,分析PAHs暴露与HPV感染的关系。结果宫颈细胞学异常妇女HPV感染率为32.3%,其中单一和多重感染率分别为22.8%和9.4%,高危型人乳头瘤病毒(high-risk human papillomavirus,HR-HPV)感染率为31.6%,居前5位的感染型别为HPV16、HPV58、HPV52、HPV53和HPV51。HPV及其单一/多重、HR-HPV、HPV16、HPV58、HPV52、HPV53和HPV51感染的妇女,PAHs的暴露水平均高于未感染者(均P<0.001),PAHs高暴露均可增加各类型HPV的感染风险,且随着PAHs暴露水平的升高,HPV及其单一/多重,HR-HPV,HPV16、HPV58、HPV52、HPV53和HPV51感染的风险均呈上升趋势(均P<0.05)。进一步经分层分析发现,在35~<45岁、初中及以下文化程度、被动吸烟、未绝经和产次≥3次的妇女中,PAHs高暴露发生HPV和HPV16感染的风险更大。结论PAHs高暴露可增加宫颈细胞异常的妇女HPV及高危型HPV的感染风险,尤其是35~<45岁、文化程度较低、被动吸烟、未绝经和多产次的妇女感染风险更大。

Objective This study aimed to explore the association between polycyclic aromatic hydrocarbons(PAHs)exposure and human papillomavirus(HPV)infection in women with abnormal cervical cytology.Methods A cross-sectional study was conducted on a cohort of 2285 women with abnormal cervical cytology.The cohort was previously established by our research group.The study analyzed the association between PAHs and HPV infection,using HPV infection status in cervical exfoliated cells and 1-hydroxypyrene(1-OHP)exposure levels in urine detected at the same time.Results In women with abnormal cervical cytology,the HPV infection rate was 32.3%,with single and multiple infection rates of 22.8%and 9.4%,respectively.The infection rate of high-risk HPV(HR-HPV)was 31.6%,and the top five infection types were HPV16,HPV58,HPV52,HPV53,and HPV51.The exposure levels of PAHs in women infected with HPV and its single or multiple,HR-HPV,HPV16,HPV58,HPV52,HPV53,and HPV51 were all higher than those without infection(all P<0.001).High exposure to PAHs could increase the risk of infection of the above types of HPV,showing a dose-response relationship between PAHs exposure levels and the risk of HPV infection(all P<0.05).Further stratified analysis showed that among women aged 35-<45 years,with junior high school education level or below,passive smoking,premenopausal women and parities≥3 times,the risk of HPV infection and high-risk HPV16 infection was greater in those with high PAHs exposure.Conclusions High exposure to PAHs could increase the risk of HPV or high-risk HPV infection in women with cervical cell abnormalities,especially in women aged 35-<45 years,with low education level,passive smoking,multiple parturition,and premenopausal women.