宫颈癌对阴道内环境及常见菌群的影响

The Effect of Cervical Cancer on Vaginal Environment and Common Flora

目的比较正常人群与宫颈癌人群阴道内环境及常见菌群的差异性,为预防和诊断宫颈癌提供一种新型的标志物或手段。方法采用病例对照研究方法进行配对样本量设计,选取经过病理检查确诊的50名宫颈癌患者,按照年龄、文化程度、收入水平、婚姻及性生活情况进行配对选取50名健康体检者,共同采集阴道内分泌物样本,利用五联检试剂及非厌氧的菌群培养方式检测阴道内环境及阴道内常见菌群,数据分析采用t检验或卡方检验。结果宫颈癌组的PH值为(4.8±0.03),明显高于对照组的(4.0±0.03)。乳酸杆菌、霉菌、滴虫在宫颈癌患者中的检出率分别为88%、74%和42%,与对照组比较都存在统计学差异;但在革兰阴性菌和革兰阳性菌的对比上无明显差异性。在宫颈癌患者和健康人群中都可检出大肠埃希菌、产酸克雷伯菌、表皮葡萄球菌、粪肠球菌和尿肠球菌,但宫颈癌患者中检出的特殊类型的菌种有奇异变形杆菌、阴沟肠杆菌和易变微球菌等。宫颈癌患者革兰氏阴性菌需氧菌群多样性指数低于对照组,但革兰氏阳性菌需氧菌群多样性却高于对照组。结论宫颈癌患者阴道PH值较正常人群明显升高,且不同微生物的检出比例和菌群多样性与正常人群存在明显不同。

Objective To compare the differences of vaginal environment and common flora between cervical cancer patients and healthy patients,and provide a new indicator or method in preventing and curing cervical cancer. Methods A casecontrol study was conducted in all 50 cervical cancer patients and 50 paired healthy patients. The paired criteria were age,degree of education,income,marriage and sexual life. The vaginal environment and common flora were detected and analyzed by 5 inspection reagents and non-anaerobic bacteria culture. T test and χ2test were used to compare the differences between the 2 groups. Results PH value( 4. 8 ± 0. 03) in cervical cancer patients was higher than that( 4. 0 ± 0. 03) in healthy patients. The detection rate of lactic acid bacillus,mould and trichomonad were 88%,74%,42% respectively,which showed significant differences between the 2 groups. However,there were no differences in gram-positive aerobic bacteria and gram-negative aerobic bacteria between the 2 groups. The common floras in both groups were E. coli,klebsiella oxytoca,staphylococcus epidermidis,enterococcus faecalis and enterococcus faecium. But some unique types of bacteria were also found in cervical cancer patients,such as bacillus milabilis,enterobacter cloacae,micrococcus varians et al. The Shannon index of gram-negative bacteria in cervical cancer patients was lower than that of the control group,but showed higher values in Shannon index of gram-positive bacteria. Conclusion Vaginal PH value in cervical cancer patients is much higher than the healthy patients. There has significant difference in vaginal environment and diversity of bacteria between cervical cancer patients and healthy patients.