检验医学与临床2024，Vol.21Issue(13)：1890-1894,5.DOI:10.3969/j.issn.1672-9455.2024.13.014
阴道微生态变化与宫颈人乳头瘤病毒感染及宫颈病变的相关性研究
Study on the correlation between vaginal microecological changes and cervical human papillomavirus infection and cervical lesions
摘要
Abstract
Objective To analyze the changes of vaginal microecology and human papillomavirus(HPV)infection in patients with different cervical lesions,and to explore the correlation between vaginal microecology and cervical lesions and HPV infection.Methods A total of 361 patients with cervical lesions treated in our hospital from January 2022 to August 2023 were retrospectively analyzed as the study group.According to the severity of cervical lesions,the study group was divided into cervical cancer group(11 cases),high-grade lesion group(CIN Ⅱ-CIN Ⅲ,64 cases),low-grade lesion group(CIN Ⅰ,204 cases)and cervicitis group(82 ca-ses).Another selection in the same period for physical examination and normal cervical cytology and HPV negative women 140 cases as control group.Test groups of vaginal secretion of saliva acid glycosides enzyme(SNa)positive,lack of hydrogen peroxide(H2 O2),leukocyte esterase(LE)positive,pH value＞4.5,N-acetyl aminocaproic glycosidase(NAG)positive cases and observation of bacterial vaginal disease(BV).vulva vagina candida(VVC),trichomonas vaginitis disease(TV).The infection of HPV subtypes in patients with different severity of cervical lesions and the microecology of patients with different subtypes of infection were detected and recorded.Results There were significant differences in SNa positive,H2O2 deficiency,LE positive,pH value＞4.5,NAG and BV between cervical cancer group,high-grade lesion group,low-grade lesion group,cer-vicitis group and control group(P＜0.05).The positive rate of cervicitis group,low-grade lesion group,high-grade lesion group and cervical cancer group increased with the deepening of the severity of the lesion,and the differences were statistically significant(P＜0.05).There was no significant difference in VVC and TV a-mong the 5 groups(P＞0.05).Among 361 patients,265 cases were HPV positive,with a positive rate of 73.4％,including 250 cases of high-risk HPV(HR-HPV)positive,accounting for 94.3％(250/265),and 15 cases of low-risk HPV(LR-HPV)positive,accounting for 5.7％(15/265).The positive rate of HR-HPV was 90.9％(10/11)in cervical cancer group,87.5％(56/64)in high-grade lesion group,83.8％(171/204)in low-grade lesion group and 34.1％(28/82)in cervicitis group,compared with cervicitis group,the positive rate of each group was statistically significant(P＜0.05).The three subtypes with the highest proportion of HR-HPV positive rates were HPV52,HPV16 and HPV58,and HPV16 was the main HPV subtype in cervical cancer group,accounting for 54.5％.The proportions of SNa positive,H2O2 deficiency,pH＞4.5 and BV in high-risk HPV infection patients were higher than those in low-risk HPV infection patients,and the differ-ences were statistically significant(P＜0.05).There was no significant difference in the proportion of LE pos-itive,NAG positive,VVC and TV between patients with high-risk HPV infection and patients with low-risk HPV infection(P＞0.05).Conclusion Vaginal microecological imbalance can promote the carcinogenic effect of persistent HPV infection and aggravate the progress of cervical lesions.Cervical lesions are closely related to HPV infection and vaginal microecological imbalance.It is of great significance to pay attention to the chan-ges of vaginal microecology and maintain the balance of vaginal microecology for the prevention of HPV infec-tion and the treatment and outcome of cervical cancer.关键词
阴道微生态/人乳头瘤病毒感染/宫颈病变/宫颈癌/相关性Key words
vaginal microecology/Human papillomavirus infection/cervical lesions/cervical cancer/relevance分类
医药卫生引用本文复制引用
钟水娇,卢志勇,杨瑞娟,刘玉华,潘勇,朱雅文..阴道微生态变化与宫颈人乳头瘤病毒感染及宫颈病变的相关性研究[J].检验医学与临床,2024,21(13):1890-1894,5.基金项目
赣州市2023年指导性科技计划项目(GZ2023ZSF564). （GZ2023ZSF564）
