Study On The Risk Factors Of Persistent HPV Infection And Its Relationship With Vaginal Inflammatory Factors And Microorganisms

Part Ⅰ:Risk factors of persistent HPV infectionBackground and purposeCervical cancer is one of the tumors with high mortality among women due to malignant tumors.the morbidity and mortality of cervical cancer are different in different regions.The incidence of cervical cancer is also different in different regions and races of our country.Persistent infection of human papillomavirus(Human papilloma virus,HPV)is considered to be an important factor in cervical cancer.Therefore,the risk factors of persistent HPV infection are concerned by more and more researchers.This study conducted a questionnaire and follow-up of women with persistent HPV infection in Zhengzhou to explore the risk factors of persistent HPV infection,hoping to lay a foundation for effective prevention of HPV infection and prevention and control of cervical cancer.MethodsA total of 1400 patients with HPV(+)detected by PCR+diversion hybridization method in the gynecology clinic of the third affiliated Hospital of Zhengzhou University from January 2017 to December 2018 were selected and followed up.1201patients were included in the valid questionnaire,with an effective rate of 85.7%.552patients who completed follow-up,revisit and complete data after 12 to 14 months were selected as the study subjects.ResultsThe 552 patients who were included in the study were tested for HPV again,of which 120 patients were still HPV(+).Univariateχ~2test analysis showed that age,history of cervical cancer and precancerous lesions,family history of cervical cancer,exposure to secondhand smoke for more than 6 months and contraceptive methods may be the factors affecting HPV persistent infection.The factors that might be related to HPV persistent infection in univariate analysis were included in the multivariate Logistics regression model,and no risk factors for high-risk HPV persistent infection were found.ConclusionAge,history of cervical cancer and precancerous lesions,exposure to secondhand smoke for more than 6 months,and contraceptive methods may be related factors of persistent HPV infection.Part Ⅱ: The relationship between HPV infection and the expression of IL-2,IL-12,IFN-γ,sIgA and microorganisms in vaginaBackground and purpose Cervical cancer is one of the most common cancers in women,its mortality accounts for the fourth among female malignant tumors,and the incidence is getting younger.Based on the large population base in China,more than 100000 women die of cervical cancer every year,which has become an important factor affecting women’s health.At present,it is considered that human papillomavirus(Human papilloma virus,HPV)is an important factor leading to cervical cancer.In this paper,the expression of cellular immune factors IL-2,IL-12,IFN-γ and sIgA in vagina of patients with HPV infection and the changes of vaginal microorganisms after HPV infection were studied to explore the relationship between HPV infection and vaginal inflammatory factors and microorganisms,so as to provide basis for the prevention of HPV infection and local treatment of vagina after HPV infection.Methods From October 2017 to March 2018,we collected 175 women who were positive for HPV by using the second generation hybrid capture method(Hybrid Capture 2,HC2).The exfoliated cells of their cervical cells were detected by Thin Prep2000 liquidbased thin layer cytology system(Cytyc Co.,USA).The diagnostic criteria were TBS report system 2014,and the results were divided into 4 groups.They were(No intraepithelial lesions or malignant lesions,NILM)without intraepithelial lesion or malignant lesion,atypical squamous cell(Atypical squamous cells of undetermined significance,ASCUS)with unknown significance,low-grade squamous intraepithelial lesion(Low-grade squamous intraepithelial lesion,LSIL),high-grade squamous intraepithelial lesion(High-grade squamous intraepithelial lesion,HSIL),and 62 healthy women with NILM/HPV(-)in the same period served as the control group.The vaginal cleanliness,fungal,BV and trichomonas infection were detected under microscope,and the expression of IL-2,IL-12,IFN-γ and sIgA in the vagina was detected by enzyme-linked immunosorbent assay(ELISA).All statistical methods were analyzed using SPSS 19.0.Results 1.Compared with the control group,the vaginal cleanliness of the experimental group was decreased(P < 0.05),there was no significant difference between the experimental groups.2.Compared with the control group,the positive rates of LSIL/ HPV(+)and HSIL/ HPV(+)BV were 20.83% and 33.33% respectively,but there was no significant difference between NILM/HPV(+)group and ASCUS/ HPV(+)group.3.Compared with the control group,the positive rates of fungi in ASCUS/ HPV(+)group,LSIL/ HPV(+)group and HSIL/ HPV(+)group were 16.00%,16.67% and 22.22%,respectively,but there was no significant difference in NILM/HPV(+)group.There was no significant difference among ASCUS/ HPV(+)group,LSIL/ HPV(+)group and HSIL/ HPV(+)group.4.Compared with the control group,the positive rate of trichomoniasis in the experimental group had no significant difference(P < 0.05),and there was no significant difference between the experimental groups(P < 0.05).5.Compared with the control group,the expression of IL-2 in ASCUS/ HPV(+)group,LSIL/ HPV(+)group and HSIL/ HPV(+)group decreased,but the expression of NILM/HPV(+)had no significant difference.The expression of IL-2 in vagina decreased gradually with the aggravation of cervical lesions among ASCUS/ HPV(+)group,LSIL/ HPV(+)group and HSIL/ HPV(+)group.6.Compared with the control group,the expression of sIgA in vagina was significantly decreased in all experimental groups.Compared with ASCUS/ HPV(+)group,the expression in LSIL/HPV(+)group was significantly lower than that in LSIL/HPV(+)group.There was no significant difference between NILM/HPV(+)and ASCUS/ HPV(+)groups,and there was no significant difference between LSIL/HPV(+)and HSIL/HPV(+)groups.7.Compared with the control group,the expression of IFN-γ in NILM/HPV(+)group and ASCUS/ HPV(+)group increased,while that in LSIL/ HPV(+)group and HSIL/ HPV(+)group decreased(P < 0.05).The expression level of ASCUS/ HPV(+)group was higher than that of NILM/HPV(+)group,but there was no significant difference between LSIL/ HPV(+)group and HSIL/ HPV(+)group.8.Compared with the control group,the expression of IL-12 in ASCUS / HPV(+)group,LSIL/ HPV(+)group and HSIL/ HPV(+)group decreased,but there was no significant difference in NILM/HPV(+)group.There was no significant difference among ASCUS/HPV(+)group,LSIL/ HPV(+)group and HSIL/ HPV(+)group.Conclusion BV,fungal infection and abnormal vaginal cleanliness were synergistic factors of HPV infection.The expression of immune factors IL-2,IL-12 and sIgA was negatively correlated with the degree of cervical lesion after HPV infection.