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最近研究证实,吸烟为宫颈癌的危险因素,但高危人乳头状瘤病毒感染的混杂作用并不明确。因此,研究采用基于人群的前瞻性队列研究的方法,分析吸烟作为宫颈上皮瘤2+和高危人乳头状瘤病毒感染的独立性危险因素的作用。根据吸烟情况,研究者将3187名妇女组成的队列分为3组:从不吸烟组、以往吸烟组和现吸烟组。研究者通过对854名妇女的前瞻性随访来分析高危人乳头状瘤病毒、宫颈上皮瘤、高危人乳头状瘤病毒感染和细胞学异常的危险因素。结果显示,这3组在主要指标或危险性行为(性行为史)混杂性方面存在明显差异。在现吸烟组中,高度鳞状上皮内病变/低度鳞状上皮内病变/不明意义的非典型鳞状细胞细胞学或宫颈上皮瘤1+/宫颈上皮瘤2+/宫颈上皮瘤3+没有改变。仅有少数的高危人乳头状瘤病毒和宫颈上皮瘤2+的混杂因素在3组中较常见,这表明吸烟状况为强干扰因素。3组中宫颈癌或高危人乳头状瘤病毒感染情况不存在差别。在多变量模式分析中,现时吸烟者是高危人乳头状瘤病毒感染的5个独立危险因素之一。除年龄因素外,高危人乳头状瘤病毒是宫颈上皮瘤2+唯一的独立危险因子。这些数据显示,吸烟并不是宫颈上皮瘤2+的独立危险因素,吸烟所增加的危险其实是由高危人乳头状瘤病毒所介导的,由于高危人乳头状瘤病毒的作用,现吸烟在多变量模型中成为独立性危险因素。
Recent studies confirm that smoking is a risk factor for cervical cancer, but the confounding effect of high-risk human papillomavirus infection is not clear. Therefore, we used a population-based prospective cohort study to analyze the role of smoking as an independent risk factor for cervical cancer2 + and high-risk human papillomavirus infections. Based on smoking prevalence, the researchers categorized 3187 cohorts of women into three groups: non-smoker group, former smoker group, and current smoker group. In a prospective follow-up of 854 women, the researchers analyzed the risk factors for high-risk human papilloma virus, cervical epithelioma, high-risk human papilloma virus infection and cytological abnormalities. The results showed that there was a significant difference between the three groups in terms of the mismatch of major indicators or risk behaviors (sexual history). In the current smoking group, high grade squamous intraepithelial lesion / low grade squamous intraepithelial lesion / unidentified atypical squamous cell cytology or cervical epithelial tumor 1 + / cervical epithelial tumor 2 + / cervical epithelial tumor 3+ without change. Only a few confounders of high-risk human papillomavirus and cervical epithelial tumor 2+ are more common in the three groups, indicating that smoking status is a strong interfering factor. There was no difference in cervical cancer or high-risk human papilloma virus infection among the three groups. In the multivariate model analysis, current smokers are one of five independent risk factors for high-risk human papillomavirus infection. In addition to age, high-risk human papillomavirus is the only independent risk factor for cervical epithelial tumor2 +. These data show that smoking is not an independent risk factor for cervical epithelial tumor 2 +. The increased risk of smoking is actually mediated by high-risk human papillomavirus. Due to the high-risk human papilloma virus, The variable model becomes a risk factor for independence.