Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy.
Anatomic Pathology Unit, Department of Advanced Biomedical Sciences, School of Medicine, University of Naples Federico II, Naples, Italy.
Pathol Res Pract. 2020 Dec;216(12):153234. doi: 10.1016/j.prp.2020.153234. Epub 2020 Oct 1.
Gardnerella vaginalis (GV) and Trichomonas vaginalis (TV) infections have been proposed as risk factors for persistence or progression of low-grade precancerous cervical lesions (CIN1/L-SIL). However, their role is still undefined. We aimed to assess if GV and TV infections affect the risk of persistence/progression of CIN1/L-SIL. A retrospective cohort study was performed to assess the risk of CIN1/L-SIL persistence or progression, persistence alone and progression alone in patients with GV and/or TV infections (GV + and/or TV+), only GV (GV+), only TV (TV+), or GV and TV coinfections compared to patients without these infections. Relative risk (RR) with 95 % confidence intervals (CI) was adopted (significant p-value>0.05). Two hundred and seventy patients were included. RR for CIN1/L-SIL persistence or progression was 1.63 in GV + and/or TV+ (p = 0.02), 1.99 in GV+ (p = 0.0008), 0.25 in TV+ (p = 0.32), 1.78 in coinfection (p = 0.26). RR for persistence was 1.55 in GV + and/or TV+ (p = 0.1), 2.179 in GV+ (p = 0.0013), 0.32 in TV+ (p = 0.41), 0.45 in coinfection (p = 0.55). RR for progression was 1.92 in GV + and/or TV+ (p = 0.22), 1.34 in GV+ (p = 0.68), 1.16 in TV+ (p = 0.91), 8.39 in coinfection (p = 0.0002). In conclusion, GV infection may be a risk factor for CIN1/L-SIL persistence. TV infection alone does not significantly affect the risk of persistence or progression of such lesions, while it may greatly increase the risk of progression when associated with GV infection.
阴道加德纳菌（GV）和阴道毛滴虫（TV）感染已被提议为低度癌前宫颈病变（CIN1/L-SIL）持续或进展的危险因素。然而，它们的作用仍未确定。我们旨在评估 GV 和 TV 感染是否会影响 CIN1/L-SIL 的持续/进展风险。进行了一项回顾性队列研究，以评估 GV 和/或 TV 感染（GV+和/或 TV+）、仅 GV（GV+）、仅 TV（TV+）或 GV 和 TV 合并感染患者与无这些感染患者相比，CIN1/L-SIL 持续或进展、持续存在和进展的风险。采用相对风险（RR）和 95%置信区间（CI）（显著 p 值>0.05）。共纳入 270 例患者。GV+和/或 TV+的 CIN1/L-SIL 持续或进展的 RR 为 1.63（p=0.02），GV+的 RR 为 1.99（p=0.0008），TV+的 RR 为 0.25（p=0.32），合并感染的 RR 为 1.78（p=0.26）。GV+和/或 TV+的持续存在的 RR 为 1.55（p=0.1），GV+的 RR 为 2.179（p=0.0013），TV+的 RR 为 0.32（p=0.41），合并感染的 RR 为 0.45（p=0.55）。GV+和/或 TV+的进展 RR 为 1.92（p=0.22），GV+的 RR 为 1.34（p=0.68），TV+的 RR 为 1.16（p=0.91），合并感染的 RR 为 8.39（p=0.0002）。总之，GV 感染可能是 CIN1/L-SIL 持续存在的危险因素。TV 感染单独不会显著影响此类病变的持续或进展风险，但当与 GV 感染相关时，可能会大大增加进展的风险。
