持续高危型HPV感染和妇女阴道微生态的关系研究
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摘要
目的探讨持续高危型人乳头瘤病毒(HPV)感染和妇女阴道微生态的关系。方法选择我院收治的高危型HPV感染患者1 586例,根据随访结果是否为持续高危型HPV感染分为持续感染组(n=292)和非持续感染组(n=1 294)。所有患者接受HPV分型及阴道微生态检查。结果 1 586例高危型HPV感染患者中包括持续性HPV感染患者292例,持续性HPV感染率为18.41%。持续感染组和非持续感染组HPV各亚型感染的构成比比较,差异无统计学意义(P>0.05)。持续感染组细菌性阴道病和混合性阴道炎比例显著高于非持续感染组,阴道微生态正常比例显著低于非持续感染组(P<0.05)。结论阴道微生态环境的改变特别是细菌性阴道病和混合性阴道炎与持续性高危型HPV感染密切相关,改善阴道微生态环境可能有助于降低持续性高危型HPV感染的发生率。
Objective To investigate the relationship between persistent high-risk human papillomavirus(HPV) infection and vaginal microecology in women. Methods A total of 1 586 patients with high risk HPV infection in our hospital were selected and divided into two groups according to the follow-up results: persistent high risk HPV infection group(n=292)and non-persistent infection group(n=1 294). All patients underwent HPV typing and vaginal microecological examination.Results A total of 1 586 cases of high-risk HPV infection including 292 patients with persistent HPV infection, and the persistent HPV infection rate was 18.41%. There was no significant difference in the proportions of HPV subtypes infection between persistent infection group and non-persistent infection group(P>0.05). The proportion of bacterial vaginosis and mixed vaginitis in persistent infection group were significantly higher than those in non-persistent infection group, and the normal ratio of vaginal microecology was significantly lower than that in non-persistent infection group(P <0.05).Conclusion The change of vaginal microecological environment, especially bacterial vaginosis and mixed vaginitis, it is closely related to persistent high-risk HPV infection. Improving vaginal microecological environment may help to reduce the incidence of persistent high-risk HPV infection.
Objective To investigate the relationship between persistent high-risk human papillomavirus(HPV) infection and vaginal microecology in women. Methods A total of 1 586 patients with high risk HPV infection in our hospital were selected and divided into two groups according to the follow-up results: persistent high risk HPV infection group(n=292)and non-persistent infection group(n=1 294). All patients underwent HPV typing and vaginal microecological examination.Results A total of 1 586 cases of high-risk HPV infection including 292 patients with persistent HPV infection, and the persistent HPV infection rate was 18.41%. There was no significant difference in the proportions of HPV subtypes infection between persistent infection group and non-persistent infection group(P>0.05). The proportion of bacterial vaginosis and mixed vaginitis in persistent infection group were significantly higher than those in non-persistent infection group, and the normal ratio of vaginal microecology was significantly lower than that in non-persistent infection group(P <0.05).Conclusion The change of vaginal microecological environment, especially bacterial vaginosis and mixed vaginitis, it is closely related to persistent high-risk HPV infection. Improving vaginal microecological environment may help to reduce the incidence of persistent high-risk HPV infection.
引文
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[11]WANG ZL,FU LY,XIONG ZA,et al.Diagnosis and microecological characteristics of aerobic vaginitis in outpatients based on preformed enzymes[J].Taiwan J Obstet Gyne,2016,55(1):40-44.
[12]何丽,黄琳娟,徐冬梅.妊娠期阴道微生态与阴道感染性疾病相关性的研究进展[J].中华医院感染学杂志,2015,25(16):3838-3840.
[2]WRIGHT TC,STOLER MH,BEHRENS CM,et al.Primary cervical cancer screening with human papillomavirus:end of study results from the ATHENA study using HPV as the first-line screening test[J].Gynecol Oncol,2015,136(2):189-197.
[3]HU Z,ZHU D,WANG W,et al.Genome-wide profiling of HPV integration in cervical cancer identifies clustered genomic hot spots and a potential microhomology-mediated integration mechanism[J].Nat Genet,2015,47(2):158.
[4]PETROSKY E,BOCCHINI JJ,HARIRI S,et al.Use of 9-valent human papillomavirus(HPV)vaccine:updated HPV vaccination recommendatio ns of the advisory committee on immunization practices[J].MMWR Morbid Mortal W,2015,64(11):300-304.
[5]BRANCA M,CIOTTI M,SANTINI D,et al.Activation of the ERK/MAP kinase pathway in cervical intraepithelial neoplasia is related to grade of the lesion but not to high-risk human papillomavirus,virus clearance,or prognosis in cervical cancer[J].Am J Clin Pathol,2015,122(6):902-911.
[6]ARROSSI S,THOUYARET L,HERRERO R,et al.Effect of self-collection of HPV DNA offered by community health workers at home visits on uptake of screening for cervical cancer(the EMA study):a population-based cluster-randomised trial[J].The Lancet Global Health,2015,3(2):e85-e94.
[7]CLIFFORD GM,TULLY S,FRANCESCHI S.Carcinogenicity of human papillomavirus(HPV)types in HIV-positive women:a meta-analysis from HPV infection to cervical cancer[J].Clin Infect Dis,2017,64(9):1228-1235.
[8]卢丹华,王颖楠,石展鹰,等.不同妊娠期孕妇人乳头瘤病毒感染情况及对母婴结局的影响[J].中华医院感染学杂志,2017,27(15):3552-3554.
[9]吴翠霞,张艳红,葛小花,等.高危型HPV感染与宫颈癌前病变与宫颈癌的相关性研究[J].中华医院感染学杂志,2016,26(11):2568-2570.
[10]ZHANG D,LI T,CHEN L,et al.Epidemiological investigation of the relationship between common lower genital tract infections and high-risk human papillomavirus infections among women in Beijing,China[J].PLoS One,2017,12(5):e0178033.
[11]WANG ZL,FU LY,XIONG ZA,et al.Diagnosis and microecological characteristics of aerobic vaginitis in outpatients based on preformed enzymes[J].Taiwan J Obstet Gyne,2016,55(1):40-44.
[12]何丽,黄琳娟,徐冬梅.妊娠期阴道微生态与阴道感染性疾病相关性的研究进展[J].中华医院感染学杂志,2015,25(16):3838-3840.