Interaction between vaginal micro-environment alterations and HPV16 infection in cervical intraepithelial neoplasia / 中华流行病学杂志

ABSTRACT

Objective To explore the effect of vaginal micro-environment alterations and HPV1 6 infection and their interaction in the progression of cervical intraepithelial neoplasia.Methods The participants of this study came from the cervical lesions study cohort in Shanxi province,including 623 women with normal cervical (NC),303 patients with pathogenically diagnosed low-grade cervical intraepithelial neoplasia (CIN Ⅰ) and 93 patients with pathogenieally diagnosed high-grade cervical intraepithelial neoplasia (CIN Ⅱ/Ⅲ).The data of the demographic characteristics of the study subjects and factors related to cervical intraepithelial neoplasia were collected,and HPV16 infection were detected by using flow-through hybridization technology and H2O2,β-glucuronidase,clotting enzyme,neuraminidase and leucocyte esterase in vaginal secretions were detected by using the combined detection kit of aerobic vaginitis and bacterial vaginosis.pH value and vaginal cleanliness were also detected at the same time.The database was established and analyzed by SPSS statistical software (version 22.0).Results The HPV16 infection rate (trend x2=55.45,P＜0.001) and the abnormal rates of H2O2 (trend x2 =26.19,P＜0.001),pH (trend x2=5.06,P=0.024),vaginal cleanliness (trend x2=19.55,P＜0.001),β-glucuronidase (trend x2 =17.52,P＜0.001) and neuraminidase (trend x2 =14.90,P＜ 0.001) increased gradually along with the severity of cervical intraepithelial neoplasia,but the abnormal rates of clotting enzyme and leucocyte esterase showed no same trend.The results of GMDR model analysis showed that there was interaction between HPV16 infection and abnormalities of H2O2,β-glucuronidase,clotting enzyme and neuraminidase in CIN Ⅰ group,and the interaction between HPV16 infection and the abnormalities of vaginal cleanliness,H2O2,β-glucuronidase and neumminidase in CIN Ⅱ/Ⅲ group.Conclusion Our findings indicated that the vaginal micro-environment alterations and HPV1 6 infection could increase the risk of cervical intraepithelial neoplasia,and they might have an important synergistic effect in the progression of cervical intraepithelial neoplasia.