NEJM:百万人数据研究表明,四价HPV疫苗接种可显著降低浸润性宫颈癌风险

2020-10-21 王木木 生物探索

HPV(人类乳头瘤病毒)是一类能引起皮肤乳头瘤样病变的病毒,目前已分离出100多种亚型,根据感染的组织部位和症状被分为低危型的和高危型,通常会导致尖锐湿疣和包括宫颈癌在内的多种癌症。

HPV(人类乳头瘤病毒)是一类能引起皮肤乳头瘤样病变的病毒,目前已分离出100多种亚型,根据感染的组织部位和症状被分为低危型的和高危型,通常会导致尖锐湿疣和包括宫颈癌在内的多种癌症,其中宫颈癌是全世界导致妇女死亡的第二大癌症。

先前的研究表明,HPV疫苗可以有效预防主要致癌类型的HPV感染,即尖锐湿疣和可发展为宫颈癌的癌前宫颈病变。不过,目前尚未有研究评估疫苗对宫颈癌中最严重的一类浸润性宫颈癌的有效性,同时缺乏以人群为基础的大型研究。

近日,一项由瑞典卡罗林斯卡大学的研究团队发表在《The New England Journal Of Medicine》上的一项研究报告发现,接种四价HPV疫苗可显着降低女性患浸润性宫颈癌的风险,且在17岁之前接种的收益更为明显。

研究人员使用瑞典全国人口和健康登记册,追踪了2006-2017年期间年龄在10-30岁间的超167万名女性,统计其四价HPV疫苗接种情况,以及年龄、教育程度、居住地、家庭收入、父母特征、孕产妇疾病史等协变量信息。同时在随访期间统计其浸润性宫颈癌的确诊情况,以评估HPV疫苗接种与浸润性宫颈癌风险之间的关联。

研究人群基线时的特征

对统计数据进行分析,发现在此研究期间,共有527,871名女性接种了四价HPV疫苗,且83.2%女性的接种时间在17岁之前。最终有19例接受四价HPV疫苗接种的女性和538例未接受疫苗接种的女性被诊断为宫颈癌。对宫颈癌的累积发病率分析,发现到30岁时,未接种HPV疫苗女性的宫颈癌的累积发病率为94例/每十万人,而已接种女性的累积发病率为47例/每10万人。对于17至30岁间接种疫苗的女性,到30岁时的累积发病率为54例/每10万人。而在17岁之前就接种疫苗的女性中,其到28岁时的累积发病率仅为4例/每10万人。

HPV疫苗接种和浸润性宫颈癌发生统计信息

不同HPV疫苗接种人群的浸润性宫颈癌的累积发病率

然后研究人员使用Poisson回归模型评估并比较了接种疫苗和未接种疫苗的女性的宫颈癌发病率,调整协变量信息后,发现HPV疫苗接种与浸润性宫颈癌发病风险的显着降低有关,与未接种HPV疫苗的女性相比,接种HPV疫苗的女性的整体宫颈癌患病风险降低了63%,其中17至30岁之间接种疫苗的女性患子宫颈癌的风险降低了一半,而在17岁之前就接种疫苗的女性其宫颈癌风险显着降低了88%。

该研究的作者Jiayao Lei 表示,“总的来说,我们的研究表明,四价HPV疫苗接种可以显着降低子宫颈癌的患病风险,尤其是在17岁以前接种收益会更大。这是我们首次在人口水平上证明,HPV疫苗接种不仅可以预防可能是宫颈癌前体的细胞变化,而且可以预防实际的浸润性宫颈癌。”

原始出处:

Jiayao Lei, Alexander Ploner, K Miriam Elfstrom, et al.HPV Vaccination and the Risk of Invasive Cervical Cancer.N Engl J Med. 2020 Oct 1;383(14):1340-1348. doi: 10.1056/NEJMoa1917338.

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    2020-10-23 一闲
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    2020-10-22 ms2000000956980985

    已经错过宫颈癌疫苗最佳接种时期😂

    0

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    2020-10-22 Psycho.Dr Du

    快去排队打HPV疫苗#HPV疫苗#

    0

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    2020-10-21 旺医

    顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息

    0

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