1660例育龄女性高危型人乳头瘤病毒感染与阴道菌群异常的相关性

Association of high-risk human papillomavirus infection with vaginal dysbiosis in 1 660 reproductive-age women

目的研究高危型人乳头瘤病毒(HR-HPV)感染与阴道菌群异常的相关性,探讨阴道菌群在HR-HPV感染中的作用。方法分析2015年1月至2016年12月于中国医科大学附属盛京医院妇科门诊就诊的1660例宫颈细胞学(TCT)阴性育龄女性HRHPV感染、细菌性阴道病(BV)、滴虫阴道炎(TV)及外阴阴道假丝酵母菌病(VVC)的相关临床资料,根据结果分为HR-HPV阳性病例组228例,HR-HPV阴性对照组1432例。组间率的比较采用χ^(2)检验;非条件logistic回归分析HR-HPV感染与BV、TV、VVC的相关性。结果病例组单纯性BV感染率(23.7%,54/228)明显高于对照组(13.0%,185/1432,χ^(2)=20.451,P<0.001);BV与HR-HPV感染风险呈正相关(OR=2.18,95%CI:1.55~3.08)。TV、VVC与HR-HPV感染无相关性(P>0.05)。BV合并HPV感染者以HRHPV为主,占90.1%(64/71)。结论BV增加HR-HPV感染风险,可能促进宫颈癌变的过程。

Objective Persistent high-risk human papillomavirus infection is the cause of uterine cervical cancer(CC)and its precursor,i.e.,high-grade cervical intraepithelial neoplasm(CIN).The aim of this study was to investigate the association of high-risk human papillomavirus(HR-HPV)infection with vaginal dysbiosis,and to explore the role of vaginal microbiota in the process of HR-HPV infection.Methods A total of 1660 women with cervical cytology-negative(TCT),who visited the gynecologic clinic at Shengjing hospital of China Medical University from January 2015 to December 2016 were enrolled in this study.Clinical data related to HPV infection,bacterial vaginitis(BV),trichomonal vaginitis(TV)and vulvovaginal candidiasis(VVC)were retrieved.The case group included 228 HR-HPV positive patients,while the controls composed of 1432 HR-HPV negative women.The rates of each group were compared using the chisquare test,and the associations of HR-HPV infection with BV,TV,and VVC were analyzed using unconditional logistic regression.Results The prevalence of simple BV in the case group(23.7%,54/228)was obviously higher than that of the controls(13.0%,185/1432)(χ^(2)=20.451,P<0.001).Moreover,BV was positively related to the risk of HR-HPV infection(OR=2.18,95%CI:1.55-3.08).TV or VVC was not associated with HR-HPV infection(P>0.05).The majority of patients infected with HPV and BV were HR-HPV positive,accounting for 90.1%(64/71).Conclusion BV increases the risk of HR-HPV infection,which might contribute to the process of cervical carcinogenesis.