| Objective:To analyze the correlation between vaginal microenvironment disorder and high-risk human papilloma virus(HR-HPV)and cervical lesions.Methods:410 female patients were selected as the research objects,who attended the Department of Obstetrics and Gynecology of Handan Central Hospital from September2019 to September 2020,met the inclusion and exclusion criteria and had HPV genotype testing,including 210 HR-HPV positive patients and 200 HR-HPV negative patients.All patients were tested for cervical fluid-based thinprep cytologic test(TCT),vaginal microenvironmental factors,vaginal pathogens,and vaginal local immune factors.Colposcopy was performed for patients with positive cytology results or positive HR-HPV results of HPV16 and HPV18.Cervical biopsy was performed under colposcopy.According to the pathological results,the included patients were divided into four groups: 110 cases of normal cervical(NC),187 cases of low-grade squamous intraepithelial lesions(LSIL),66 cases of high-grade squamous intraepithelial lesions(HSIL),and 47 cases of cervical squamous cell carcinoma(CSCC).The differences of vaginal microenvironment,pathogens infection,local immune factors IL-2 and IL-10 between HR-HPV positive and negative groups were retrospectively analyzed.And we also compared the differences of HR-HPV infection,vaginal microenvironment,pathogens infection,local immune factors IL-2 and IL-10 in different cervical lesions groups.Results:(1)The results of vaginal microenvironment detection showed that the leukocyte esterase(LE)and sialidase activity(SNA)of HR-HPV positive group were higher than those of HR-HPV negative group,and the differences were statistically significant(P<0.05).(2)The results of vaginal pathogen detection showed that the infection of ureaplasma urealyticum,trichomonas and Candida in HR-HPV positive group were higher than those in HR-HPV negative group,and the differences were statistically significant(P<0.05).(3)Logistic regression analysis showed that LE and SNA were positively correlated with HR-HPV infection(P<0.05).(4)Among 410 cases,210 patients were HR-HPV positive,accounting for 51.22%,while 200 patients were HR-HPV negative,accounting for 48.78%.The infection rates of HR-HPV in different pathological groups were 16.36% in NC group,48.66% in LSIL group,87.88% in HSIL group and 91.49% in CSCC group.(5)The most commonly infected HPV subtypes were mainly the following four types: HPV-16(58 cases,27.62%),HPV-52(49 cases,23.33%),HPV-18(23 cases,10.95%),HPV-58(19 cases,9.05%),and other types(61 cases,29.05%).(6)The results of vaginal local immune factor detection showed that there were statistically significant differences in the concentration of immune factors between patients with cervical lesions and NC patients in HR-HPV positive group and HR-HPV negative group(P<0.05).The expression of IL-2 decreased and the expression of IL-10 increased with the increase of lesion degree.Comparison of the expression of immune factors between HR-HPV groups showed that the expression of IL-2 in the positive group was higher than that in the negative group(P<0.05),but there was no significant difference in IL-10 expression between the two groups(P>0.05).(7)The degree of vaginal microenvironment disorder increased with the severity of cervical lesions(P<0.05).(8)The infection rates of vaginal ureaplasma urealyticum,trichomonas,Candida and bacteria increased with the increase of the severity of cervical lesions,and the differences were statistically significant(P<0.05).Conclusion:(1)There was a positive correlation between vaginal microenvironment disorder and pathogen infection and HR-HPV susceptibility.(2)HR-HPV infection is closely related to vaginal microenvironment disorder,microbial infection,abnormal local immune factors and cervical lesions.(3)HR-HPV infection,vaginal microenvironment disorder,pathogen infection and local immune factor change have early warning effect on the occurrence and progression of cervical lesions. |
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