Abstract
BackgroundEvidence suggested that vaginal microbiome played a functional role in the progression of cervical lesions in female infected by HPV. This study aimed at evaluating the influence of common vaginal infection on the carcinogenicity of high risk HPV (hr-HPV).MethodsFrom January 15, 2017 to December 31, 2017, 310,545 female aged at least 30 years old had been recruited for cervical cancer screening from 9 clinical research centers in Central China. All the recruited participants received hr-HPV genotyping for cervical cancer screening and vaginal microenvironment test by a high vaginal swab. Colposcopy-directed biopsy was recommended for female who were infected with HPV 16 and HPV 18, and other positive hr-HPV types through test had undertaken triage using liquid-based cytology, cases with the results ≥ ASCUS among them were referred to colposcopy directly, and cervical tissues were taken for pathology examination to make clear the presence or absence of other cervical lesions.ResultsAmong 310,545 female, 6067 (1.95%) were tested with positive HPV 16 and HPV 18, 18,297 (5.89%) were tested with other positive hr-HPV genotypes, cervical intraepithelial neoplasia (CIN) 1, CIN 2, CIN 3 and invasive cervical cancer (ICC) were detected in 861 cases, 377 cases, 423 cases, and 77 cases, respectively. Candida albicans and Gardnerella were not associated with the detection of cervical lesions. Positive trichomonas vaginitis (TV) was correlated with hr-HPV infection (p < 0.0001). Co-infection with TV increased the risk of CIN 1 among female infected with hr-HPV (OR 1.18, 95% CI: 1.42–2.31). Co-infection with TV increased the risk of CIN 2–3 among female infected with HPV 16 (OR 1.71, 95% CI: 1.16–2.53).ConclusionsCo-infection of TV and HPV 16 is a significant factor for the detection of cervical lesions.
Highlights
Evidence suggested that vaginal microbiome played a functional role in the progression of cervical lesions in female infected by HPV
Correlation between Candida albicans, Gardnerella, trichomonas vaginitis (TV) and the detection of cervical lesions stratified by different high risk HPV (hr-HPV) types The distribution of potential risk factors among cervical intraepithelial neoplasia (CIN)/ invasive cervical cancer (ICC) and normal participants are shown in Additional
Multivariate analysis of the risk of CIN/ICC by TV stratified by hr-HPV infection status Among the overall participants, 5683 (1.83%) participants were infected with TV; among them, 1952 (0.63%) female were co-infected with hr-HPV
Summary
Evidence suggested that vaginal microbiome played a functional role in the progression of cervical lesions in female infected by HPV. Gardnerella vaginalis is considered as playing a vital role in the pathogenesis of bacterial vaginitis (BV) [6], and BV shows a correlation with severity of cervical neoplasia in HPVpositive female [7]. Some studies have demonstrated a correlation between vaginal infection and the carcinogenicity of hr-HPV, but most of them are small-scale researches, and their conclusions are inconsistent [5, 9,10,11,12,13,14,15,16]. This research is with the most massive scale and the most comprehensive investigation about the correlation between cervical hr-HPV infection, CIN/ ICC, and the vaginal microbiome
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