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阴道微生态、人乳头瘤病毒感染与宫颈上皮内瘤变关系的荟萃分析

A meta-analysis of the relationship between vaginal microecology, human papillomavirus infection and cervical intraepithelial neoplasia.

作者信息

Liang Yuejuan, Chen Mengjie, Qin Lu, Wan Bing, Wang He

机构信息

The Department of Gynecological of Guangxi Medical University Cancer Hospital, Nanning City, 530021 Guangxi Zhuang Autonomous Region China.

出版信息

Infect Agent Cancer. 2019 Oct 26;14:29. doi: 10.1186/s13027-019-0243-8. eCollection 2019.

Abstract

Microecology is an emerging discipline in recent years. The female reproductive tract is an important microecological region, and its microecological environment can directly affect women's cervical health. This meta-analysis aimed to analyze the effects of vaginal microecology on Human papillomavirus (HPV) infection and cervical intraepithelial neoplasia (CIN). PubMed and Web of Science were systematically searched for eligible publications from January 2000 to December 2017. Articles were selected on the basis of specific inclusion and exclusion criteria. The design and quality of all studies were evaluated using the Newcastle-Ottawa Scale (NOS). Odds ratios (ORs) with a 95% confidence interval (95% CI) were calculated. Thirteen eligible studies were selected to evaluate the association of vaginal microecology with HPV infection and CIN. The factors related to HPV infection were bacterial vaginosis (BV) (OR 2.57, 95% CI 1.78-3.71, P<0.05), (VVC) (OR 0.63, 95% CI 0.49-0.82,  < 0.05), Chlamydia trachomatis (CT) (OR 3.16, 95% CI 2.55-3.90,  < 0.05), and Ureaplasma urealyticum (UU) (OR 1.35, 95% CI 1.20-1.51,  < 0.05). BV was also related to CIN (OR 1.56, 95% CI 1.21-2.00,  < 0.05). This meta-analysis of available literature suggested an intimate association of vaginal microecology and HPV infection with CIN. BV, CT and UU were associated to increased HPV infection, VVC was associated to decreased HPV infection, Lactobacillus is not associated to increased HPV infection, BV was associated to increased CIN development risk. Further large-scale studies are needed to confirm our findings.

摘要

微生态学是近年来新兴的一门学科。女性生殖道是一个重要的微生态区域,其微生态环境可直接影响女性的宫颈健康。本荟萃分析旨在分析阴道微生态对人乳头瘤病毒(HPV)感染和宫颈上皮内瘤变(CIN)的影响。系统检索了PubMed和Web of Science数据库,以查找2000年1月至2017年12月期间符合条件的出版物。根据特定的纳入和排除标准选择文章。使用纽卡斯尔-渥太华量表(NOS)评估所有研究的设计和质量。计算了比值比(OR)及其95%置信区间(95%CI)。选择了13项符合条件的研究来评估阴道微生态与HPV感染及CIN之间的关联。与HPV感染相关的因素有细菌性阴道病(BV)(OR 2.57,95%CI 1.78 - 3.71,P<0.05)、外阴阴道假丝酵母菌病(VVC)(OR 0.63,95%CI 0.49 - 0.82,P<0.05)、沙眼衣原体(CT)(OR 3.16,95%CI 2.55 - 3.90,P<0.05)和解脲脲原体(UU)(OR 1.35,95%CI 1.20 - 1.51,P<0.05)。BV也与CIN相关(OR 1.56,95%CI 1.21 - 2.00,P<0.05)。对现有文献的这一荟萃分析表明,阴道微生态和HPV感染与CIN密切相关。BV、CT和UU与HPV感染增加相关,VVC与HPV感染减少相关,乳酸杆菌与HPV感染增加无关,BV与CIN发生风险增加相关。需要进一步的大规模研究来证实我们的发现。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9e91/6815368/2324fcca2f41/13027_2019_243_Fig1_HTML.jpg

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