Association Of Bacterial Vagionsis With Cervical Squamous Intraepithelial Lesion : A Meta-analysis

Objective: The vaginal microecological environment of normal women is in dynamic balance.When the balance is broken,it will lead to bacterial vaginosis(BV),and may also promote the occurrence of cervical squamous intraepithelial lesions(SIL)to a certain extent,causing cervical cancer.The purpose of this study is to investigate the correlation between bacterial vaginosis(BV)and cervical squamous intraepithelial(SIL).Methods: Seven databases were retrieved by computer.The English databases included: The Cochrane Library,Pub Med,Web of Science;Chinese databases included: CNKI,CBM,Wanfang Data and VIP database.The searching time was from the establishment of the database to 15 st September 2019.Two investigators independently searched and evaluated the research quality of the relevant literature.R3.6.2 software and stata14.0 software were used for meta analysis of extracted data.Results: Twenty literatures were included,all of which were case-control studies.A total number of 10113 cases were enrolled.They were divided into 4042 cases in SIL group and 6071 cases in normal cervical group.Meta analysis showed that(1)The infection rate of HR-HPV in SIL group was higher than that in control group(OR= 14.106;95% CI: 7.636～26.059,P = 0),there was statistically significant differences;(2)The detection rate of BV infection in SIL group was0.319(95% CI: 0.256～0.385),that in LSIL group was 0.232(95% CI: 0.179～0.288),and that in HSIL group was 0.314(95% CI: 0.225～0.412),respectively compared with the normal cervical group was 0.129(95%CI:0.090～0.172),P= 0,there were statistically significant differences.The detection rate of BV infection in LSIL group was significantly different from that in HSIL group(P =0);(3)The infection rate of BV with HR-HPV in SIL group was higher than that in the control group(OR=34.732;95%CI:11.988～100.627,P=0),there was statistically significant differences.Conclusions: HR-HPV infection is a risk factor for the occurrence of SIL;there is a correlation between BV infection and SIL;the detection rate of BV in HSIL group is higher than that in LSIL group,thus it is speculated that BV may play a role in the development of cervical low-grade lesions to high-grade lesions.