人乳头瘤病毒感染情况、阴道微环境指标与宫颈病变的相关性分析

Correlation analysis of human papillomavirus infection,vaginal microenvironment index and cervical lesions

目的探讨人乳头瘤病毒(HPV)感染情况、阴道微环境指标与宫颈病变的相关性。方法选取2022年1月至2023年4月该院收治的307例宫颈病变患者作为研究对象,按照其液基细胞学检查(TCT)和病理检查结果分为低级别上皮内瘤变(LSIL)组(169例)、高级别上皮内瘤变(HSIL)组(97例)和宫颈癌组(SCC)(41例);另选取同期该院200例TCT结果正常无宫颈病变的健康体检者作为对照组。对所有研究对象进行HPV和阴道微环境检测。采用Spearman相关对宫颈病变严重程度与年龄的相关性进行分析。结果宫颈病变严重程度与年龄呈正相关关(r=0.306,P<0.05)。HPV感染率较高的型别依次为16、52、58、53型。LSIL组、HSIL组和SCC组HPV多重感染率均高于对照组,HSIL组和SCC组均高于LSIL组,差异均有统计学意义(P<0.05);SCC组HPV多重感染率与HSIL组比较,差异无统计学意义(P>0.05)。酸碱度(pH)、过氧化氢(H 2O 2)、白细胞酯酶(LE)异常比例均为SCC组>HSIL组>LSIL组>对照组,且SCC组、HSIL组和LSIL组与对照组比较,差异均有统计学意义(P<0.05)。阴道清洁度异常比例为SCC组>HSIL组>LSIL组>对照组,LSIL组阴道清洁度异常比例与对照组比较,差异无统计学意义(P>0.05),HSIL组和SCC组阴道清洁度异常比例与对照组比较,差异均有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,阴道pH>4.5、LE阳性、清洁度为Ⅲ°~Ⅳ°增加了宫颈病变发生的风险,H 2O 2阳性对宫颈病变的发生有抑制作用。结论HPV感染、阴道微环境指标异常改变与宫颈病变的发生和发展存在一定的相关性,可为临床预防和治疗宫颈病变提供参考依据。

Objective To investigate the correlation between human papillomavirus(HPV)infection,vaginal micro-environmental indicators and cervical lesions.Methods A total of 307 patients with cervical lesions admitted to the hospital from January 2022 to April 2023 were selected as the research objects.According to the results of liquid-based cytology(TCT)and pathological examination,they were divided into low grade intraepithelial neoplasia(LSIL)group(169 cases),high grade intraepithelial neoplasia(HSIL)group(97 cases)and cervical cancer(SCC)group(41 cases).In addition,200 healthy subjects with normal TCT results and no cervical lesions were selected as the control group.All subjects were tested for HPV and vaginal microenvironment.Spearman correlation was used to analyze the correlation between age and the severity of cervical cancer.Results The severity of cervical lesions was positively correlated with age(r=0.306,P<0.05).HPV infection rates were higher in 16,52,58 and 53 types.The multiple infection rates of HPV in LSIL,HSIL and SCC groups were higher than those in the control group,and those in HSIL and SCC groups were higher than those in LSIL group,the differences were statistically significant(P<0.05).There was no significant difference in HPV multiple infection rate between SCC group and HSIL group(P>0.05).The proportion of Ph value(pH),hydrogen peroxide(H 2O 2)and leukocyte esterase(LE)were SCC group>HSIL group>LSIL group>control group,and the 3 groups compared with control group,the differences were statistically significant(P<0.05).The proportion of abnormal vaginal cleanliness was SCC group>HSIL group>LSIL group>control group.There was no significant difference in the proportion of abnormal vaginal cleanliness between the LSIL group and the control group(P>0.05).The proportion of abnormal vaginal cleanliness in the HSIL group,SCC group and the control group were significantly different(P<0.05).Multivariate Logistic regression analysis showed that vaginal pH>4.5,LE positive,Ⅲ°-Ⅳ°cleanliness increased the risk of cervical lesions,H 2O 2 positive had inhibitory effect on the occurrence of cervical lesions.Conclusion HPV infection and abnormal changes of vaginal micro-environmental indicators are related to the occurrence and development of cervical diseases,which can provide reference for clinical prevention and treatment in cervical lesions.