Peters N, Van Leeuwen A M, Pieters W J, Hollema H, Quint W G, Burger M P
Department of Obstetrics and Gynaecology, University Hospital, Groningen, The Netherlands.
Sex Transm Dis. 1995 Sep-Oct;22(5):296-302. doi: 10.1097/00007435-199509000-00005.
It has been suggested that bacterial vaginosis may play a role in the etiology of cervical neoplasia. The authors analyzed the prevalence, risk factors, and impact on histologic changes of bacterial vaginosis in women with cytological abnormalities of the uterine cervix.
Two-hundred-eighty women with dyskaryotic smears were surveyed. Using a questionnaire, data were obtained on smoking habits and sexual history. Bacterial vaginosis was the diagnosis if the vaginal discharge produced a fishy odor upon alkalinization and if clue cells were seen in the wet smear. Cervical scrapes were analyzed for the presence of human papillomavirus DNA, and cervical tissue specimens were analyzed for the presence and severity of (intraepithelial) neoplasia and the proliferation rate (mitotic index) of the lesion. Chlamydia trachomatis was identified by culture of an endocervical swab.
Bacterial vaginosis was found in 56 (20%) out of the 280 women. The presence of bacterial vaginosis was significantly associated with the number of cigarettes smoked per day, age at first sexual intercourse, the lifetime number of sexual partners, and current Chlamydia trachomatis infection. The number of cigarettes currently smoked per day and the lifetime number of sexual partners were independent significant risk factors for the presence of bacterial vaginosis. There was no relation between the presence of bacterial vaginosis and the human papillomavirus infection. Bacterial vaginosis did not influence the severity of the (intraepithelial) neoplasia or the mitotic index.
In women with dyskaryotic cervical smears, the prevalence of bacterial vaginosis did not seem to be increased, and bacterial vaginosis did not influence the histologic changes. Therefore, bacterial vaginosis is unlikely to be important in the etiology of cervical neoplasia, despite the similarity between its epidemiologic features and those of cervical human papillomavirus infection and cervical neoplasia.
有人提出细菌性阴道病可能在宫颈肿瘤的病因学中起作用。作者分析了宫颈细胞学异常女性中细菌性阴道病的患病率、危险因素及其对组织学变化的影响。
对280名核异质涂片的女性进行了调查。通过问卷获取吸烟习惯和性史的数据。如果阴道分泌物在碱化后产生鱼腥味且在湿涂片中可见线索细胞，则诊断为细菌性阴道病。分析宫颈刮片中是否存在人乳头瘤病毒DNA，并分析宫颈组织标本中（上皮内）肿瘤的存在情况和严重程度以及病变的增殖率（有丝分裂指数）。通过宫颈管拭子培养鉴定沙眼衣原体。
280名女性中有56名（20%）患有细菌性阴道病。细菌性阴道病的存在与每日吸烟量、首次性交年龄、性伴侣终生数量以及当前沙眼衣原体感染显著相关。当前每日吸烟量和性伴侣终生数量是细菌性阴道病存在的独立显著危险因素。细菌性阴道病的存在与人乳头瘤病毒感染之间没有关系。细菌性阴道病不影响（上皮内）肿瘤的严重程度或有丝分裂指数。
在宫颈核异质涂片的女性中，细菌性阴道病的患病率似乎没有增加，且细菌性阴道病不影响组织学变化。因此，尽管细菌性阴道病的流行病学特征与宫颈人乳头瘤病毒感染及宫颈肿瘤的特征相似，但细菌性阴道病在宫颈肿瘤病因学中不太可能起重要作用。
