Study On The Relationship Between Microecological Change Of Vagina And HPV Infection And Cervical Lesion

Objective The infection of cervical HPV in patients with cervical intraepithelial neoplasia（Cervical Intraepithelial Neoplasia,CIN）,squamous cell carcinoma of the cervix（Cervical Squamous Cell Caicinoma,CSCC）and cervicitis in the outpatient department of affiliated Hospital of Inner Mongolia Medical University was investigated.The factors of vaginal microecological flora and PH,fertility status,living habits and other factors were analyzed to explore the correlation between cervical cancer,CIN of different grades and HPV infection,vaginal microecological abnormality,and provide a new way for the prevention and treatment of CIN and cervical cancer.Methods From September 2016 to June 2018,100 cases of CIN I diagnosed by colposcopy,cervical biopsy and pathological examination were collected from the out-patient department of the affiliated Hospital of Inner Mongolia Medical University（low-grade pathological group）.There were 100 cases of CIN II grade and 30 cases of cervical squamous cell carcinoma as experimental group and 30cases of cervical squamous cell carcinoma as experimental group,and 100 cases of cervicitis women as control group.The questionnaire survey of pedestrian characteristics and related factors,vaginal microecological examination and HPV test were carried out among the women who met the criteria.Results:（1）The general demographic characteristics:the age of patients with cervical squamous cell carcinoma,the smoking of husband,the age of first sexual behavior,the times of pregnancy and the times of labor were significantly different from those of,CIN I group and CIN II/CIN III group in cervicitis group（P<0 05）.The average age of onset of cervical squamous cell carcinoma was 47.6±9.32 years old,which was significantly higher than that of other groups,while the average age of first sexual life was 21.3±1.84 years old,which was lower than that of other groups,and the proportion of husband smoking was also significantly higher than that of other groups.In addition,there was a significant difference in family income between the experimental group（CINI CINII/CINIII and squamous cell carcinoma）and the control group（P<0 05）.（2）Detection of cervical HPV:the positive rate of HPV in CINI group and cervicitis group was lower than that in CINII/CINIII group and cervical squamous cell carcinoma group（P<0.0001）,but in CINI group and cervicitis group,CINII/CINIII group was significantly lower than that in cervical squamous cell carcinoma group（P<0.05）.There was no significant difference in the positive rate of HPV.（3）High-risk HPV（HR-HPV）detection:compared with the control group（cervicitis）,the high-risk HPV in the experimental group（CINI CINII/CINIII and squamous cell carcinoma）was more than that in the control group（P<0.05）,and the difference was statistically significant.The proportion of high-risk HPV in CINII/CINIII group and cervical squamous cell carcinoma group was higher than that in CINI group,but there was no statistical difference between CINII/CINIII group and cervical squamous cell carcinoma group.（4）Detection of pH of vagina:comparison between experimental group（CINI CINII/CINIII and squamous cell carcinoma）and control group（cervicitis）,PH value of(CINI,in experimental group was higher than that in control group.CINII/CINIII and cervical squamous cell carcinoma group（4.68±0.27,4.73±0.26,4.74±0.21,4.88±0.33）were higher than those in control group（4.54±0.45）（P<0.01）.The pH value of vagina was also increased,the difference was statistically significant.（5）The results of microbiological examination showed that the infection rates of trichomonad in cervicitis group,CIN I、CIN II,CIN III and cervical squamous cell carcinoma were 2、2、4、2and 16.67respectively.The difference was statistically significant（χ²=22.12,P=0.03）.The infection rate of mycosis in cervicitis group,CIN II,CIN III and cervical squamous cell carcinoma were 1,2.3.and 2.3.3,respectively.The difference was statistically significant（χ²=22.12,P=0.03）.The infection rate of bacterial vaginosis in cervicitis group,CIN I CIN II,CIN III and cervical squamous cell carcinoma were11.13.16.13 and 16.67,respectively.The difference was statistically significant（χ²=22.12,P=0.03）.（6）Hydrogen peroxide（H₂O₂）:compared with the control group（cervicitis）,the negative rate of hydrogen peroxide in the experimental group（CINI CINII/CINIII and squamous cell carcinoma）was higher than that in the control group（P<0.001）,and there was significant difference between CINI,CIN II/CINIII and cervical squamous cell carcinoma.（7）The positive rate ofβ-glucuronidase（GUS）:in experimental group（CINI CINII/CINIII and squamous cell carcinoma）was higher than that in control group（P<0.001）,and the positive rate ofβ-glucuronidase in experimental group was significantly higher than that in control group（P<0.05）.There was significant difference between CINI,CIN II/CIN III and cervical squamous cell carcinoma.（8）The ratio of sialidase（SNa）:Compared with the control group（cervicitis）,the positive rate of sialidase（SNa）:in the experimental group（CINI CINII/CINIII and squamous cell carcinoma）was significantly higher than that in the control group（P<0.001）.（9）The ratio of leukocyte esterase（LE）:The positive rate of leukocyte esterase in CIN II/CIN III and cervical squamous cell carcinoma was higher than that in the control group and the CIN I group（P<0.001）,and there was no statistical difference between the CIN I and the cervicitis group.（10）The ratio of coagulase（GADP）:The positive rate of coagulase（GADP）:CIN II/CIN III and cervical squamous cell carcinoma was higher than that of control group（P<0.005）.There was no significant difference between CIN I and cervicitis group.Conclusion:（1）With the increase of age,smoking of husband,small age of first sexual intercourse,more times of pregnancy and childbirth,low family income may be the risk factors of cervical cancer.（2）The occurrence of cervical lesions was related to the increase of HR-HPV positive rate,and the positive rate of HPV in high grade cervical lesions and cervical squamous cell carcinoma was significantly higher.（3）The increase of PH value of vagina may promote the occurrence of cervical lesions,the imbalance of vaginal microecology may be the risk factor of cervical lesions,bacterial vaginosis,trichomoniasis vaginitis,vulvovaginal candidiasis may be related to the occurrence of cervical lesions.（4）The imbalance of five preenzyme factors in microecology may promote the development of cervical cancer in CIN.