Role Of Vaginal Microbial Metabolites And Enzymes,HR-HPV In The Development Of Cervical Intraepithelial Neoplasia

Objective:To investigate the role of vaginal microbial metabolites and enzymes changes and high-risk human papillomavirus?HR-HPV?infection in cervical intraepithelial neoplasia?CIN?and their interaction effects.Methods:From June 2014 to December 2014,demographic characteristics and CIN-related factors and cervical liquid-based cytology?TCT?examinations were completed on 40,000community-based populations from two regions of Shanxi Province.After excluding glandular cell abnormalities,the patients who were voluntarily enrolled were further tested for vaginal microecology,HPV testing,and colposcopy and pathology.At last,782 cases with pathological diagnosis of CIN were chosen as the case group.1503 patients with normal pathological results,complete data,and voluntary enrollment were chosen as a control group,and a four-year prospective cohort study was established.A multivariate logistic regression model was established to analyze the vaginal microbial metabolites and enzymes cross-sectionally and evaluate the association between vaginal microbial metabolites and enzymes changes and CIN risk.We were using a multiplicative interaction model to analyse the interaction between vaginal microbial metabolic enzymology and HR-HPV in the development of CIN.Results:After adjusting for relevant factors and HR-HPV infection,the expression quantity of hydrogen peroxide?H₂O₂?,?-glucuronidase?GUS?,sialidase?SNA?were statistically correlated with CIN risk,and the odds ratio were 1.60?95%CI:1.30-1.96?,1.58?95%CI:1.30-1.92?,1.45?95%CI:1.18-1.79?,respectively.The expression quantity of Acetylglucosaminidase?NAG?and leukocyte esterase?LE?have no statistical association with CIN risk.Interaction analysis showed that there were positive multiplicative interactions between H2O2,GUS,SNA and HR-HPV infections in the occurrence of CIN.Conclusion: Vaginal microbial metabolites and enzymes such as H₂O₂,GUS,and SNA are associated with increased risk of CIN,and they have positive interaction with HR-HPV infection,which increases the risk of CIN.