Evidence for Chlamydia trachomatis as a human papillomavirus cofactor in the etiology of invasive cervical cancer in Brazil and the Philippines

被引:181
作者
Smith, JS
Muñoz, N
Herrero, R
Eluf-Neto, J
Ngelangel, C
Franceschi, S
Bosch, FX
Walboomers, JMM
Peeling, RW
机构
[1] Int Agcy Res Canc, F-69372 Lyon 08, France
[2] Proyecto Epidemiol Guanacaste, San Jose, Costa Rica
[3] Univ Sao Paulo, Sao Paulo, Brazil
[4] Univ Philippines, Philippine Gen Hosp, Manila, Philippines
[5] Inst Catala Oncol, Barcelona, Spain
[6] Free Univ Amsterdam Hosp, Amsterdam, Netherlands
[7] Hlth Canada, Natl Lab Sexually Transmitted Dis, Winnipeg, MB, Canada
关键词
D O I
10.1086/338569
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Chlamydia trachomatis infection was examined as a cause of invasive cervical cancer (ICC) among women with human papillomavirus (HPV) infection. In total, 499 women with incident ICC (ICC patients) and 539 control patients from Sao Paulo, Brazil, and Manila, the Philippines, were included. C. trachomatis antibodies were detected by microimmunofluorescence assay. Presence of HPV DNA in cervical specimens was determined by a polymerase chain reaction-based assay. C. trachomatis seropositivity was associated with sexual behavior but not with HPV infection. C. trachomatis increased the risk of squamous cervical cancer among HPV-positive women (odds ratio, 2.1; 95% confidence interval, 1.1-4.0). Results were similar in both countries. There was a suggestion of increasing squamous cancer risk with increasing C. trachomatis antibody titers. This large study examined C. trachomatis and cervical cancer, taking into account the central role of HPV infection. C. trachomatis infection was found to be a possible cofactor of HPV in the etiology of squamous cervical cancer, and its effect may be mediated by chronic inflammation.
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页码:324 / 331
页数:8
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