| Objectives Human papillomavirus (HPV) is the major cause of cervical cancer, although infection with HPV is common, relatively few infections persist and progress to malignancy. We directly investigate the roles of HPV, HPV16E2/E6, estrogen, progesterone in cervical cancer, meanwhile study whether elevations in the physiologic levels of female hormones, such as estrogen, progesterone predispose to the development of cervical cancer in HPV positive women.Methods This study was a hospital-based case-control study in tumoural hospital of Shanxi province during 2001–2002. Cases were 74 women invasive cancer and controls with hysteromyoma were matched to cases in a 1:1 ratio. All controls were matched to cases by 3-years age group, nationality, habitation and days since be in hospital. All cases and controls were investigated directly by specific person with the same questionnaire. The structured questionnaire included information on personal characteristics and habits; education and other socioeconomic factors; general lifestyle habits such as smoking and alcohol consumption; a few indicators of sexual habits; gynaecological and obstetric data; related medical history; and lifetime use of oral contraceptives, hormonal replacement therapy in menopause, and female hormone preparations for other indications. All of the women donated a 3ml blood sample in follicular phase (NO.8-10 day of menstrual cycle) that was collected in a sterile tube and the blood serum was isolated and frozen at -30℃. Estrogen, progesterone were detected by ELISA assays. Cervical tissues were collected after operation. One part were tested for the presence of HPVs HPV16 E2/E6 using PCR, another part were tested the estrogen receptors (ER) and progesterone receptors (PR) by immunohistochemistry. All information was analyzed by SPSS10.0 using χ2-test, t-test, univariate and multiple Cox regression analysis.Results (1) The expressions of HPVs, HPV16 E2/E6 in cases were significantly higher than controls, regardless of their menopausal status (premenopausal or postmenopausal); (2) Both in cases and controls, there was a absence of HPV16 E2; (3) The associations between the levels of estradiol and cervical cancer were both significant in pre-and postmenopause women; (4) The levels of progesterone in cases were higher than controls regardless of their menopausal status, but there were no statistically significant difference; (5) There were clear trend of increasing risk of cervical cancer with increasing levels of estradiol and progesterone; (6) The levels of estradiol in cases were significantly higher than controls, regardless of their infectious status(HPV positive or negative) , there were clear trend of increasing risk of cervical cancer with increasing levels of estradiol in HPV positive; (7) The levels of progesterone in cases were higher than controls, regardless of their infectious status(HPV positive or negative) , but there were no statistically significant difference, furthermore there were no clear trend of increasing risk of cervical cancer with increasing levels of progesterone in HPV positive; (8) The expressions of ER and PR were lower in postmenopause women with cervical cancer; (9) Occupation, family members, menopause, age at first marriage, age at first sexual intercourse, age at first pregnancy and parity were also associated with cervical; (10) Estradiol, HPV16 E6, age at first sexual intercourse and menopause were involved in multiple Cox regression model.。Conclusions (1) The infection of HPV, especially high-risk HPV16 was related to the development of cervical cancer, HPV16 infection was more significant for cervical cancer; (2) The expressions of HPV16 E2/E6 in cervical cancer were higher than hysteromyoma, and followed by a absent of HPV16 E2; (3) The higher levels of estradiol and progesterone could increase the risk of cervical cancer, especially estradiol, and regardless of their menopausal status (premenopausal or postmenopausal); (4) In some sense,ER could protect from progress to cervical... |
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