Changes Of Vaginal Microenvironment And Correlation Of Immune Cytokines With Different Levels Of Cervical Lesions

Objective:To analyze the correlation between changes in vaginal microenvironment and different levels of cervical lesions,and to provide guidance for the prevention,control and early intervention of cervical lesions in clinical practice.Methods:A total of 127 patients with cervical lesions confirmed by histopathology(cervical coneectomy)at the gynecological clinic of our hospital during the period from 2018.01 to 2019.06 were selected as the research objects.Internal lesion group(47 cases,referred to as low-level group),high-grade squamous intraepithelial lesion group(62 cases,referred to as high-level group),cervical cancer group(18 cases),and 50 patients who were confirmed to have no cervical lesions during the same period Women as the reference group,and another 50 women with no cervical lesions in the same period as the reference group were selected as a reference group to conduct a controlled study to detect various indicators of the vaginal microenvironment of subjects in the cervical lesion group and the reference group,including pathogen infection,vagina The positive rate and cleanliness of microenvironmental factors,and the levels of vaginal immune cytokines(IL-4,IL-10,IL-12,CCL22)and HPV infection in each group were detected.Compare the inspection indicators of each group with the Spearman correlation analysis to describe the correlation between the observation indicators and the classification of cervical lesions,the indicators of vaginal microenvironment and the correlation between vaginal immune cytokines and HPV infection,and comprehensively evaluate the vaginal microenvironment Changes in correlation with different levels of cervical lesions.Results:(1)The detection rate of AV,trichomoniasis,and BV in each subgroup of the cervical lesion group was higher than that of the reference group,and the detection rate increased with the increase of the lesion level,and the difference was statistically significant(P<0.05);The detection rate of VVC in each subgroup of the lesion group was slightly higher than that of the reference group,but the difference was not statistically significant(P>0.05).The positive rates of vaginal microenvironmental factors LE,NAG,SNA,H2O2,and pH in each subgroup of the cervical lesion group were higher than those in the reference group,and the positive rates of each factor increased with the level of the lesion,and the pH values were higher than those in the reference group.It increased with the level of lesions,and the difference was statistically significant(P<0.05).The cleanliness of the vaginal eco-environment in each subgroup of the cervical lesion group is worse than that of the reference group.The proportion of patients with grades Ⅰ to Ⅱ is lower than the reference group,and the proportion of patients with grades Ⅲ to Ⅳ is higher than the reference group.The difference was statistically significant(P<0.05).(2)The levels of IL-4,IL-10,and CCL22 in each subgroup of the cervical lesion group were higher than those in the reference group.The higher the level of lesions,the higher the levels of IL-4,IL-10,and CCL22,and the IL-12 was lower than that in the reference group.The higher the IL-12 level,the lower the statistical significance(P<0.05).(3)The detection rate of low-risk and high-risk HPV infections in each subgroup of the cervical lesion group was higher than that of the reference group.The detection rate of low-risk HPV infection decreased with the level of cervical lesions,and the detection rate of high-risk HPV infection was lower.The output rate increased with the level of cervical lesions,and the difference was statistically significant(P<0.05).(4)Spearman correlation analysis confirmed that AV,trichomoniasis,BV,LE,H2O2,pH,cleanliness,HPV infection,IL-4,IL-10,IL-12,and CCL22 were all related to the classification of cervical lesions.Among them,H2O2,IL-12 had a negative correlation with the grade of cervical lesions,and other indicators had a positive correlation with the grade of cervical lesions(all P<0.001),while NAG and SNA had no correlation with the grade of cervical lesions(P>0.05).And AV,Trichomonas infection,BV,LE,H2O2,pH,and cleanliness are all related to HPV infection.AV,Trichomonas infection,BV,LE,NAG,SNA,H2O2,pH,and cleanliness are all immune cytokines(IL-4,IL-10,IL-12,CCL22)are closely related.Conclusion:Patients with cervical lesions have obvious changes in vaginal microenvironment,local vaginal cellular immune dysfunction,and HPV infection.All of the above changes are related to the level of cervical lesions.The more obvious the changes are,the more severe the cervical lesions are,and the higher the level is.In addition,changes in vaginal microenvironment are closely related to HPV infection and changes in immune cytokines.Changes in vaginal microenvironment will aggravate HPV infection,damage local immune function,and promote the development of cervical lesions.