日本性感染症学会誌 Journal of Japanese Society for Sexually Transmitted Infections

Online ISSN: 2434-2505 Print ISSN: 0917-0324
日本性感染症学会 Japanese Society for Sexually Transmitted Infections
〒162-0801東京都新宿区山吹町358-5アカデミーセンター Japanese Society for Sexually Transmitted Infections Academy Center, 358-5 Yamabuki-cho, Shinju-ku, Tokyo 162-0801, Japan
Japanese Journal of Sexually Transmitted Infections 30(1): 1-6 (2019)
doi:10.24775/jjsti.O-2019-0003

原著原著

男性における尿検体を用いたHuman Papillomavirus検査の意義The significance of human papillomavirus screening in urine samples among men

1金沢大学大学院医薬保健学総合研究科泌尿器集学的治療学Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science

2石川県立中央病院泌尿器科Department of Urology, Ishikawa Prefectural Central Hospital

3能美市立病院泌尿器科Department of Urology, Nomi City Hospital

4性の健康医学財団Japanese Foundation for Sexual Health Medicine

受付日:2019年3月5日Received: March 5, 2019
受理日:2019年5月22日Accepted: May 22, 2019
発行日:2019年8月31日Published: August 31, 2019
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【目的】男性における尿検体を用いたHPV検査の意義について検討した。

【対象と方法】泌尿器科外来を受診した788例を対象とし、亀頭の擦過検体と尿検体を採取した。各検体からDNAを採取し、HPV検査を実施した。

【結果】年齢は53.9±20.8歳。HPV検出率は亀頭検体24.1%、尿検体6.6%であり、亀頭検体で有意に高かった。そのうち高リスク型HPV検出率は亀頭54.7%、尿50.0%であった。外性器HPV検出に対する尿検体の特異度および感度は、それぞれ65%、79%であった。HPV陽性例の中で、発がんに最も関連するHPV16の検出率は、亀頭5.8%、尿23.1%であり、尿検体において有意に高かった。

【結論】男性において性器HPV感染のスクリーニングとしては、亀頭の擦過検体を用いるべきである。一方、尿からは16型が多く分離され、その病原性を検討するには、尿検体も用いたほうが良いかもしれない。

Objective: We assessed the significance of human papillomavirus (HPV) screening in urine samples among men.

Patients and Methods: We enrolled 788 patients who attended urological outpatient clinics and collected glans-rubbed samples and urine samples from each one. Following DNA extraction, HPV-DNA testing and genotyping were performed using a polymerase chain reaction-based Luminex method.

Results: The mean age of the cohort was 53.9±20.8 years. The HPV prevalence rate was 24.1% (95%CI: 21.1–27.1%) and 6.6% (95%CI: 4.8–8.4%) in the glans and urine samples, respectively. Among the HPV-positive samples, high-risk HPV was detected in 54.7% and 50.0% of the glans and urine samples, respectively. The sensitivity and specificity of HPV detection in urine samples for genital HPV infection were 65% (95%CI: 52–78%) and 79% (95%CI: 76–82%), respectively. HPV16 was detected in 11 cases (5.8%) in glans samples and 12 (23%) in urine samples, and the prevalence was significantly higher in urine than in glans samples.

Conclusions: Although glans-rubbed samples can be used for genital HPV screening among men, HPV16 was significantly prevalent in urine compared with glans samples, suggesting that urine samples were more suited to the investigation of HPV-induced pathogenesis in the urinary tract.

Key words: male; human papillomavirus; urine

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