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生殖支原体感染与人类乳头瘤病毒感染、宫颈细胞病理学异常及宫颈癌之间的关联:一项系统评价与荟萃分析

Association between genital mycoplasmas infection and human papillomavirus infection, abnormal cervical cytopathology, and cervical cancer: a systematic review and meta-analysis.

作者信息

Ye Hui, Song Tiange, Zeng Xi, Li Lin, Hou Minmin, Xi Mingrong

机构信息

Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Number 20-9, Third Section of People's South Road, Chengdu, 610000, China.

West China School of Medicine, Sichuan University, Chengdu, 610000, China.

出版信息

Arch Gynecol Obstet. 2018 Jun;297(6):1377-1387. doi: 10.1007/s00404-018-4733-5. Epub 2018 Mar 8.

Abstract

BACKGROUND

Some studies demonstrated that female genital mycoplasmas play important roles in human papillomavirus (HPV) infection, abnormal cervical cytopathology, and cervical cancer. However, those results remained inconclusive. We aimed to perform a systematic review and meta-analysis to investigate the association between female genital mycoplasmas and those disorders.

METHODS

Computerized databases were comprehensively searched before 26 January 2017. Pooled odd radios (ORs) and correlative 95% confidence intervals (CIs) were adopted to evaluate the strength of association.

RESULTS

Our meta-analysis included 22 studies with 16,181 participants. Ureaplasma urealyticum and Ureaplasma parvum were associated with a significantly increased risk of overall HPV infection (OR 1.57, 95% CI 1.05-2.34; OR 3.02, 95% CI 2.10-4.33, respectively), and U. urealyticum and Mycoplasma genitalium were associated with a significantly increased risk of high-risk HPV infection (OR 1.37, 95% CI 1.05-1.80; OR 1.50, 95% CI 1.11-2.02, respectively). In addition, U. urealyticum, U. parvum, and Mycoplasma hominis were associated with a significantly increased risk of abnormal cervical cytopathology (OR 1.51, 95% CI 1.23-1.85; OR 1.41, 95% CI 1.10-1.80; OR 1.48, 95% CI 1.10-1.99, respectively).

CONCLUSION

We found that U. urealyticum and M. genitalium may increase the risk of high-risk HPV infection, while U. urealyticum, U. parvum, and M. hominis may increase the risk of abnormal cervical cytopathology.

摘要

背景

一些研究表明,女性生殖道支原体在人乳头瘤病毒(HPV)感染、宫颈细胞病理学异常及宫颈癌中发挥重要作用。然而,这些结果仍无定论。我们旨在进行一项系统评价和荟萃分析,以研究女性生殖道支原体与这些疾病之间的关联。

方法

在2017年1月26日前全面检索计算机化数据库。采用合并比值比(OR)和相关的95%置信区间(CI)来评估关联强度。

结果

我们的荟萃分析纳入了22项研究,共16181名参与者。解脲脲原体和微小脲原体与总体HPV感染风险显著增加相关(OR分别为1.57,95%CI为1.05 - 2.34;OR为3.02,95%CI为2.10 - 4.33),解脲脲原体和生殖支原体与高危型HPV感染风险显著增加相关(OR分别为1.37,95%CI为1.05 - 1.80;OR为1.50,95%CI为1.11 - 2.02)。此外,解脲脲原体、微小脲原体和人型支原体与宫颈细胞病理学异常风险显著增加相关(OR分别为1.51,95%CI为1.23 - 1.85;OR为1.41,95%CI为1.10 - 1.80;OR为1.48,95%CI为1.10 - 1.99)。

结论

我们发现解脲脲原体和生殖支原体可能增加高危型HPV感染风险,而解脲脲原体、微小脲原体和人型支原体可能增加宫颈细胞病理学异常风险。

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