Vaginal Microflora Changes With HPV And Cervical Squamous Intraepithelial LesionRelated Research

OBJECTIVE:To analyze the correlation between cervical squamous intraepithelial lesions?SIL?at different levels with human papillomavirus?HPV?and vaginal microecological abnormalities,explore the vaginal microecological characteristics of patients who were HR-HPV 16 and/or 18 positive or negative,and investigate the effect of vaginal microecological changes on SIL course so as to provide references of early prevention,screening and treatment of cervical precancerous lesions and high-risk groups.Method:A retrospective analysis was performed on 400 women with sexual experience.They visited the Gynecological Outpatient Department of Baogang Hospital of Inner Mongolia between January 2018 and December 2019,where they had human papillomavirus?HPV?test,thin-prep cytologic test?TCT?and vaginal micro-ecological evaluation in the outpatient department.For patients whose TCT test report indicates“atypical squamous cell of undetermined significance?ASCUS?,pathological or more serious results and positive HR-HPV”,“ASCUS and pathological or more serious results”,“positive HR-HPV16”,or“positive HR-HPV18”,Colposcopy and Cervical Biopsy were performed.HR-HPV 16infection,HR-HPV 18 infection,electronic colposcopy and cervical biopsy were used for their examination.258 HPV-positive patients with SIL were selected for the research,including 135 cases of high squamous intraepithelial lesion?HSIL?of the cervix,123 cases of low squamous intraepithelial lesion?LSIL?of the cervix based on the pathology results.Among them,83 cases were HR-HPV 16 and/or HR-HPV 18positive,while 175 cases were HR-HPV 16 and/or HR-HPV 18 negative.There were142 HPV negative and TCT negative cases as the control.Statistics were collected on the types of HPV for comparing PH,hydrogen peroxide?H₂O₂?,leukocyte esterase?LE?,bacterial vaginitis?BV?,vulvovaginal candidiasis?VVC?and trichomonal vaginitis?TV?in combination with vaginal microecological functions between groups.Results:1.The comparison among the control group,LSIL group and HSIL group indicates significant statistical differences in terms of the mean age?P<0.05?,but shows no significant statistical differences in terms of gestation and delivery?P>0.05?.2.As for the HPV test results of patients with SIL,it can be seen that among 258 SIL patients,the most common types of HR-HPV involved 16,52,58,18 and 53,including 83 HPV16/18 positive cases and 175 HPV16/18 negative cases.3.As indicated by the comparison of vaginal micro-ecological functional indicators,it is found that there were significant statistical differences in PH value,positive H₂O₂ and positive LE rates between the control group,LSIL group and HSIL group?P<0.05?.4.4.Comparison of pathogen infection in control group with LSIL group and HSIL group,LSIL group and HSIL group shows that the incidence of BV increased with the progression of disease,and the difference of positive rate between the three groups was statistically significant?P<0.05?.There was no significant statistical difference in the incidence of TV and VCC among the three groups?P>0.05?.5.Comparison of the vaginal microecology between the HR-HPV 16/18 positive and negative groups indicates demonstrates that the difference in the incidence of BV was statistically significant?P<0.05?,and the difference in the incidence of PH value,H₂O₂,LE,TV,and VVC was not statistically significant.The results of univariate Logistic regression analysis suggested that BV was an independent influencing factor of HPV 16/18,and the OR value of BV was 2.316?95%CI 1.247-3.658?.Conclusion:1.Age may be a risk factor for SIL pathological progression.Among SIL patients from Baotou,the main types of HR-HP include type 16,followed by type52,58,18 and 53.2.Increased PH,abnormal lactobacillus and LE may be risk factors for cervical lesions.3.BV may be a risk factor in the transition from LSIL to HSIL,and BV is an independent risk factor for HR-HPV 16/18.