Is bacterial vaginosis associated with cervical intraepithelial neoplasia?

Boyle, D. C. M.; Barton, Staci C.; Uthayakumar, S; Hay, P; Pollock, J. W.; Steer, PJ; Smith, J. R.

doi:10.1136/ijgc-00009577-200303000-00010

Cited by 14 publications

(5 citation statements)

References 10 publications

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“…However, these ambivalent results may be attributed to the different tools used in the diagnosis of BV. Of the above-mentioned studies, two used a BV diagnosis with three other measurements, including pH, clue cells after Gram stain, and a positive amine or whiff test [23,25], and the other used the Nugent scale [24]. Although the correlation between BV and CIN remains to be determined, our results are in support of such a correlation.…”

Section: Discussionsupporting

confidence: 67%

“…To date, several studies have explored the role of BV in cervical neoplasia; they have reported conflicting findings. In one prospective study, the CIN rate and the quantity of nitrosamines produced in women with BV did not differ from those in women with normal flora [23]. Another longitudinal study reported no influence of abnormal flora on the presence of atypical endocervical cells [24].…”

Section: Discussionmentioning

confidence: 99%

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The association of uterine cervical microbiota with an increased risk for cervical intraepithelial neoplasia in Korea

Kim

Seo

et al. 2015

Clinical Microbiology and Infection

162

193

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Recent studies have suggested potential roles of the microbiome in cervicovaginal diseases. However, there has been no report on the cervical microbiome in cervical intraepithelial neoplasia (CIN). We aimed to identify the cervical microbiota of Korean women and assess the association between the cervical microbiota and CIN, and to determine the combined effect of the microbiota and human papillomavirus (HPV) on the risk of CIN. The cervical microbiota of 70 women with CIN and 50 control women was analysed using pyrosequencing based on the 16S rRNA gene. The associations between specific microbial patterns or abundance of specific microbiota and CIN risk were assessed using multivariate logistic regression, and the relative excess risk due to interaction (RERI) and the synergy index (S) were calculated. The phyla Firmicutes, Actinobacteria, Bacteroidetes, Proteobacteria, Tenericutes, Fusobacteria and TM7 were predominant in the microbiota and four distinct community types were observed in all women. A high score of the pattern characterized by predominance of Atopobium vaginae, Gardnerella vaginalis and Lactobacillus iners with a minority of Lactobacillus crispatus had a higher CIN risk (OR 5.80, 95% CI 1.73-19.4) and abundance of A. vaginae had a higher CIN risk (OR 6.63, 95% CI 1.61-27.2). The synergistic effect of a high score of this microbial pattern and oncogenic HPV was observed (OR 34.1, 95% CI 4.95-284.5; RERI/S, 15.9/1.93). A predominance of A. vaginae, G. vaginalis and L. iners with a concomitant paucity of L. crispatus in the cervical microbiota was associated with CIN risk, suggesting that bacterial dysbiosis and its combination with oncogenic HPV may be a risk factor for cervical neoplasia.

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Section: Discussionsupporting

confidence: 67%

Section: Discussionmentioning

confidence: 99%

The association of uterine cervical microbiota with an increased risk for cervical intraepithelial neoplasia in Korea

Kim

Seo

et al. 2015

Clinical Microbiology and Infection

162

193

View full text Add to dashboard Cite

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“…Previous studies examining the relationship between BV and CIN have produced conflicting results and conclusions. The results ranged from a very strong association between the two conditions such as that found in the study by Platz Christensen et al to there being no association as in the study by Peters et al 19 Our study shows that BV was associated with a significantly increased risk of HPV infection and CIN. However, BV combined with HPV infection does not increase the prevalence of CIN (x 2 = 3.61, P = 0.462).…”

Section: Genital Tract Infections In Beijingsupporting

confidence: 64%

Prevalence and risk factors of lower genital tract infections among women in Beijing, China

Zhang

et al. 2011

J of Obstet and Gynaecol

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“…One proposed mechanism suggesting that carcinogenic nitrosamines acting either independently or via human papillomavirus (HPV) has not been fully tested previously. Boyle et al 16 undertook a prospective, case-controlled, cross-sectional study where the presence of HPV, which is known to be associated with the development of CIN, was controlled for. Women with BV were not found to have CIN more frequently than women with normal vaginal flora and the quantities of nitrosamines produced by women with BV did not differ significantly from women without BV.…”

Section: Discussionmentioning

confidence: 99%

Inflammatory events as detected in cervical smears and squamous intraepithelial lesions

Roeters

Boon

Haaften

et al. 2009

Diagnostic Cytopathology

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The Dutch cytological coding system, KOPAC, enables to code for eight inflammatory events, that is koilocytosis (related to human papillomavirus (HPV)), Trichomonas, dysbacteriosis [related to bacterial vaginosis (BV)], Candida, Gardnerella, Actinomyces, Chlamydia, and non-specific inflammation (leucocytosis). This study presents an analysis of 1,008,879 smears. Of each smear, the age of the woman and the reason for smear taking (screening or indication) was available. The cytoscores (per mille) for these codes were calculated. For the screening smears, the cytoscores were for koilocytosis (HPV) 2.6, for Trichomonas vaginalis 1.9, for dysbacteriosis 31.4, for Candida albicans 9.8, for Gardnerella vaginalis 0.7, for Actinomyces 6.9, for Chlamydia 0.8, and for non-specific inflammatory changes 66.4. For the calculation of the Odds Ratio (OR), normal smears were used as a reference. The cytoscores for Chlamydia and Gardnerella covaried with high grade SIL (HSIL), with an OR of 7 and 12, respectively. In addition, the OR for Trichomonas vaginalis, for dysbacteriosis, and for leucocytosis proved to be significantly high in the indication smears. This study provides an oversight of HSIL and the full range of cervical infections as detected by cytology, proving that this infectious byproduct of screening can be very valuable.

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Is bacterial vaginosis associated with cervical intraepithelial neoplasia?

Cited by 14 publications

References 10 publications

The association of uterine cervical microbiota with an increased risk for cervical intraepithelial neoplasia in Korea

The association of uterine cervical microbiota with an increased risk for cervical intraepithelial neoplasia in Korea

Prevalence and risk factors of lower genital tract infections among women in Beijing, China

Inflammatory events as detected in cervical smears and squamous intraepithelial lesions

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