| Objective:To compare and analyze changes in vaginal microecology of patients with cervical cancer after different treatments such as surgery,radiotherapy and chemotherapy,and to explore the clinical significance of vaginal microecology evaluation system for the treatment and follow-up of patients with cervical cancer.Methods:140 patients with the FIGO staging of IA-IIA cervical cancer who were treated in our hospital from October 2018 to December 2020 were selected as the research objects.According to the specific treatment methods of the patients,they were divided into surgery alone group,surgery+radiotherapy In the chemotherapy group,70 patients were enrolled in each group.At the time of initial treatment,3 months after surgery,and 3 months after surgery+radiotherapy and chemotherapy,vaginal flora density,flora diversity,dominant bacteria,lactobacillus grade,H2O2,PH value,cleanliness,leukocyte esterase,Sialidase,AV,BV,VVC and other items were tested,and the changes in the vaginal microecological environment of cervical cancer patients after different treatments such as surgery,radiotherapy and chemotherapy were compared and analyzed.In addition,70 healthy women who underwent physical examination in our hospital during the same period were selected as the control group to detect the corresponding vaginal microecological indicators.Analyze and compare the differences in various indicators of vaginal microecology among the three groups of patients.Results:①In the physical examination group,60 cases of vaginal flora density were II-III,accounting for 85.71%;bacterial diversity was Ⅱ-Ⅲ,53 cases,accounting for 75.71%;the dominant bacteria was Gram-positive large bacilli,59 cases,Accounted for 84.29%;52 cases with Lactobacillus grade I-IIa,accounting for 74.29%;23 cases with PH≤4.5,accounting for 32.86%;27 cases with cleanliness Ⅰ-Ⅱ,accounting for 38.57%;sialidase negative There were 39 cases,accounting for 55.71%;the BV infection rate was 18.57%,and the AV infection rate was 14.29%.Compared with the surgery group and the surgery+radio-chemotherapy group before treatment,the differences of these indexes were statistically significant(p<0.05).The preoperative vaginal flora density of patients in the surgical group was Class Ⅱ-Ⅲ,with 42 cases,accounting for 60.00%;the dominant bacteria were Gram-positive bacteria,with 33 cases,accounting for 47.14%;Lactobacillus was classified as ClassⅠ-Ⅱa,with 22 cases,Accounting for 31.43%;BV infection rate was 44.29%.These indicators were compared with those in the surgery+radiotherapy and chemotherapy group before treatment,and the differences were statistically significant(p<0.05).② In the simple operation group,33 cases of vaginal dominant bacteria were Gram-positive large bacteria,accounting for 47.14%;22 cases of Lactobacillus gradeⅠ-Ⅱa,accounting for 31.43%;cleanliness of Ⅰ-Ⅱ,10 cases,Accounting for 14.29%;BV infection rate was 44.29%.Compared with postoperatively,the differences in these indexes were statistically significant(p<0.05).③Before treatment,there were 10 cases of vaginal lactobacillus in the surgery+radio-chemotherapy group as Ⅰ-Ⅱa,accounting for 14.29%.After treatment,there were 3 cases,accounting for 4.28%.The difference between the two is statistically significant(p<0.05).④In the surgery-only group,there were 12 cases of Lactobacillus grade Ⅰ-Ⅱa,accounting for 17.14%;51 cases of sialidase negative,accounting for 72.86%;6 cases of hydrogen peroxide negative,accounting for 8.57%.These indexes were significantly different from those in the surgery+radiotherapy and chemotherapy group after treatment(p<0.05).⑤In the operation-only group,there were 15 cases with reserved ovaries and 55 cases with ovariectomy.In patients with ovarian preservation,9 cases of vaginal dominant bacteria were Gram-positive large bacteria,accounting for 60.00%;Lactobacillus was graded Ⅰ-Ⅱa in 6 cases,accounting for 40%;PH≤4.5 had 3 cases,accounting for 20.00%;BV The infection rate was 33.33%,and the AV infection rate was 26.67%.Compared with the patients with ovariectomized,the differences in these indicators were statistically significant(p<0.05).⑥In the surgery+radio-chemotherapy group,there were 17 cases of ovarian preservation and 53 cases of ovariectomy.There was no significant difference in vaginal microecological indicators between the two groups after treatment.(p>0.05).Conclusions:① Compared with normal healthy people,patients with cervical cancer have obvious vaginal microecological disorders.It shows that vaginal microecology is closely related to the occurrence and development of cervical cancer,and microecology is an important synergistic carcinogenic factor.②Compared with the patients in the surgery-only group,the patients in the surgery+radio-chemotherapy group had a higher degree of vaginal microecological disorder before treatment.It shows that there may be a certain correlation between the vaginal microecology and the condition and prognosis of cervical cancer.The more severe the microecological disorder,the more severe the condition and the worse the prognosis.③Different treatment methods such as surgery,radiotherapy and chemotherapy will further damage the vaginal microecology of patients.Therefore,it is necessary to pay attention to the status of vaginal microecological disorders in patients with cervical cancer after treatment,appropriate application of probiotics to correct the microecological disorders,and to rebuild the vaginal microecological balance.④Reserving the ovaries may have a certain degree of positive significance in restoring the vaginal microecological balance of patients,indicating that the body’s endocrine function has a certain degree of protective effect on the vaginal microecological. |
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