Study On The Effect Of Vaginal Microecological Environment On High-risk HPV Infection In Women

Objective:High-risk HPV(Human Papilloma Virus)infection is the most important cause of cervical cancer.However,most HPV infections can be eliminated through autoimmunity,and only a small part of HPV infections can develop into persistent infections..Previous studies have pointed out that the vaginal microecological environment plays an important role in inducing the occurrence and development of cervical cancer.However,whether the imbalance of the vaginal microecological environment will promote high-risk HPV infection is still inconclusive.Method:Through the analysis of patients who attended the gynecological clinic of Taizhou People’ Hospital from November 2019 to November 2020,those who did not meet the enrollment criteria were excluded,and 458 patients who met the inclusion criteria were collected.Obtain basic data of patients through outpatient medical records,collect patients’ cervical exfoliated cells and vaginal secretions,and use PCR(Polymerase Chain Reaction)technology to detect whether they have HPV infection and HPV typing,and they will be infected with HPV 16,18,Types 31,33,35,39,45,51,52,53,56,58,59,66,68 are set as "high-risk HPV positive group";other patients are set as "high-risk HPV negative" Group"(including HPV 6,11,40,42,43,44,55,57,67,73 positive and HPV negative).Using morphological and functional testing methods,analyze the pH value of vaginal secretions(Pondus,Hydrogenii,hydrogen ion concentration index),hydrogen peroxide,white blood cell,esterase and sialidase levels,and analyze common vaginas through microscopy Microorganism type,clear whether there is BV(Bacterial Vaginosis),AV(Aerobic Vaginitis),TV(Trichomonal Vaginitis,Trichomonal Vaginitis),VVC(Vulvovaginal Candidiasis)Saccharomycosis)and mixed vaginitis;comprehensive relevant parameters to assess the relationship between the vaginal microecological environment and high-risk HPV infection in women.Result:1.Among the 458 cases that met the inclusion criteria,there were 106 patients in the high-risk HPV positive group,accounting for 23.14%,and 352 patients in the high-risk HPV negative group,accounting for 76.86%.2.Among 106 high-risk HPV infections,there were a total of 82 cases of single-type infection and 24 cases of mixed-type HPV infection.Among the single infections,the infection types are 16(32.93%,27/82),52(20.73%,17/82),58(18.29%,15/82),18(9.76%,8 /82),type 33(4.88%,4/82),type 31(4.88%,4/82),and other types accounted for 8.53%(7/82).Among the 24 cases of mixed infection,there were 8 cases of type 16 combined with other types,7 cases of type 52 combined with other types,6cases of type 51 combined with other types,and 4 cases of type 18 and type 68 combined with other types.There were 3 cases of type 59 combined with other types,2cases of type 56 and 66 combined with other types,and 1 case of type 33,35,39,and 58 combined with other types.3.The average age of patients in the high-risk HPV-positive group was(41.56±9.20)years old,median age was 42.00 years old,first pregnancy age(24.25±1.51)years old,pregnancy times(2.46±1.18)times,and parity times(1.40±0.74)times,The frequency of sexual life(2.48±1.36)times/month;the average age of the corresponding high-risk HPV-negative group is(40.54±8.06)years,the median age is40.68 years,the first pregnancy age is(24.46±1.53)years,pregnant Times(2.41±1.10)times,parity times(1.25±1.20)times,and sex frequency(2.23±1.16)times/month.There was no statistically significant difference between the two groups in the average age,age of first pregnancy,times of pregnancy,number of births,and frequency of sexual life(P>0.05).4.Using the pH value of 4.5 as the boundary,the difference in the pH of vaginal secretions between the two groups was analyzed.The results showed that the proportion of patients in the high-risk HPV positive group with a pH value of ≥4.5 was 61.32%(65cases),while the negative patients corresponded The ratio was 48.01%(169 cases),there was a statistically significant difference between the two groups(P=0.016);the positive rate of hydrogen peroxide in the high-risk HPV positive group was 45.28%(48cases)was higher than the negative group 32.39%(114 cases)),and the difference was statistically significant(P=0.015);the white blood cell.Esterase positive rate of the high-risk HPV positive group was 64.15%(68 cases)higher than that of the negative group 52.56%(185 cases),the difference was statistically significant(P=0.035);the positive rate of sialidase in the high-risk HPV-positive group was 28.30%(30 cases)was also higher than that of the negative group was 15.06%(53 cases),and the difference was also statistically significant(P=0.002).5.Analyze the common types of vaginal microorganisms through microscopy to clarify the incidence of BV,AV,TV,VVC and mixed vaginitis.The results show that the incidence of BV in high-risk HPV-positive patients is 25.47%(27 cases)and Compared with 11.93%(42 cases)of the negative patient group,the difference was statistically significant(P=0.001);the high-risk HPV positive group had an AV incidence of 10.38%(11 cases)higher than that of the negative group 4.26%(15 cases).The difference was statistically significant(P=0.017);the incidence of VVC in the high-risk HPV positive group was 4.72%(5 cases)and 4.83%(17 cases)in the negative group,and there was no statistical difference(P=0.962)The incidence of TV is high.The incidence of risk positive group is 2.83%(3 cases)higher than that of negative group 1.14%(4 cases),but the difference is not statistically significant(P=0.213);mixed vaginitis The incidence of positive group and negative group were 12.26%(13 cases)and 10.23%(36cases)respectively,and there was no statistically significant difference between the two groups(P=0.552).Conclusion:1.The increase in the pH value of vaginal secretions and the increase in the positive rate of leukocyte esterase,hydrogen peroxide,and sialidase can increase the possibility of high-risk HPV infection.2.The occurrence of BV and AV is correlated with high-risk HPV infection,while the occurrence of VVC,TV and mixed vaginitis is not significantly correlated with high-risk HPV infection.3.The results of this study suggest that the vaginal microecological environment is related to high-risk HPV infection,and the disorder of the vaginal microecological environment can increase high-risk HPV infection.However,due to the limitation of sample size,the results need to be further demonstrated.