Bacterial Vaginosis and Inflammatory Response Showed Association with Severity of Cervical Neoplasia in HPV-Positive Women
Bacterial Vaginosis and Inflammatory Response Showed Association with Severity of Cervical Neoplasia in HPV-Positive Women
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DOI：
10.1002/dc.23388
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发表时间：
2016-02-01
影响因子：
1.3
通讯作者：
Zeferino, Luiz Carlos
中科院分区：
文献类型：
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作者：
de Castro-Sobrinho, Jucara Maria;Rabelo-Santos, Silvia Helena;Zeferino, Luiz Carlos
阴道感染可能影响人乳头瘤病毒（HPV）感染的易感性和清除，慢性炎症与致癌有关。本研究旨在评估HPV感染妇女中细菌性阴道病（BV）和炎症反应（IR）与宫颈肿瘤严重程度之间的关系。使用PGMY 09/11引物扩增HPV DNA，并在211例接受转化区切除的妇女宫颈样本中使用反向线印迹杂交法进行基因分型。在巴氏染色涂片中评估细菌植物群，BV阳性定义为>20%的线索细胞。目前的炎症反应定义为在10003倍放大下每个视野中>= 30个中性粒细胞。年龄大于29岁（OR：1.91 95% CI 1.06-3.45），16和/或18型感染（OR：1.92 95% CI 1.06-3.47），与16和/或18型相关的单一或多重感染（OR：1.92 CI 95% 1.06-3.47），BV（OR：3.54 95%CI 1.62-7.73）和IR（OR：6.3395%CI 3.06-13.07）与宫颈癌病变的严重程度相关（CIN 2或更严重的诊断），而不吸烟则表现出保护作用（OR：0.51 95%CI 0.26-0.98）。在控制混杂因素后，BV（OR：3.90 95% CI 1.64-9.29）和IR（OR：6.43 95% CI 2.92-14.15）仍与宫颈癌病变的严重程度相关。细菌性阴道病和炎症反应与HPV阳性妇女宫颈肿瘤的严重程度独立相关，这似乎表明微环境与宫颈肿瘤的自然史有关。（C）2015 Wiley Periodicals，Inc.
Vaginal infections may affect susceptibility to and clearance of human papillomavirus (HPV) infection and chronic inflammation has been linked to carcinogenesis. This study aimed to evaluate the association between bacterial vaginosis (BV) and inflammatory response (IR) with the severity of cervical neoplasia in HPV-infected women. HPV DNA was amplified using PGMY09/11 primers and genotyping was performed using a reverse line blot hybridization assay in 211 cervical samples from women submitted to excision of the transformation zone. The bacterial flora was assessed in Papanicolaou stained smears, and positivity for BV was defined as >20% of clue cells. Present inflammatory response was defined as >= 30 neutrophils per field at 10003 magnification. Age higher than 29 years (OR: 1.91 95% CI 1.06-3.45), infections by the types 16 and/or 18 (OR: 1.92 95% CI 1.06-3.47), single or multiple infections associated with types 16 and/or 18 (OR: 1.92 CI 95% 1.06-3.47), BV (OR: 3.54 95% CI 1.62-7.73) and IR (OR: 6.33 95% CI 3.06-13.07) were associated with severity of cervical neoplasia (CIN 2 or worse diagnoses), while not smoking showed a protective effect (OR: 0.51 95% CI 0.26-0.98). After controlling for confounding factors, BV(OR: 3.90 95% CI 1.64-9.29) and IR (OR: 6.43 95% CI 2.92-14.15) maintained their association with the severity of cervical neoplasia. Bacterial vaginosis and inflammatory response were independently associated with severity of cervical neoplasia in HPV-positive women, which seems to suggest that the microenvironment would relate to the natural history of cervical neoplasia. Diagn. (C) 2015 Wiley Periodicals, Inc.