鲍氏清包网:口交危害大于吸烟？

一种通过口交传播的病毒引起的男性患上喉咙癌的几率可能大于吸烟。这一发现使得一些人呼吁，需进行大量药物试验以防治感染。

Researchers examined 271 throat-tumor samples collected over 20 years ending in 2004 and found that the percentage of oral cancer linked to the human papillomavirus, or HPV, surged to 72 percent from about 16 percent, according to a report released yesterday in the Journal of Clinical Oncology. By 2020, the virus-linked throat tumors -- which mostly affected men -- will become more common than HPV-caused cervical cancer, the report found. 

临床肿瘤学杂志昨天发布的报告称，到2004年，研究人员已经花费二十多年检查了271个喉道肿瘤案例。最终发现，与人乳头瘤病毒相关的抠像癌症发病几率从16%急剧攀升到了72%。报告指出，到2020年，主要感染对象是男性的病毒性喉道癌将比人乳头瘤病毒导致的宫颈癌更加普遍。

HPV is known for infecting genitals. The finding that it can spread to the throat and cause cancer may increase pressure on Merck & Co., the second-largest U.S. drugmaker, to conduct large-scale trials to see if its vaccine Gardasil, which wards off cervical cancer in women, also prevents HPV throat infections. 

人乳头瘤病毒以感染男性生殖器而为人所知。而新近发现这一病毒能够扩散到喉部并引起能够引发癌症。这一发现可能会给作为美国第二大制药商的默克公司对其生产的加德西宫颈癌疫苗进行大规模试验增加压力。加德西疫苗被认为技能防治女性宫颈癌，也能防止人乳头瘤病毒感染喉部。

“The burden of cancer caused by HPV is going to shift from women to men in this decade,” Maura Gillison, an oncologist at Ohio State University and study senior author, said in a telephone interview. “What we believe is happening is that the number of sexual partners and exposure to HPV has risen over that same time period.” 

“最近十年，人乳头瘤病毒引起癌症这一压力正由女性转向男性。”俄亥俄州立大学肿瘤学家和该研究高级作者莫拉 吉里森说。“性伴侣和被人乳头瘤病毒感染的数量与过去同一时期相比增加了许多，我们深信这一状况仍在持续。”

Gillison said she worked with researchers at Whitehouse Station, New Jersey-based Merck several years ago to design a study in men. After Merck acquired Schering-Plough Corp. in 2009, though, the trial “was canceled,” she said. 

吉里森称，几年前她和几位研究人员在默克公司新泽西州的基地怀特豪斯站曾经针对男性做过一项研究。然而在2009年默克公司并购了先灵葆雅公司之后，这一试验就被取消了。

No Further Study 

尚无进一步研究

Pamela Eisele, a spokeswoman for Merck, said the company decided not to move ahead with a big oral cancer study “due to competing research and business priorities.” GlaxoSmithKline Plc (GSK) has “no plans” to study the company’s competing vaccine Cervarix outside of cervical cancer, Jennifer Armstrong, a company spokeswoman, said in an e-mail. 

默克公司的发言人，帕梅拉 艾斯勒称，默克公司由于充满竞争的研究和业务考虑，不再对口腔癌症进行大规模的研究。葛兰素史克公司的发言人珍妮弗 阿姆斯特朗在电子邮件里称，该公司也无与宫颈癌疫苗卉妍康无关的疫苗研究计划。

Gardasil is approved for preventing cervical, vaginal and anal cancers and genital warts, and is recommended for girls and women ages 9 through 26. It is also approved for preventing genital warts and anal cancer in boys and young men of the same ages. Glaxo’s Cervarix is approved for preventing cervical cancer in females ages 9 through 25. 

加德西疫苗已被批准用于宫颈、阴道、肛肠癌和生殖器疣的防治。这一疫苗主要针对9到26岁的女性使用。它同样对于防治相同年龄男性的肛肠癌和生殖器疣也有效用。葛兰素史克公司的卉妍康也被用来防治9-26岁女性的宫颈癌。

Both vaccines target the HPV strain linked to oral cancer, Gillison said. 

吉里森称，这两种疫苗对引发口腔癌的人乳头瘤病毒病毒都有效用。

HPV-linked throat cancers, or orophyaryngeal cancer, are increasing so rapidly that by 2020 there will be 8,700 U.S. cases, with 7,400 cases in men, versus 7,700 cases of cervical cancer, the study said. Male cases alone will outnumber cervical cancer cases soon after 2020, Gillison said. The Ohio State study is based on tumor samples from several U.S. states. 

人乳头瘤病毒引发的喉道癌，或咽喉癌正在急速增长。研究称，到2020年，美国将会有8700病例，而男性患者将占7400位，与之相对的，将会有7700宫颈癌病例。吉里森称，2020年后，仅男性病例都会超过宫颈癌病例。俄亥俄州立大学的研究以美国多个州的肿瘤病例为基础。

HPV Infections 

人乳头瘤病毒感染

Roughly 20 million Americans have genital HPV infections, according to the Atlanta-based Centers for Disease Control and Prevention. At least half of sexually active women and men get it at some point in their lives, the CDC says. Most of the time it doesn’t cause health problems. 

据亚特兰大疾病控制和防治中心，约两千万美国人生殖器感染了HPV病毒。该中心称，至少一半性生活活跃的女性和男性在不同程度上受到了感染，但是大多数时间这并不会引起健康问题。3

Until recently, head and neck cancer mainly occurred in older patients and was associated with tobacco and alcohol use. The HPV-linked head and neck cancers, usually of the tonsils, palate or tongue, hit men their 30s, 40s, and 50s, Gillison said. It is unclear why women are affected much less often than men, she said. 

吉里森称，直到最近，头颈部癌症患者主要是老年人，而且都与吸烟喝酒有关。人乳头瘤病毒感染的头颈部癌症一般会病发于扁桃体、上颚和舌头，患病男性都是在三十到五十岁。现在尚不清楚为什么女性患者会远远少于男性。

The decline in HPV-negative oral cancers mirrors the decline of smoking in the U.S., the study said. 

研究称，人乳头瘤病毒关联的口腔癌症增加也反映了美国吸烟人数的下降。1

Treatment involving chemotherapy, radiation and sometimes surgery, “is very nasty,” said Gillison. “It can leave people with permanent physical disfigurement, difficulty with speech and swallowing and poor dental health.” 

吉里森称，化学疗法、放射疗法以及一些外科手术非常麻烦。这种病可能会导致永久性的生理缺陷、说话困难、饮食难咽以及糟糕的牙齿健康。

Research Effort 

研究努力

Gillison started researching the oral cancer epidemic more than a decade ago as a fellow at Johns Hopkins University. Another researcher told her about a report from Europe of a case of oral cancer that was HPV positive, she said. 

十年前，吉里森在约翰霍普金斯大学工作时，一位研究者告诉她一份在欧洲发现的由人乳头瘤病毒引起口腔癌症案例的报告，她很快就开始对口腔流行疾病的研究。

“I started working on it immediately,” she said. 

“我立即开始着手研究。”她说。

In a 2007 epidemiology study published in the New England Journal of Medicine, Gillison and her colleagues found that having a high number of oral or vaginal sex partners are risk factors for HPV-associated throat cancer. The cancer may also be spread by open-mouth kissing, Gillison said in the interview. 

在一份由吉里森和她的同事共同发表在《新英格兰医学杂志》上的《2007年流行病学研究》中，他们声称，大量人乳头瘤病毒相关的喉道癌是由口交引发的。吉里森在采访中说，而这种癌还会通过接吻散播。

“Nobody paid attention to oral HPV infections until 2007,” she said. “We are about 15 years behind in the research” compared with the data on cervical cancer and HPV, she said. 

吉里森说，2007年以前，根本没人关注口头人乳头瘤病毒感染，与宫颈癌和人乳头瘤病毒相比，我们人乳头瘤病毒引发的口腔癌症研究已经晚了15年。

An editorial accompanying the study concluded that trials to see whether vaccines prevent oral cancer “are needed, given that prevention through vaccination will almost certainly be the ultimate solution” to HPV-positive oral cancers. 

该研究的最后认为，考虑到疫苗是人乳头瘤病毒相关口腔癌症防治的最终解决方式，对疫苗是否会防治口腔癌症有效进行试验是很有必要的

A key step would be to perform a natural history study that would follow people over a number of years and track in more detail how HPV-oral infections lead to cancer. This could help inform how to design a vaccine trial, Gillison said. 

进行一项多年人口跟踪调查并研究人乳头瘤病引起的口腔感染如何导致癌症的自然历史研究是非常必要的一个步骤。这对于设计一种疫苗试验很有作用，吉里森称。