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子宫颈高级别鳞状上皮内病变治疗前后阴道微生物群分析

Analysis of vaginal microbiota before and after treatment of high-grade squamous intraepithelial lesions of the uterine cervix.

作者信息

Ventura Patrícia Mendonça, Guimarães Isabel Cristina Chulvis do Val, Velarde Luis Guillermo Coca, Fialho Susana Cristina Aidé Viviani, Ferreira Douglas Guedes, Fernandes Matheus Madureira, Machado Rafael Augusto Chaves

机构信息

Universidade Federal Fluminense NiteróiRJ Brazil Universidade Federal Fluminense, Niterói, RJ, Brazil.

出版信息

Rev Bras Ginecol Obstet. 2024 Dec 4;46. doi: 10.61622/rbgo/2024rbgo86. eCollection 2024.

Abstract

OBJECTIVE

HPV infection is considered the most common sexually transmitted virus today. The persistence of HPV is the main cause for the development of precursor lesions and cervical cancer. There are environmental and non-environmental factors that contribute to the persistence of the virus. Studies indicate a possible relationship between the vaginal microbiota (environmental factor) and the risk of high-grade cervical squamous intraepithelial lesions and cervical cancer. This study evaluates the association between the type of vaginal microbiota and the occurrence of high-grade squamous intraepithelial lesions of the cervix.

METHODS

Observational, longitudinal, prospective, and analytical studies carried out between 2019 and 2021, which evaluated the vaginal microbiota of patients diagnosed with high-grade cervical squamous intraepithelial lesion before and after treatment in two collections with an interval of 6 months, using scrapings and vaginal swabs.

RESULTS

In Group I (with lesions) 28 women participated and 29 in Group II (without lesions). According to Nugent, in the initial collection of Group I, 16 women (57%) had lactobacillary microbiota, eight (28%) intermediate, and four (14%) coccus. In Group II, twenty-one (75%) were lactobacillary, one (3%) was intermediate, and seven (24%) werecoccus. With p=0.03.

CONCLUSION

According to Nugent's criteria, there was an association between the type of vaginal microbiota and the occurrence of high-grade cervical squamous intraepithelial lesions of the cervix. The same was not observed in the Donders classification. Studies with a larger sample are needed to confirm our results.

摘要

目的

人乳头瘤病毒(HPV)感染被认为是当今最常见的性传播病毒。HPV持续感染是前驱病变和宫颈癌发生的主要原因。有环境和非环境因素导致该病毒的持续感染。研究表明阴道微生物群(环境因素)与高级别宫颈鳞状上皮内病变及宫颈癌风险之间可能存在关联。本研究评估阴道微生物群类型与宫颈高级别鳞状上皮内病变发生之间的关联。

方法

在2019年至2021年期间开展观察性、纵向、前瞻性和分析性研究,使用刮片和阴道拭子,对诊断为宫颈高级别鳞状上皮内病变的患者在治疗前后间隔6个月的两次采集样本中评估阴道微生物群。

结果

第一组(有病变)有28名女性参与,第二组(无病变)有29名女性参与。根据纽金特标准,在第一组的初始采集中,16名女性(57%)有乳酸杆菌微生物群,8名(28%)为中间型,4名(14%)为球菌型。在第二组中,21名(75%)为乳酸杆菌型,1名(3%)为中间型,7名(24%)为球菌型。p值为0.03。

结论

根据纽金特标准,阴道微生物群类型与宫颈高级别鳞状上皮内病变的发生之间存在关联。在东德斯分类中未观察到同样情况。需要更大样本量的研究来证实我们的结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e9b/11637450/3ef92021c138/1806-9339-rbgo-46-e-rbgo86-gf01.jpg

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