Wiik Johanna, Sengpiel Verena, Kyrgiou Maria, Nilsson Staffan, Mitra Anita, Tanbo Tom, Monceyron Jonassen Christine, Møller Tannæs Tone, Sjøborg Katrine
Department of Gynecology and Obstetrics, Østfold Hospital Trust, Kalnes, Norway.
Department of Obstetrics and Gynecology, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden.
BMC Womens Health. 2019 Feb 6;19(1):30. doi: 10.1186/s12905-019-0727-0.
Local treatment for cervical intraepithelial neoplasia (CIN) by Loop Electrosurgical Excision Procedure (LEEP) has been correlated with reproductive morbidity, while the cervicovaginal microbiota is also known to affect the risk of preterm delivery. CIN and treatment by LEEP might change the cervical microbiota. The main aim of this study was to describe the cervical microbiota before and after LEEP and assess its associaton with cone depth and HPV persistence. Further, we aimed to compare the microbiota to references with normal cervical cytology.
Between 2005 and 2007, we prospectively identified 89 women planned for LEEP in a Norwegian hospital and recruited 100 references with a normal cervical cytology. Endocervical swabs were collected prior to treatment and at six (n = 77) and 12 months (n = 72) post LEEP for bacterial culture and PCR, and post LEEP for DNA testing for human papillomavirus (HPV). We compared the cervical microbiota composition before and after treatment and between women planned for LEEP vs references.
There was a reduction in the number of non-Lactobacillus bacterial species six and 12 months after LEEP compared to before treatment and a tendency towards a concomitant increase in Lactobacillus. No association between the detection of cervical bacteria, HPV persistence or cone depth was found. Women planned for LEEP carried significantly more Bacteroides spp., Gardnerella vaginalis, Mycoplasma hominis and Ureaplasma parvum as well as a greater number of bacterial species than the references.
Local excisional treatment appears to alter the cervical microbiota towards a less diverse microbiota. Women with CIN have a more diverse cervical microbiota compared to women with normal cervical cytology.
宫颈环形电切术（LEEP）对宫颈上皮内瘤变（CIN）的局部治疗与生殖系统疾病相关，而宫颈阴道微生物群也会影响早产风险。CIN及LEEP治疗可能会改变宫颈微生物群。本研究的主要目的是描述LEEP术前、术后的宫颈微生物群，并评估其与锥切深度及人乳头瘤病毒（HPV）持续感染的相关性。此外，我们旨在将该微生物群与宫颈细胞学正常的对照者进行比较。
2005年至2007年期间，我们前瞻性地在挪威一家医院确定了89例计划接受LEEP治疗的女性，并招募了100例宫颈细胞学正常的对照者。在治疗前、LEEP术后6个月（n = 77）和12个月（n = 72）采集宫颈管拭子进行细菌培养和聚合酶链反应（PCR），并在LEEP术后进行HPV DNA检测。我们比较了治疗前后以及计划接受LEEP治疗的女性与对照者之间的宫颈微生物群组成。
与治疗前相比，LEEP术后6个月和12个月非乳酸杆菌属细菌种类数量减少，乳酸杆菌有增加趋势。未发现宫颈细菌检测、HPV持续感染或锥切深度之间存在关联。计划接受LEEP治疗的女性携带的拟杆菌属、阴道加德纳菌、人型支原体和微小脲原体数量显著多于对照者，且细菌种类更多。
局部切除治疗似乎会使宫颈微生物群向多样性更低的方向改变。与宫颈细胞学正常的女性相比，CIN女性的宫颈微生物群更为多样。
