口腔HPV感染患者发生宫颈病变的危险因素

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目的:探讨口腔HPV感染患者发生宫颈上皮内瘤变(CIN)及宫颈癌的风险。方法:采用荧光定量PCR技术测定术前确诊为宫颈病变(包括CIN及宫颈癌)的120例患者和980例同期行常规身体检查的体检者口腔HPV感染情况。对HPV阳性者行病例-对照研究,比较口腔HPV阴性及阳性患者宫颈病变发生情况及人口学特征,另外对宫颈病变患者行病例-对照研究,并采用Logistic多因素分析宫颈病变发生的危险因素。结果:PCR技术显示,口腔HPV阳性52例(5.31%),宫颈HPV阳性68例(6.94%)。宫颈病变患者口腔HPV阳性38例(31.67%),宫颈HPV均为阳性。HPV阳性病例对照显示,口腔HPV阳性及阴性患者宫颈病变发生率分别为93.33%、28.52%,有统计学差异(P<0.05)。研究显示,宫颈病变患者(包括CINⅠ~Ⅲ、宫颈癌)口腔HPV阳性率、口交>3次/周、性伴侣>3个的比例显著高于宫颈正常患者(P<0.05)。结论:口腔HPV感染可增加宫颈癌发生风险,口交频繁、性伴侣>3个是口腔及宫颈HPV感染的共同因素。临床应加强对口腔HPV阳性者宫颈病变筛查,并尽早给予相应治疗,降低宫颈癌发生风险。 Objective: To investigate the risk of cervical intraepithelial neoplasia (CIN) and cervical cancer in patients with oral HPV infection. Methods: The oral HPV infection of 120 patients with preoperative diagnosis of cervical lesions (including CIN and cervical cancer) and 980 patients who underwent routine physical examinations during the same period were measured by fluorescence quantitative PCR. A case-control study was conducted on HPV positive patients. The incidence of cervical lesions and demographic characteristics of oral HPV negative and positive patients were compared. Case-control study was performed on patients with cervical lesions, and the risk factors of cervical lesions were analyzed by Logistic multivariate analysis. Results: The results of PCR showed that oral HPV was positive in 52 cases (5.31%) and cervical HPV was 68 cases (6.94%). Cervical lesions were positive for oral HPV in 38 cases (31.67%), cervical HPV were positive. HPV-positive case control showed that oral HPV-positive and -negative patients with cervical lesions were 93.33%, 28.52%, respectively, with statistical significance (P <0.05). The study showed that the positive rate of oral HPV in patients with cervical lesions (including CINⅠ-Ⅲ, cervical cancer), oral sex> 3 times per week, and the number of sexual partners> 3 were significantly higher than those of normal cervical patients (P <0.05). Conclusion: Oral HPV infection can increase the risk of cervical cancer, frequent oral sex, sexual partners> 3 are oral and cervical HPV infection common factors. Cervical lesions should be screened for oral HPV-positive patients, and appropriate treatment should be given as soon as possible to reduce the risk of cervical cancer.
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