Relationships Between Abnormal Vaginal Microecology With HSIL And Different HPV Groups

ObjectiveTo investigate the relationship between various abnormal vaginal microecological,including bacterial vaginosis(BV),vulva vagina candidiasis(VVC),aerobic bacteria(AV),mixed infection,WBC > 10 / hpf,PH > 4.5,reduction of lactobacilli and high squamous intraepithelial neoplasia sample lesions(HSIL),and to explore the relationship between hpv 16/ 18,multiple and pure HR-HPV and the vaginal microecological,hoping to find the relationship between the lower genital tract infection with HSIL,thus providing a new method for the prevention of cervical cancer Methods142 women for health examination or physical examination before pregnancy with negative results of HPV and cervical cytology were enrolled as control group;Among 382 cases of HR-HPV infection,75 cases of high squamous intraepithelial lesion were recruited as study group.Epidemiological data surveys and microecological microscopy were performed on 217 women.And the results were compared between the two groups.We attend Patients of case and control study with vaginal microecological microscopy examination.Professional doctors use disposable sterile vaginal dilator into the vagina gently,then take the discharge of upper third of vaginal wall with two sterile cotton swabs.The first sterile cotton swab is used to detect PH values with medical PH wiping paper PH(range from 3.8 to 5.4),according to the standard of color matching,PH > 4.5 is considered high,then 1 ~ 2 drops of 10% potassium hydroxide(KOH)on the first cotton swab,judge whether whiff test was positive.The second cotton swab smear on a clean glass slide evenly,and then perform gram staining steps,which include early dyeing,mordant dyeing,bleaching,second dyeing,drying.We preceed examination of microscopy under the microscope of 1000 times after sealing pieces,observe whether have false hyphae or blastospore.Nugent score 7 or more points is diagnosed with BV.1 to 2 drops of 10% KOH solution on a clean glass slide,the second cotton swab evenly smear on a clean glass slide area of potassium hydroxide solution.Observe the presence of pseudohyphae under the 100 and 400 times of microscope,calculation of discontinuous five horizons,then count the number of white blood cells under the average visual field,the WBC >10/HPF is considered high.A score of 3 or more points is diagnosed AV based on Donders AV diagnostic criteria.If there is false hyphae or blastospore with gram staining and wet piece of microscopy,that can be diagnosed with VVC.ResultsTo compare the epidemiological data of study and the control group,we found older than 29,degree of education lower than high school,smoking,the number of sexual partners more than 1,the number of pregnancy more than 2,the number of labor more than 1,non-condom form of contraception was higher in HSIL,the difference is significant.The single factor Logistic regression analysis of micro ecological anomalies and HSIL show BV,AV,mixed infection,the WBC > 10 / HPF,PH > 4.5 and reduction of lactobacilli may be associated with HSIL,OR value and 95% CI respectively is 2.71(1.20 ~ 6.14),4.71(1.40 ~ 1.58),4.77(1.20 ~ 19.02),3.24(1.62 ~ 6.48),2.73(1.24 ~ 6.06),3.05(1.54 ~ 6.04);Multiariable Logistic regression of high-risk factors and HSIL show: older than 29,the number of sexual partners > 1,the WBC > 10 / HPF may be independent risk factors for HSIL OR and 95% CI respectively is 5.72(1.98 ~ 16.59),4.55(2.03 ~ 10.19),5.97(2.11 ~ 16.93),more than high school education degree could be HSIL protection factor,the OR and 95% CI0.17(0.07 ~ 0.42).Mixed vaginitis rates were higher in the HPV 16/18 group,and the difference was significant.Multiple HR-HPV infections increase the incidence of AV and mixed vaginitis.ConclusionThe study found older than 29,the number of sexual partners more than 1,inflammatory reaction may be independent risk factors for HSIL,high school or above is a protect factor.Mixed vaginitis incidence is higher in the group HPV16 / 18,HPV16 / 18 stronger pathogenicity.Follow-up of HPV16/18 and standardized treatment of mixed infection is important,The effect need further research.The study found multiple HR-HPV infections increase AV and mixed vaginitis,Compared with mixed HPV infections,pure HR-HPV didn't increase the risk of various vaginitis.