阴道微生态异常与宫颈上皮内病变的相关性研究

Study on the correlation between vaginal microecology disorder and cervical lesions

目的探讨阴道微生态异常与宫颈上皮内病变的相关性。方法选取本院就诊同时行阴道微生态与宫颈活检患者888例,收集年龄、高危型人乳头瘤病毒(HR-HPV)、阴道微生态、孕产史、避孕方式、病理结果等临床资料,分析阴道微生态异常与子宫颈上皮内病变的相关性。结果 888例患者中,232例高级别宫颈鳞状上皮内病变(HSIL)中,前6位的HR-HPV型别分别为HPV16、58、33、52、31、18型,19例宫颈癌中前5位的型别分别为HPV16、18、33、45、58型。阴道炎与HR-HPV感染HSIL及以上病变(HSIL+)发生风险的OR值分别为1.631(95%CI:1.122~2.373)和4.865(95%CI:1.918~12.341),HPV16、18型增加发生HSIL+风险的OR值为7.456(95%CI:2.938~18.921),其他13种HPV高危型别增加的风险OR值为3.956(95%CI:1.546~10.122),差异均有统计学意义(P <0.05)。结论 HR HPV感染与阴道炎均能增加宫颈HSIL+的发病风险。

Objective To analyze the characteristics of vaginal microecology in patients with cervical lesions,and to explore the correlation between vaginal microecology disorder and cervical lesions. Methods From January 2015 to August 2019, a total of 888 cases of patients were enrolled,who have underwent the histopathological examination guided by colposcopy and vaginal microecology test in the meantime. The clinical data of age, HPV infection, vaginal microecology test,pregnancy and childbirth history, contraceptive method, and histopathology result were collected to analyze the correlation between them and cervical lesions. Results In 888 patients, the top 6 types of high grade squamous intraepithelial lesion(HSIL)were HPV16, 58, 33, 52, 31, 18, and the top 5 types of cervical cancer were HPV16, 18, 33, 45, 58, respectively. The risk of HSIL+ was increased by vaginitis and HR HPV infection, OR value was1.631(95%CI: 1.122 ~ 2.373) and 4.865(95%CI:1.918 ~ 12.341) respectively. The risk of HSIL+ increased by HPV16 and 18 was 7.456(95%CI: 2.938 ~ 18.921), other 13 high-risk HPV types had an increased risk OR of 3.956(95%CI: 1.546 ~ 10.122). The differences were statistically significant(P < 0.05). Conclusion Both HR HPV infection and vaginitis can increase the risk of HSIL +.