Meta Analysis And Systematic Review Of The Relationship Between Cervical Lesions,HPV And Vaginal Microenvironment

ObjectiveMeta-analysis system was used to evaluate the relationship between cervical lesions,HPV and vaginal microenvironment.MethodsPub Med,Webof Science,Cochrane and Embase databases were searched for relevant literatures published from 2016 to December 2020.According to the inclusion and exclusion criteria,the literature was screened and data were extracted.The design and quality of all studies were evaluated by Newcastle Ottawa scale(NOS).Meta analysis was performed by stata16 statistical software,and the literature was systematically evaluated.ResultsA total of 483 related articles were searched,including 8 research articles,3 by Meta analysis and 5 by systematic review.the overall relative risk of CST in HPV positive group compared with HPV negative group was0.93.the overall relative risk of CST in 95%CI:0.76-1.4),LSIL group compared with normal cytology group was 0.81(95%CI:0.58-1.13).The overall relative risk of CST in HSIL group and cervical cancer group was0.77(95%CI:0.47-1.28)and 1.26(95%CI:0.55-2.90),respectively.Begg and egger were used to detect the relative risk of CST in cervical cancer group and normal cytology group.It was found that there was publication bias in HPV positive group(P value of begg and egger were 0.067 and 0.247)and cervical cancer group(P value of begg and egger were 0.677 and 0.457respectively).Considering the insufficient number of samples,there was no publication bias in the other two groups.the overall results of sensitivity analysis of the four groups were robust,and the overall P values of the four groups were all greater than 0.1,which was not statistically significant,but CSTIV in HSIL group and cervical cancer group was statistically significant.There was significant difference in CSTIII between HPV positive group and LSIL group.Conclusion1.Cervical lesions and HPV are related to the increase of vaginal microbial diversity,to a certain extent,vaginal microbial diversity is increased.2.HPV infection may have an adverse risk to CSTIII,resulting in the increase of CSTIII type bacteria.3.LSIL is correlated with CSTIII type,while HSIL,cervical Cancer and CSTIV have influences.In addition,the CSTIV of forest plots from LSIL,HSIL to Cancer(RR values of the three groups were 1.23,1.69,2.17,respectively)shows that the RR value gradually increases,indicating an increased risk of adverse effects.This has certain guiding significance for early clinical diagnosis and intervention,but further large-scale studies are needed to confirm our findings.4.The RR value of CSTV increases with the progression of cervical lesions,and its adverse risk increases,but the sample size is small and the evidence is insufficient,which needs to be further studied.