Potential Association between Vaginal Microbiota and Cervical Carcinogenesis in Korean Women: A Cohort Study.

Gi-Ung Kang,Da-Ryung Jung,Jae-Ho Shin,Yoon Hee Lee,Se Young Jeon,Hyung Soo Han,Gun Oh Chong

doi:10.3390/microorganisms9020294

Gi-Ung Kang, Da-Ryung Jung + Show 5 more

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https://doi.org/10.3390/microorganisms9020294

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Abstract

Convincing studies demonstrated that vaginal flora is one of the most impactful key components for the well-being of the genital tract in women. Nevertheless, the potential capability of vaginal-derived bacterial communities as biomarkers to monitor cervical carcinogenesis (CC) has yet to be studied actively compared to those of bacterial vaginosis (BV). We hypothesized that vaginal microbiota might be associated with the progression of CC. In this study, we enrolled 23 participants, including healthy controls (HC group; n = 7), patients with cervical intraepithelial neoplasia (CIN) 2 and 3 (CIN group, n = 8), and patients with invasive cervical cancer (CAN group; n = 8). Amplicon sequencing was performed using the Ion Torrent PGM to characterize the vaginal microbiota. Patients with CIN and CAN presented vaginal microbiota dysbiosis compared with HC. The alpha diversity analysis revealed that CC has a trend to be increased in terms of diversity indexes. Moreover, CC was associated with the abundance of specific microbes, of which Lactobacillus and Gardnerella were the most significantly different between HC and CIN, whereas Streptococcus was differentially abundant in CAN compared with CIN. We then evaluated their diagnostic abilities. Testing in terms of diagnostic ability using the three genera revealed considerably high performance with an area under the receiver-operating characteristic curve of 0.982, 0.953, and 0.922. The current study suggests that the presence of Gardnerella and Streptococcus may be involved in the advancment of CC.

Highlights

Compelling studies revealed that persistent infection with certain types of the oncogenic virus, known as human papillomavirus (HPV), is a necessary cause of the progress of cervical intraepithelial neoplasia (CIN) and invasive cervical cancer (ICC) [1,2,3]
There is no doubt that HPV infection is the primary cause, data regarding whether the virus drives full tumorigenesis is still insufficient
The HC group accounted for seven women; the CIN group, for eight women; and the CAN group, for eight women

Summary

Introduction

Compelling studies revealed that persistent infection with certain types of the oncogenic virus, known as human papillomavirus (HPV), is a necessary cause of the progress of cervical intraepithelial neoplasia (CIN) and invasive cervical cancer (ICC) [1,2,3]. The indigenous vaginal microbial ecosystem—known as the microbiota—is composed of microorganisms that can strongly affect gynecological wellness and women’s health, being involved in the metabolic process [5] and immunological response [6,7]. Microorganisms 2021, 9, 294 the microbiota, Lactobacillus spp., which produce lactic acid [8] and bacteriocins [9], are the key microbes in healthy women and involved in creating the stability of the vaginal microbial composition, maintaining a low-pH environment [10,11]. With the development of next-generation sequencing that revolutionized traditional microbiology, Ravel et al [12]

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