The possible role of bacterial vaginosis in the pathogenesis of cervical precancerous lesions
Abstract
The role of papillomavirus infection in the development of precancerous diseases and cervical cancer is known. Bacterial vaginosis was found to induce the deficiency of immune response of the vaginal mucosa surface. This disease is a frequent satellite of papillomavirus infection. Colposcopy and cytology are routinely used in the detection of precancerous processes of the cervix. A biopsy is used to confirm the diagnosis, thereby reducing the invasiveness of treatment and related complications. A study of the possible role of bаcterial vaginosis in the pathogenesis of cervical intraepithelial lesion and cervical cancer in patients with human papillomavirus infection was performed. 126 reproductive-aged women were enrolled in the study, 30 of them were practically healthy and included in Group I. In Group II, 46 women with pathological processes of the uterine cervix and human papillomavirus infection were observed. In group III, there were 50 patients with cervical intraepithelial lesions, human papillomavirus infection and bacterial vaginosis. The vaginal discharge bacterioscopy, colposcopy, cytology, quantification and typing of vaginal commensals by polymerase chain reaction were done in the study population. It was found that even with the normal type of cytological smear, chronic cervicitis was observed in 17.7 % of patients, and cervical intraepithelial neoplasia in 11.5 %. The sensitivity of cytological Pap smears with respect to the diagnosis of cervical intraepithelial neoplasia and cervical cancer was 86.5 %, and specificity 70.0 %. The incidence of cervical intraepithelial neoplasia and cervical cancer was 42.0 % and 23.3% in Group III and Group II, respectively. The presence of bacterial vaginosis in patients with papillomavirus infection was a possible factor that increased the risk of diagnosing cervical intraepithelial neoplasia and cervical cancer by 15.8 %. This result demonstrates the necessity for further study of vaginal biotope disorders in women with papillomavirus infection and associated cervical intraepithelial neoplasia and cervical cancer.
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Boccardo, E., Lepique, A. P., Villa, L. L. (2010). The role of inflammation in HPV carcinogenesis. Carcinogenesis, 31, 1905–1912. DOI: 10.1093/carcin/bgq176
Zorzi, M., Del Mistro, A., Farruggio, A., et al. (2013). Use of a high-risk human papillomavirus DNA test as the primary test in a cervical cancer screening programme: a population-based cohort study. BJOG, 120 (10), 1260–1267. DOI: 10.1111/1471-0528.12272
Dahoud, W., Michael, C. W., Gokozan, H., et al. (2019). Association of Bacterial Vaginosis and Human Papilloma Virus Infection With Cervical Squamous Intraepithelial Lesions. Am J Clin Pathol, 152 (2), 185-189. DOI: 10.1093/ajcp/aqz021
Lakhno, I. V. (2016). Treatment of Genital Warts: Focus on Vaginal Dysbiosis. Reproductive Endocrinology, 28(1), 30-32. DOI: http://dx.doi.org/10.18370/2309-4117.2016.27.30-32
Chrysostomou, A. C., Stylianou, D. C., Constantinidou, A., Kostrikis, L. G. (2018). Cervical Cancer Screening Programs in Europe: The Transition Towards HPV Vaccination and Population-Based HPV Testing. Viruses, 10 (12), E729. DOI: 10.3390/v10120729
Yi, Y., Fang, Y., Wu, K., et al. (2020). Comprehensive gene and pathway analysis of cervical cancer progression. Oncol Lett, 19 (4), 3316–3332. DOI: 10.3892/ol.2020.11439.
Barros, M. R., Jr, de Melo C. M. L., Barros, M. L., et al. (2018). Activities of stromal and immune cells in HPV-related cancers. J Exp Clin Cancer Res,5, No3 7(1), 137. DOI: 10.1186/s13046-018-0802-7.
Romero-Morelos, P., Bandala, C., Jiménez-Tenorio, J., et al. (2019). Vaginosis-associated Bacteria and Its Association With HPV Infection Observational Study. Med Clin (Barc), 152 (1), 1-5. DOI: 10.1016/j.medcli.2018.01.027.
Smith, R. A., Andrews, K. S., Brooks, D., et al. (2018). Cancer screening in the United States, 2018: A review of current American Cancer Society guidelines and current issues in cancer screening. CA Cancer J Clin, 68 (4), 297–316. DOI: 10.3322/caac.21446.
Ferreira, C. S. T., Donders, G. G., Parada, C. M. G. L., et al. (2017). Treatment failure of bacterial vaginosis is not associated with higher loads of Atopobium vaginae and Gardnerella vaginalis. J Med Microbiol, 66 (8), 1217–1224. DOI: 10.1099/jmm.0.000561
Massad, L. S. (2018). Methods of Screening for Cervical Cancer-Reply. JAMA, 320 (18), 1939. DOI: 10.1001/jama.2018.13943
Ortashi, O., Abdalla, D. (2019). Colposcopic and Histological Outcome of Atypical Squamous Cells of Undetermined Significance and Atypical Squamous Cell of Undetermined Significance Cannot Exclude High-Grade in Women Screened for Cervical Cancer. Asian Pac J Cancer Prev, 20 (9), 2579–2582. DOI: 10.31557/APJCP.2019.20.9.2579
Sawaya, G. F., Smith-McCune, K., Kuppermann, M. (2019). Cervical Cancer Screening: More Choices in 2019. JAMA, 321 (20), 2018–2019. DOI: 10.1001/jama.2019.4595
Stoler, M. H., Vichnin, M. D., Ferenczy, A., et al. (2011). The accuracy of colposcopic biopsy: Analyses from the placebo arm of the Gardasil clinical trials. Int J Cancer, 128, 1354–1362. DOI: 10.1002/ijc.25470
Trevethan, R. (2017). Sensitivity, Specificity, and Predictive Values: Foundations, Pliabilities, and Pitfalls in Research and Practice. Front Public Health, 5, 307. DOI: 10.3389/fpubh.2017.00307
Vorobiova, L. I., Dunaievska, V. V., Koshmerynska, A. M. (2015). Pathogenetic Therapy of Cervical Intraepithelial Neoplasia II-III. Reproductive Endocrinology, 24 (4), 74-77. DOI:10.18370/2309-4117.2015.24.74-77
Frazer, I. H. (2019). The HPV Vaccine Story. ACS Pharmacol Transl Sci, 2 (3), 210–212. DOI: 10.1021/acsptsci.9b00032
Athanasiou, A., Veroniki, A. A., Efthimiou, O., et al. (2019). Comparative fertility and pregnancy outcomes after local treatment for cervical intraepithelial neoplasia and stage 1a1 cervical cancer: protocol for a systematic review and network meta-analysis from the CIRCLE group. BMJ Open, 9 (10), e028009. DOI: 10.1136/bmjopen-2018-028009
Mazur, Yu. Yu., Pyrohova, V. I., Kuz, N. M. (2018). Vaginal Biocenosis State Assessment in Patients With Cervical Ectopy Relapse in the Conditions of Human Papillomavirus Infection. Health of Woman, 5 (132), 37–41. DOI: 10.15574/HW.2018.132.37
Romanenko, T. G., Dovbnia, T. V. (2018). Papillomаvirus Infection of the Genitals (Clinical Lecture). Health of Woman, 2 (128), 9–15. DOI 10.15574/HW.2018.128.9
