Association Of Vaginal Microbiome Abnormalities With HPV Infection And Cervical Cancer Disease

Objective: Through cervical cancer screening,the distribution of HPV infection and subtypes,the prevalence of vaginal microecological abnormalities and cervical cancer(≥CINI.)in 14 divisions under the Xinjiang Production and Construction Corps were analyzed,the risk factors of HPV infection were analyzed,the relationship between HPV and vaginal microecological abnormalities was deeply explored,and the relationship between cervical cancer(≥ CINI.)and vaginal microecological abnormalities was analyzed,providing a valuable scientific basis for HPV infection and cervical cancer prevention and treatment,and actively doing a good job in the "three mornings",that is,early detection,early prevention and early treatment.Methods: The group sampling method was used to select the resident married women aged 35～64 in 14 divisions under the Xinjiang Production and Construction Corps as the research object,actively do a good job in the recording and quality control of various screening items,record HPV test results,gynecological examination results,and histopathological results in detail,and strictly implement the promotion of each examination item.Chi-square test and bivariate/multivariate logistic regression model were used to analyze the relationship between vaginal microbiome abnormalities and HPV infection and cervical cancer(≥CINI.).Results: 95233 people were finally included in this study,with an average age of49.71 ± 6.75 years.The overall positive rate of HPV was 10.30%.The positive rate of HPV ranked in the top five,including 11(13.31%),8(12.01%),10(11.98%),9(10.25%)and 13(10.15%),and all of them were more than 10%.The top five high-risk subtypes with the highest overall positive rate of HPV high-risk subtypes were HPV16(1.40%),HPV52(1.27%),HPV58(0.96%),HPV31(0.47%),HPV18(0.34%)and HPV56(0.34%);The overall prevalence rate of vaginal micro-ecological abnormalities is 14.72%,and the prevalence rate of vaginal micro-ecological abnormalities ranks in the top five divisions:12 divisions(26.47%),6 divisions(25.80%),2 divisions(23.93%),5 divisions(23.56%),and 13 divisions(21.20%).The prevalence rate of various gynecological diseases in lower genital tract diseases ranks in the top five in the whole corps,including BV(8.34%),MPC(3.96%),other genital tract infections(1.54%),VVC(1.39%),and cervicitis(1.10%).Chi-square analysis showed that the positive rate of HPV was different among different regions,age groups and whether the vaginal micro-ecology was abnormal(P<0.05).Multivariate analysis found that the region,age and abnormal vaginal micro-ecology were the risk factors for HPV(OR>1,P<0.05),and the risk of HPV infection increased with age.HPV infection is closely related to the abnormal vaginal micro-ecology(OR=1.18,P<0.05).The study found that the prevalence of BV in the abnormal vaginal micro-ecology(8.34%)and the prevalence of HPV positive(9.38%)are the highest,while the prevalence of TV in the overall is 0.74%,and the prevalence of VVC in HPV positive is 1.25%.TV and BV are closely related to HPV infection,and are risk factors of HPV infection(OR>1,P<0.05).The positive rate of HPV single high/low risk type(9.56%)was higher than that of HPV high/low risk type double infection(0.74%).There was a statistical difference between TV and BV and HPV single high/low risk type infection(P>0.05),BV was the risk factor of HPV high/low risk double infection(OR>1,P<0.05).The overall positive rate of HPV high-risk type and the positive rate in vaginal micro-ecological abnormalities were higher than those of HPV low-risk type.The univariate analysis found that the positive rate of HPV high-risk type/low-risk type infection was different from that of BV and other lower genital tract infections(P<0.05).The multivariate analysis found that BV and HPV high-risk type were correlated(OR=1.16,P<0.05),and other lower genital tract infections were correlated with HPV low-risk type(OR=2.39,P<0.05).The positive rate of HPV16/18 in the positive group of vaginal micro-ecology abnormality(19.14%)was higher than that in the negative group of vaginal micro-ecology abnormality(16.15%).The positive rate of HPV16/18 was different between TV and MPC(P<0.05),The study found that TV(OR=1.60,P<0.05)and MPC(OR=1.33,P<0.05)increased the risk of HPV16/18 infection.Combined with the above results,BV was highly correlated with HPV high-risk type(OR=1.16,P<0.05),but BV was not associated with HPV16/18 type,BV may be a risk factor for other high-risk HPV types.Univariate analysis found that cervical cancer(≥ CIN Ⅰ)had statistical difference with region and age(P<0.05),and had no statistical difference with whether the vaginal micro-ecology was abnormal(P>0.05),but had statistical difference with BV and other lower genital tract infections(P<0.05).Logistic analysis found that BV increased the risk of cervical cancer(≥ CIN Ⅰ)(OR=1.64,P<0.05).Conclusion: The health status of vaginal microecology is closely related to HPV infection and cervical cancer(≥ CINI.),and the study found that TV(OR=1.79,CI: 1.48～2.17,P<0.05),BV(OR=1.23,CI: 1.15～1.32,P<0.05)infection were risk factors for HPV infection,TV and BV infection were related to HPV monotype infection,and BV infection was related to HPV superinfection.BV infection was associated with HPV high-risk infection(OR=1.16,CI=1.01～1.33,P<0.05),while other lower genital tract infections were associated with HPV low-risk infection(OR=2.39,CI=1.72～3.31,P<0.05).The incidence of HPV16/18 in HPV positivity was 16.64%,and TV and MPC were associated with HPV16/18 infection(P<0.05),and BV infection was an independent risk factor for cervical cancer(≥CINI.)(OR=1.64,CI=1.08～2.49,P<0.05),which helped to effectively carry out the prevention and treatment of HPV and cervical cancer.