宫颈癌术后HPV持续感染者阴道微生态状况分析

The vaginal microecosystem in cervical cancer patients with persistent HPV infection after cervical cancer surgery

目的通过宫颈癌术后HPV持续感染者阴道微生态状况分析,探讨发病的特点,为恢复阴道微生态平衡,HPV转阴,提供治疗依据。方法对75例(肿瘤组)宫颈癌术后HPV持续感染者取阴道分泌物,并取50例绝经期体检妇女作为对照组。结果发现肿瘤组阴道微生态失调占72.0%,优势菌占50.7%,菌群密集度++^+++为46.7%,菌群多样性++^+++为42.7%,pH值≤4.5为28.0%;与对照组比较差异有统计学意义(P<0.05)。肿瘤组≤55岁组阴道优势菌占59.1%,与>55岁组比较差异有统计学意义(P<0.05),其余阴道菌群密集度、菌群多样性、pH、阴道微生态失调、VVC、BV差异无统计学意义。结论 (1)肿瘤组阴道微生态失调;(2)肿瘤组内>55岁组的阴道优势菌有更明显差异;(3)评价宫颈癌术后HPV持续感染阴道微生态的状况,对治疗纠正微生态,及HPV的转阴有重要的指导意义。

Objective To discuss the pathogenic characteristics and provide evidence for recovery of vaginal microecological balance and HPV treatment through analyzing the vaginal microecosystem in cervical cancer patients with persistent post-operative HPV infection. Methods 75 cervical cancer patients with persistent post-operative HPV infection were included, with 50 healthy postmenopausal women as the controls; their vaginal secretion specimens were dtected. Results The rate of vaginal microecosystem imbalance in Patient group was 72.0%; dominant bacteria accounted for 50.7%; 46.7% of patients showed level Ⅱ - Ⅲ of bac- teria concentration; 42.7% showed level Ⅱ - Ⅲ of bacteria diversity; pHi4.5 accounting for 28.0% ; all of which were significantly different compared with the control group （P〈0.05）. In patients not elder than 55 years, the dominant bacteria accounted for 59.1%, significantly different from that in patients elder than 55 years （P〈0.05）3 No significant differences were found in bacteria concentration, bacterial diversity, pH value, vaginal microecological imbalance, VVC and BV. Conclusion （1） Vaginal microecosystem imbal- ance exists in Patient group. （2） The dominant bacteria in the vagina of patients〉55 years showed obvious differences. （3） Evaluation of vaginal microeeosystem for persistent post-operative HPV infection in patients with cervical cancer has important guiding significance for recovery of vaginal microeeologieal balance and HPV treatment.