A population‐based study of age‐related associations between vaginal pH and the development of cervical intraepithelial neoplasia

Teng, Peng; Hao, Min

doi:10.1002/cam4.2845

Cited by 14 publications

(10 citation statements)

References 31 publications

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“…Previous research demonstrated that having a vaginal infection complicated with HR-HPV affects the development of CIN in subjects with ASC-US cytology [ 19 ]. Vaginal infections are consistently associated with the development of cervical cancer [ 20 ]. However, the association between different types of vaginal and HPV infections and cervical precancerous lesions has remained elusive.…”

Section: Discussionmentioning

confidence: 99%

Association between common vaginal and HPV infections and results of cytology test in the Zhoupu District, Shanghai City, China, from 2014 to 2019

Xiao

Xing

et al. 2022

Virol J

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Background HPV (human papillomavirus) is an important cause of cervical cancer. Cervical-vaginal infection with pathogens, such as herpes simplex virus (HSV), bacterial vaginosis Trichomonas vaginalis and vaginal candidiasis could be a cofactor. This study aimed to assess the relationship between vaginal infection with HPV genotype and cytology test results and analyze the relationship between vaginal and HPV infections and cervical cancer. Methods We performed a district-based study to elucidate the relationship among the vaginal and HPV infections and cervical cancer. We collected the cervical exfoliation data of 23,724 women admitted to the Shanghai Zhoupu Hospital and received ThinPrep cytology test (TCT) and HPV detection between 2014 and 2019. Results Total vaginal infection rate was 5.3%, and the HPV-positive group had a slightly higher vaginal infection rate than the HPV-negative group (P < 0.01). The incidence rate of cervical intraepithelial neoplasia or cervical cancer with vaginal infection was higher than without vaginal infection (P < 0.001). Conclusion HPV/vaginal infection-positive women tended to have abnormal results of TCT. Women with vaginal infection were more likely to develop HPV infection. HSV combined with HPV infection was noted as a causal factor for HSIL.

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Section: Discussionmentioning

confidence: 99%

Association between common vaginal and HPV infections and results of cytology test in the Zhoupu District, Shanghai City, China, from 2014 to 2019

Xiao

Xing

et al. 2022

Virol J

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“…In most patients with single VVC, the vaginal pH was normal, and in pure CV patients, the vaginal pH level was lower than 4.5 due to the high levels of lactobacillus, whereas in the majority of patients with BV, TV, AV, or AV mixed infections, the vaginal pH value was high (pH > 4.5) [19]. Unfortunately, the results indicate that pH levels in simple or mixed AV were not significantly different, but a recent study suggested that vaginal pH level had a significant association with CIN [31]. Therefore, due to the overlap between simple and mixed AV, it is difficult to draw firm conclusions for differentiating simple AV from mixed AV by pH level.…”

Section: Discussionmentioning

confidence: 92%

Characteristics of aerobic vaginitis among women in Xi’an district: a hospital-based study

et al. 2020

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Background: Aerobic vaginitis (AV) is a reproductive tract infection that affects health of women. The objective of this study was to analyze the characteristics of simple and mixed AV patients in Xi'an district and provide reference data for the clinical treatment of AV. Methods: Patients were recruited from the outpatient Department of Obstetrics and Gynecology in the First Affiliated Hospital of Xi'an Jiaotong University from September 2014 to April 2019 in strict accordance with inclusion and exclusion criteria. The study principally examined the vaginal ecosystem, age distribution, levels of functional enzymes, and changes in pH levels in these women. Differences within groups were analyzed. Results: A total of 284 AV patients were enrolled to investigate the distribution of simple and mixed AV infection. AV infection was found to be mainly simple infection. Simple AV patients were generally aged 50-60 years, while mixed AV patients were mostly aged 30-40 years. In the present study, the density of vaginal bacteria (OR = 13.294, 95% CI = 5.869-30.115, P < 0.01), the type of predominant bacteria (OR = 3.962, 95% CI = 1.785-7.984, P < 0.01) and positive expression of coagulase (OR = 3.789, 95% CI = 1.798-7.984, P < 0.01) were considered risk factors for mixed AV infection. Conclusions: The epidemiology of simple and mixed AV infection were found to be different, with density of vaginal bacteria (I or IV), species that are predominant and levels of coagulase being risk factors for mixed AV infection.

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“…Plisko [11] recently investigated the association of abnormal vaginal flora including AV and histological findings of CIN and found that AV was significantly more common in subjects with high lesions (CIN II) than low lesions (CIN I). She also states that in women with cervical pathology there is a significantly higher pH value of the vaginal environment associated with CIN change, as well as the association of severe AV with HPV-induced lesion [55,56]. Reducing the number of lactobacilli in vaginal secretion reduces the ability to defend and change the pH value of the vaginal environment, which favors the development of bacterial inflammation.…”

Section: E Faecalis Positive Av and Hpv In The Vaginal Floramentioning

confidence: 99%

“…Reducing the number of lactobacilli in vaginal secretion reduces the ability to defend and change the pH value of the vaginal environment, which favors the development of bacterial inflammation. E. faecalis positive AV leads to a change in vaginal pH above 5, and elevated vaginal pH in HPV-positive women may be associated with [56].…”

Section: E Faecalis Positive Av and Hpv In The Vaginal Floramentioning

confidence: 99%

Aerobic Vaginitis: is Enterococcus faecalis Another Risk Factor in the Progression of Cervical Intraepithelial Neoplasia to Cervical Cancer—Literature Review

Jahic¹,

Cerovac²

2022

Clin. Exp. Obstet. Gynecol.

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Objective: The aim of our review article is to show Enterococcus faecalis (E. faecalis) as a risk factor of cervical cancer. Mechanism: Aerobic vaginitis (AV) is the absence of a balance of vaginal flora containing aerobic and intestinal pathogens, varying degrees of vaginal inflammation and immature epithelial cells. The causes of AV responsible for inflammatory changes are: E. faecalis, Esherichia coli, group B streptococcus and Staphylococcus aureus. The pathogenic effect of aerobic microorganisms such as E. faecalis shows that it causes spontaneous abortion, premature birth, puerperal sepsis, abscesses, and urinary tract infections. Findings in Brief: AV caused by E. faecalis is more common in low-grade and high-grade cervical intraepithelial neoplasia (CIN) than in women with a normal Pap test and is thought to contribute to the progression of cervical cancer. E. faecalis produces hydrogen superoxide which causes chromosomal instability in intestinal epithelial cell infection, which is considered a key factor in the carcinogenic process. The presence of the Human papilloma virus (HPV) 16 gene and genome in E. faecalis in cervical cancer biopsy material leads to a specific link that may be a risk factor in the progression of CIN toward cancer. The presence of HPV in this bacteria can lead to persistent HPV infection, CIN development and progression to cervical cancer. Conclusions: Increased vaginal pH, lactobacilli deficiency, and the ability of E. faecalis to contain HPV-16 in episomal form in E. faecalis-induced AV could be key promoters of persistence and proliferation of cervical HPV as a risk factor in development of CIN and cervical cancer.

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A population‐based study of age‐related associations between vaginal pH and the development of cervical intraepithelial neoplasia

Cited by 14 publications

References 31 publications

Association between common vaginal and HPV infections and results of cytology test in the Zhoupu District, Shanghai City, China, from 2014 to 2019

Association between common vaginal and HPV infections and results of cytology test in the Zhoupu District, Shanghai City, China, from 2014 to 2019

Characteristics of aerobic vaginitis among women in Xi’an district: a hospital-based study

Aerobic Vaginitis: is Enterococcus faecalis Another Risk Factor in the Progression of Cervical Intraepithelial Neoplasia to Cervical Cancer—Literature Review

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