RELATIONSHIP BETWEEN VAGINAL MICROECOLOGICAL CHANGES AND HIGH-GRADE SQUAMOUS INTRAEPITHELIAL NEOPLASIA AND DIFFERENT TYPES OF HPV INFECTION

Ya Chen¹, Qing Wu², Xiaoyan Chen², Lingna Chen³, Wanwan Xu⁴, Yiyi Xu⁵, Hai'ou Xu^{6, *}

¹Department of Gynecology, The First People's Hospital of Bijie City, Bijie, 551700, China - ²Department of Gynecology, Zhejiang Provincial People's Hospital, Hangzhou, 310000, China - ³Department of Gynecology, Hangzhou Obstetrics and Gynecology Hospital, Hangzhou, 310008, China - ⁴Department of Gynecology, The Fourth Affiliated Hospital of Medical College of Zhejiang University, Yiwu, 322000, China - ⁵Obstetrics and Gynecology Department, Zhuji Sixth People's Hospital, Zhuji, 311800, China - ⁶Cervical Disease Center, Hangzhou Obstetrics and Gynecology Hospital, (Hangzhou Maternal and Child Health Hospital), Hangzhou, 310008, China

Objective: This study analyzes the correlation between vaginal microecological changes and high-grade squamous intraepithelial neoplasia (HSIL), as well as different types of human papillomavirus (HPV) infection. 

Methods: 488 patients with a high-risk HPV infection in our hospital from June 2018 to August 2019 were selected. Ninety-six patients with HSIL confirmed by colposcopic biopsy were included in the observation group, and 110 normal women undergoing normal pre-pregnancy examination or routine physical examination in our hospital were selected as the control group. Bacterial vaginosis (BV), candidiasis (VVC), aerobic vaginitis (AV), white blood cell count (WBC), Lactobacillus, and vaginal pH were examined by a vaginal micro ecological microscope. 

Results: The proportion of patients with age >29 years old, education level of senior high school or below, smoking, number of sexual partners ≥2, pregnancy times >2 times, and non-condom patients in the observation group were significantly higher than those in the control group (P<0.05). Logistic regression analysis showed that age >29 years old and sexual partners ≥2 were risk factors for HSIL (P<0.05). High school education and above were protective factors of HSIL (P<0.05). Comparing the incidence rate of hair coloring in non HPV16/18 group and the HPV16/18 group, the incidence of mixed infection in the group HPV16/18 was significantly higher than that in the non-HPV16/18 group (P<0.05). Among 488 high-risk HPV infection patients, the incidence of mixed infection was significantly higher in group B than in non HPV16/18 group. Logistic regression analysis showed that BV, AV, mixed infection, decreased lactobacillus, WBC >10/HPF, pH >4.5 were the risk factors of HSIL (P < 0.05). The incidence of AV and mixed infection in patients with multiple HPV infections was significantly higher than in patients with a single HPV infection (P<0.05). 

Conclusion: hair coloring and abnormal hair coloring were the risk factors of HSIL in patients with >29 years, sexual partners 2 or more. HPV16/18 infection rate was high in HPV16/18 patients. The incidence of AV and mixed infection in multiple HPV infection patients was high.