Objective: To evaluate the effects of polycyclic aromatic hydrocarbons (PAHs) and high risk human papillomavirus (HR-HPV) infection and their interaction on the progression of cervical intraepithelial neoplasia. Methods: A total of 486 patients, including 208 women with normal cervix (NC), 154 patients with low-grade cervical intraepithelial neoplasm (CINⅠ), 124 patients with high-grade cervical intraepithelial neoplasm (CINⅡ/Ⅲ), were selected from the cervical lesions cohort from June to December, 2014. HR-HPV was detected by using flow-through hybridization technology and the urine concentration of 1-hydroxypyrene (1-OHP) was detected with high performance liquid chromatography. By using software SPSS 22.0, the χ(2) test, trend χ(2) test, Kruskal-Wallis H test, Nemenyi rank test and Spearman rank correlation analysis were performed. And the interaction effects were evaluated by additive model. Results: The HR-HPV infection rates in NC, CINⅠ and CINⅡ/Ⅲ groups were 27.9%, 37.0% and 58.9%, respectively. The urine concentrations of 1-OHP (μmol/molCr) were 0.07±0.09, 0.11±0.10 and 0.17±0.15, respectively. With increasing severity of the cervical lesions, the HR-HPV infection rate gradually increased (trend χ(2)=29.89, P<0.001) and the high exposure rate of PAHs gradually increased (trend χ(2)=27.94, P<0.001). HR-HPV infection was positively correlated with 1-OHP exposure (r=0.680, P<0.001). There was a positive additive interaction between HPV infection and PAHs exposure in CIN Ⅱ/Ⅲ group, but it was not found in CIN Ⅰ group. Conclusion: Both HR-HPV infection and high exposure of PAHs might increase the risk of cervical intraepithelial neoplasm, and might have a synergistic effect on the progression of high-grade cervical intraepithelial neoplasia.
目的： 探讨多环芳烃（PAHs）与高危型人乳头瘤病毒（HR-HPV）感染在宫颈上皮内瘤变发生发展过程中的作用及其交互效应。 方法： 从建立的自然人群队列中选取2014年6－12月经病理学确诊的正常宫颈（NC）妇女208例，低度宫颈上皮内瘤变（CIN Ⅰ）患者154例，高度宫颈上皮内瘤变（CIN Ⅱ/Ⅲ）患者124例为研究对象。采用高效液相色谱法检测其尿中1-羟基芘（1-OHP）的浓度（反映PAHs内暴露情况），应用导流杂交技术检测HPV感染状态及感染类型。利用SPSS 22.0软件进行资料的χ(2)检验、χ(2)趋势检验、Kruskal-Wallis H检验、Nemenyi秩和检验、Spearman秩相关分析，采用相加模型评价两因素间交互作用。 结果： NC、CIN Ⅰ、CIN Ⅱ/Ⅲ组HR-HPV感染率分别为27.9%、37.0%、58.9%，尿1-OHP浓度（μmol/molCr）分别为0.07±0.09、0.11±0.10、0.17±0.15。随着宫颈病变程度的加重，HR-HPV感染率（趋势检验χ(2)=29.89，P<0.001）和PAHs高暴露率（趋势检验χ(2)=27.94，P<0.001）均逐渐升高。HR-HPV感染与尿中1-OHP浓度呈正相关（r=0.680，P<0.001）。CIN Ⅱ/Ⅲ组中HR-HPV感染与PAHs高暴露存在正相加交互作用，而在CIN Ⅰ组中未发现存在类似交互作用。 结论： HR-HPV感染和PAHs高暴露均可增加宫颈上皮内瘤变的患病风险，两者在高度宫颈上皮内瘤变发生发展中存在协同作用。.
Keywords: Cervical intraepithelial neoplasia; High risk human papillomavirus; Interaction; Polycyclic aromatic hydrocarbons.