Correlation Study Between Vaginal Microecology And High-risk HPV Infection

Purposes High-risk HPV(HR-HPV)infection is an important inducing factor of cervical cancer.In recent years,with the increasing attention and in-depth research on HPV infection,the research on its correlation with vaginal microecological environment and related cytokines has drawn increasing attention.In this study,the relationship between HR-HPV infection and local vaginal cytokines was discussed,and the clinical significance of changing local vaginal microenvironment in the treatment of HR-HPV infection was discussed.1.To detect the changes in the expression levels of Th17/Treg-related cytokines in the vagina with HR-HPV infection,and to discuss the interaction between Th17/Treg-related cytokines and HR-HPV infection.2.Through the change of local vaginal microecological environment combined with antiviral treatment to treat persistent HR-HPV infection,to explore the clinical effectiveness of its treatment,and looking for effective clinical treatment method of HR-HPV infection.Methods 1.92 female patients with persistent infection of HR-HPV from September 2015 to June 2017 were selected and divided into three groups: group cervical CIN I,group cervical CIN II-III and cervical cancer group according to histopathological examination,31 healthy subjects were selected as control group.The load of HR-HPV virus was detected by HC-II;the expression levels of IL-17,IL-23,IL-6 and TGF-? in cervicovaginal lavage fluid were determined by enzyme-linked immunosorbent assay;Spearman method was used to analyze the correlation between the load of HR-HPV virus and the expression level of cytokines;ROC curve was used to analyze the predictive effect of combined detection of IL-17,IL-23,IL-6 and TGF-? on cervical HR-HPV infection.2.This subject adopts the matching design,prospective controlled clinical trial study methods,with the vaginal live lactobacillus capsules combined by human recombinant interferon gel of a combination therapy group,and human recombinant interferon gel of a single therapy group.Observe the effect of the treatment of patients of HPV patients with vaginitis,and of pure HPV patients,and determine the effect of the vaginal live lactobacillus capsules and interferon combination therapy of HPV infection;In addition,determine the effect of vaginal live lactobacillus capsules combined by interferon gel treatment regimen in pure HPV infection and HPV infection patients with vaginitis.Results 1.With the progression of cervical intraepithelial neoplasia,the viral load was on the rise(the number of people with viral load less than 100copies/ml gradually decreased(P<0.05),while the number of people with more than 1,000 copies/ml gradually increased(P<0.05));The expression of cytokines in the four groups increased significantly with the progression of cervical intraepithelial neoplasia.CIN II-III group and cervical cancer group were significantly higher than CIN I group(P<0.05)and control group(P<0.05);there was no significant difference in the levels of IL-17,IL-23,IL-6 and TGF-? between the infected HR-HPV subtypes(P>0.05);Logistic analysis showed that IL-17,IL-23,IL-6 and TGF-? levels were risk factors for cervical HR-HPV infection;Spearman analysis showed that HR-HPV load was positively correlated with the levels of cytokines IL-17,IL-23,IL-6 and TGF-?(r=0.612,0.513,0.597,0.519,P<0.05);ROC curve showed that the area under the ROC curve of IL-17,IL-23,IL-6 and TGF-? combined detection was 0.731(specificity was 81.2%,sensitivity was 76.3%).2.HR-HPV infection patients with vaginitis,respectively using vaginal live lactobacillus capsule combined by human recombinant interferon ?-2b gel and single human recombinant interferon ?-2b gel treatment,there was no significant difference in efficient ratio of both groups,but the conversion rate between the two groups was higher in the combined therapy group than in the single therapy group(P<0.05);No matter combined treatment or simple treatment,there was no difference in the effective rate and negative conversion rate to the patients with pure HR-HPV infection(P>0.05).No matter with or without vaginitis,there was no difference in the effective rate and conversion rate of HR-HPV infection in the combined treatment of the vaginal live lactobacillus capsules combined by human recombinant interferon gel(P>0.05).Conclusions 1.With the increase of cervical lesions,the load of HR-HPV increased,and the levels of IL-17,IL-23,IL-6,and TGF-? in vaginal local cytokines increased,showing a positive correlation.IL-17,IL-23,IL-6,and TGF-? may be predictors of persistent HPV infection in HR-HPV.2.Changes in local vaginal microenvironment can improve the ability of removing HR-HPV in the vaginal environment of the human body.Antiviral treatment for HR-HPV infection and the regulation of local vaginal microenvironment can help to remove HR-HPV in the vagina.