ABSTRACT
OBJECTIVE: To investigate the role of vaginal microbial metabolites and enzyme changes and high-risk human papillomavirus(HR-HPV)infection in cervical intraepithelial neoplasia(CIN)and their interaction effects.METHODS: From June 2014 to December 2014,demographic characteristics and CIN-related factors and cervical liquid-based cytology(TCT)examination results were collected from 40 000 community-based populations from two regions of Shanxi Province by the Second Hospital of Shanxi Medical University.Patients who meet the criteria for enrollment were further tested for vaginal microecology,HPV testing,and colposcopic and pathologic examination.A total of 782 cases with pathological diagnosis of CIN were chosen as the case group;1503 patients with normal pathological results were chosen as a control group.A multivariate logistic regression model was established to analyze the vaginal microbial metabolic enzymes cross-sectionally,then the association between vaginal microbial metabolic changes and CIN risk was evaluated.RESULTS: The expression of hydrogen peroxide(H2 O2),β-glucuronidase(GUS)and sialidase(SNA)was statistically correlated with CIN risk,and the odd ratios were 1.60(95% CI 1.30-1.96),1.58(95% CI 1.30-1.92),and 1.45(95% CI1.18-1.79),respectively.The expression of acetylglucosaminidase(NAG)and leukocyte esterase(LE)had no statistical association with CIN risk.Interaction analysis showed that there were positive multiplicative interactions among H2 O2,GUS,SNA and HR-HPV infections in the occurrence of CIN.CONCLUSION: Positive H2 O2,GUS,and SNA is associated with increased risk of CIN,and they have positive interaction with HR-HPV infection,which increases the risk of CIN.