阴道微生态变化与宫颈病变的相关性研究进展
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摘要
微生态是生物进化过程中,微生物与其宿主(人、动物、植物及微生物),微生物及微生物以及他们与环境由于长期相互适应形成的能独立进行物质、能量及基因相互交流的统一生物系统。最早于1977年由德国Volker Rush提出,女性阴道微生态是人类生殖道微生态系统的一部分,正常阴道微环境中,菌群多样性、密集性及比例等维持动态平衡,HPV检测通常是阴性。研究宫颈病变患者阴道分泌物发现乳杆菌检出率低于文献报道的正常妇女的检出率,而异常需氧菌的检出率高于正常妇女。高危型HPV的持续感染是导致宫颈病变的必要因素,但并非唯一因素,最新研究表明阴道微生态失衡在HPV感染及宫颈病变中发挥了重要的作用。现在可以假设,由于阴道菌群失调,阴道微生态的改变可能加重宫颈病变或阴道微生态的改变与HPV长期感染有关,故研究阴道微生态,阴道微生菌群变化与HPV感染以及宫颈病变的关系,对消除HPV感染发生从而预防宫颈病变的发生有积极的作用。
Micro-ecology is a unified biological system, which is formed by the microbes and hosts(humans,animals,plants and microbes), microorganisms and microorganisms, and their long-term interaction with the environment, and be able to exchange material,energy and genes independently. Put forward by German Volker Rush as early as 1977, women's vaginal microecology is part of the human reproductive tract micro-ecosystem. In the normal vaginal microenvironment, the diversity, concentration and proportion of the flora maintain a dynamic balance,and HPV testing is usually negative in it. Research found that The detection rate of lactobacilli in vaginal secretions of patients with cervical lesions was lower than that of normal women reported in the literature, and the detection rate of abnormal aerobic bacteria was higher than that of normal women. Sustained infection of high-risk HPV is a necessary factor for cervical lesions, but it is not the only factor. According to a new study, vaginal microecological imbalance plays an important role in HPV infection and cervical lesions. Due to vaginal flora imbalance, changes in vaginal microecology may aggravate cervical lesions or changes in vaginal microecology are related to long-term infection of HPV. The study on the relationship between vaginal microecology and changes in vaginal microbiome, HPV infection and cervical lesions has a positive effect on eliminating HPV infection and thus preventing the occurrence of cervical lesions.
Micro-ecology is a unified biological system, which is formed by the microbes and hosts(humans,animals,plants and microbes), microorganisms and microorganisms, and their long-term interaction with the environment, and be able to exchange material,energy and genes independently. Put forward by German Volker Rush as early as 1977, women's vaginal microecology is part of the human reproductive tract micro-ecosystem. In the normal vaginal microenvironment, the diversity, concentration and proportion of the flora maintain a dynamic balance,and HPV testing is usually negative in it. Research found that The detection rate of lactobacilli in vaginal secretions of patients with cervical lesions was lower than that of normal women reported in the literature, and the detection rate of abnormal aerobic bacteria was higher than that of normal women. Sustained infection of high-risk HPV is a necessary factor for cervical lesions, but it is not the only factor. According to a new study, vaginal microecological imbalance plays an important role in HPV infection and cervical lesions. Due to vaginal flora imbalance, changes in vaginal microecology may aggravate cervical lesions or changes in vaginal microecology are related to long-term infection of HPV. The study on the relationship between vaginal microecology and changes in vaginal microbiome, HPV infection and cervical lesions has a positive effect on eliminating HPV infection and thus preventing the occurrence of cervical lesions.
引文
[1]李响.阴道微生态平衡及其临床意义[J].吉林医学,2010,36(12).
[2]张为远.宫颈病变与宫颈癌[M].北京:人民卫生出版社,2012:79-87.
[3]PatelA,Galaal K, Burnley C,et al. Cervical cancer incidence in young women:a historical and geographic controlled UK regional population study[J].Br J Cancer,2012,106(11):1753.
[4]Forman D,de Martel C,Lacey CJ,et al. Global burden of human papillomavirus and related diseases[J].Vaccine,2012,30(5):12.
[5]Jemal A,Bray F,Center MM,et a1.Global cancer statistics[J].CA Cancer J Clin,2011,61(2):69-90.
[6]郑荣寿,张思维,吴良有,等.中国肿瘤登记地区2008年恶性肿瘤发病和死亡分析[J].中国肿瘤,2012,21(1):1-12.
[7]施晓,吕芸.宫颈微生态与宫颈疾病发生发展的相关性研究[J].中国现代医生,2013,51:120-122.
[8]唐金芝,高琨,李力.宫颈微环境改变与HPV感染对宫颈癌的影响[J].广西医科大学学报,2013,30(6):971-973.
[9]王鹏程,宋静慧.宫颈病变患者治疗前后阴道微生态变化与HPV感染的关系研究进展[J].中国妇产科临床杂志,2015,05(036):1672-1861.
[10]Seow SW,Rahmat JN,Mohamed AA,el al.Lactobacillus species is more cytotoxic to human bladder cancer cells than Mycobacterium Bovis(bacillus Calmette-Guerin)[J]. J Urol,2002,168(5):2236-2239.
[11]McNicol P, Paraskevas M, Guijon F,et al.Variability of polymerase chain reaction-based detection of human papillomavirus DNA is associated with the composition of vaginal microbial flora[J].Journal of Medical Virology,1994,43(2):194-200.
[12]Zhao FH,Forman MR,Belinson J,et al.Risk factors for HPVin-fection and cervical cancer among unscreened women in a high-risk rural area of China[J].International Journal of Cancer,2006.
[13]吴瑞芳,刘植华,乔友林,等.深圳女性生殖道人乳头瘤病毒感染与子宫颈上皮内瘤变现患率调查及子宫颈癌筛查方法的评价[J].中国医学科学院学报,2010(01).
[14]秦广益,陶敏芳.人乳头状瘤病毒感染及整合状态与子宫颈病变的关系[J].上海交通大学学报,2014,06.
[15]张倩,曹頔,马茜,等. 760名女性生殖道高危型人乳头瘤病毒感染自然转归规律及影响因素[J].中国医学科学院学报,2015,05.
[16]韩玉,艾桂娟,韩萍,等.阴道微生态与高危型人乳头瘤病毒感染和宫颈病变的相关性分析[J].中国计划生育和妇产科,2016,3(08):1674-4020.
[17]郑晶晶,宋静慧.阴道乳酸菌的微生态学研究进展[J].内蒙古医学院学报,2009,31(04):431-435.
[18]王新宇,梁圆,邓燕杰.阴道菌群改变与宫颈癌前病变相关性的初步研究[J].中国微生态学杂志,2018,30(05):588-593.
[19]张海琼,丁燕玲,蒋渝采,等.阴道微生态与生殖道疾病的相关性研究[J].医学综述,2017,23(21):4194-4198.
[20]Gillet E, Meys JF, Verstraelen H, et al. Association between bacterial vaginosis and cervical intraepithelial neoplasia systematic review and metaanalysis[J]. PLoS One,2012,7(10):e45201.
[21]Gillet E, Meys JF, Verstraelen H, et al. Bacterial vaginosis is associated with uterine cervical human papillomavirus infection:a meta-analysis[J].BMC Infect Dis,2011,11:10.1186/1471-2334.
[22]Al Rifai R, Nakamura K.Differences in Breast and Cervical Cancer Screening Rates in Jordan among Women from Different Socioeconomic Strata:Analysis of the 2012 Population-Based Household Survey[J]. APJCP issus,2015,16(15):6697-704.
[23]Choi Y, Roh J. Cervical cytopathological findings in Korean women with Chlamydia trachomatis, Mycoplasma hominis, and Ureaplasma urealyticuminfections[J].The Scientific WorldJournal, 2014, 2014.(16):756713.
[24]Picconi MA.Human papilomavirus detection in cervical cancer prevention[J].Medicina(B Aires),2013,73(6):585-596. Gadducci A,Guerrieri ME,Greco C,et al.Tissue biomarkers as prognostic variables of cervical cancer[J].Crit Rev Oncol Hemato 1,2013,86(2):104-129.
[25]赵丽霞,张晨,耿文.新疆地区51226例不同民族妇女宫颈病变检查结果分析[J].中国预防医学杂志,2012,13(7):322-325.
[26]SolomaonD.The1988BethesdaSystemforreportingcervical/vaginal cytological diagnoses[J]. National Cancer Institute Workshop. J AMA,1989,262(7):931-934.
[27]Wright TC, Ferenczy AF, Kurman RJ.2001 Consensus guidelines for the management of women with cervical cytological abnormalities[J].JAMA,2002,287(16):2120-2129.
[28]LeopoldGK,MyronRM.Koss’DiagnosticCytologyAndits Histopathologic Bases[J]. Lippincott Willims and Wilkins publisher. 5th Edition,2006:186-190.
[29]MatsuzakiT.Immunomodulationbytreatment with Lactobacillus casei strain Shirota[J].Int J Food Microbiol,1998,41(2):133-140.
[30]Takahashi T,Kushiro A,Nomoto K,et a1.Antitumor effects of the intravesical instillation of heat killed cells of the Lactobacillus casei strain Shirota on the murineorthotopicbladder tumorMBT-2[J].J Urol,2001,166(6):2506-2511.
[2]张为远.宫颈病变与宫颈癌[M].北京:人民卫生出版社,2012:79-87.
[3]PatelA,Galaal K, Burnley C,et al. Cervical cancer incidence in young women:a historical and geographic controlled UK regional population study[J].Br J Cancer,2012,106(11):1753.
[4]Forman D,de Martel C,Lacey CJ,et al. Global burden of human papillomavirus and related diseases[J].Vaccine,2012,30(5):12.
[5]Jemal A,Bray F,Center MM,et a1.Global cancer statistics[J].CA Cancer J Clin,2011,61(2):69-90.
[6]郑荣寿,张思维,吴良有,等.中国肿瘤登记地区2008年恶性肿瘤发病和死亡分析[J].中国肿瘤,2012,21(1):1-12.
[7]施晓,吕芸.宫颈微生态与宫颈疾病发生发展的相关性研究[J].中国现代医生,2013,51:120-122.
[8]唐金芝,高琨,李力.宫颈微环境改变与HPV感染对宫颈癌的影响[J].广西医科大学学报,2013,30(6):971-973.
[9]王鹏程,宋静慧.宫颈病变患者治疗前后阴道微生态变化与HPV感染的关系研究进展[J].中国妇产科临床杂志,2015,05(036):1672-1861.
[10]Seow SW,Rahmat JN,Mohamed AA,el al.Lactobacillus species is more cytotoxic to human bladder cancer cells than Mycobacterium Bovis(bacillus Calmette-Guerin)[J]. J Urol,2002,168(5):2236-2239.
[11]McNicol P, Paraskevas M, Guijon F,et al.Variability of polymerase chain reaction-based detection of human papillomavirus DNA is associated with the composition of vaginal microbial flora[J].Journal of Medical Virology,1994,43(2):194-200.
[12]Zhao FH,Forman MR,Belinson J,et al.Risk factors for HPVin-fection and cervical cancer among unscreened women in a high-risk rural area of China[J].International Journal of Cancer,2006.
[13]吴瑞芳,刘植华,乔友林,等.深圳女性生殖道人乳头瘤病毒感染与子宫颈上皮内瘤变现患率调查及子宫颈癌筛查方法的评价[J].中国医学科学院学报,2010(01).
[14]秦广益,陶敏芳.人乳头状瘤病毒感染及整合状态与子宫颈病变的关系[J].上海交通大学学报,2014,06.
[15]张倩,曹頔,马茜,等. 760名女性生殖道高危型人乳头瘤病毒感染自然转归规律及影响因素[J].中国医学科学院学报,2015,05.
[16]韩玉,艾桂娟,韩萍,等.阴道微生态与高危型人乳头瘤病毒感染和宫颈病变的相关性分析[J].中国计划生育和妇产科,2016,3(08):1674-4020.
[17]郑晶晶,宋静慧.阴道乳酸菌的微生态学研究进展[J].内蒙古医学院学报,2009,31(04):431-435.
[18]王新宇,梁圆,邓燕杰.阴道菌群改变与宫颈癌前病变相关性的初步研究[J].中国微生态学杂志,2018,30(05):588-593.
[19]张海琼,丁燕玲,蒋渝采,等.阴道微生态与生殖道疾病的相关性研究[J].医学综述,2017,23(21):4194-4198.
[20]Gillet E, Meys JF, Verstraelen H, et al. Association between bacterial vaginosis and cervical intraepithelial neoplasia systematic review and metaanalysis[J]. PLoS One,2012,7(10):e45201.
[21]Gillet E, Meys JF, Verstraelen H, et al. Bacterial vaginosis is associated with uterine cervical human papillomavirus infection:a meta-analysis[J].BMC Infect Dis,2011,11:10.1186/1471-2334.
[22]Al Rifai R, Nakamura K.Differences in Breast and Cervical Cancer Screening Rates in Jordan among Women from Different Socioeconomic Strata:Analysis of the 2012 Population-Based Household Survey[J]. APJCP issus,2015,16(15):6697-704.
[23]Choi Y, Roh J. Cervical cytopathological findings in Korean women with Chlamydia trachomatis, Mycoplasma hominis, and Ureaplasma urealyticuminfections[J].The Scientific WorldJournal, 2014, 2014.(16):756713.
[24]Picconi MA.Human papilomavirus detection in cervical cancer prevention[J].Medicina(B Aires),2013,73(6):585-596. Gadducci A,Guerrieri ME,Greco C,et al.Tissue biomarkers as prognostic variables of cervical cancer[J].Crit Rev Oncol Hemato 1,2013,86(2):104-129.
[25]赵丽霞,张晨,耿文.新疆地区51226例不同民族妇女宫颈病变检查结果分析[J].中国预防医学杂志,2012,13(7):322-325.
[26]SolomaonD.The1988BethesdaSystemforreportingcervical/vaginal cytological diagnoses[J]. National Cancer Institute Workshop. J AMA,1989,262(7):931-934.
[27]Wright TC, Ferenczy AF, Kurman RJ.2001 Consensus guidelines for the management of women with cervical cytological abnormalities[J].JAMA,2002,287(16):2120-2129.
[28]LeopoldGK,MyronRM.Koss’DiagnosticCytologyAndits Histopathologic Bases[J]. Lippincott Willims and Wilkins publisher. 5th Edition,2006:186-190.
[29]MatsuzakiT.Immunomodulationbytreatment with Lactobacillus casei strain Shirota[J].Int J Food Microbiol,1998,41(2):133-140.
[30]Takahashi T,Kushiro A,Nomoto K,et a1.Antitumor effects of the intravesical instillation of heat killed cells of the Lactobacillus casei strain Shirota on the murineorthotopicbladder tumorMBT-2[J].J Urol,2001,166(6):2506-2511.