Multiple sexual partners and vaginal microecological disorder are associated with HPV infection and cervical carcinoma development

Abstract

There is an indirect link between multiple sexual partners (MSP) and cervical intraepithelial neoplasia (CIN) or even cervical cancer (CC). MSP may also lead to bacterial vaginosis (BV). The relationship among MSP, BV, human papillomavirus (HPV) infection and CIN/CC development in Chinese women remains unclear. The present study was designed to clarify their association. The study retrospectively analyzed 549 female patients who had visited a physical examination center. The MSP information was acquired, and vaginal microecology, HPV and cervical conization pathology (CCP) tests were performed when necessary. MSP status was distinct among patients with different levels of BV severity. In addition, as the severity of BV progressed, the HPV-positive ratio increased. Meanwhile, MSP was significantly associated with a positive HPV outcome, including HPV 16, HPV 18 and other high-risk HPV infections. The MSP group had a significantly higher percentage of positive CCP outcomes (particularly cases with CIN-II and CIN-III). Similarly, higher BV severity meant more severe CIN/CC progression. A logistic regression model based on age, MSP status and the Nugent score level was used in order to predict the CCP outcome. Furthermore, a receiver operating characteristic curve analysis resulted in an area under the curve of 0.834. In conclusion, the combination of MSP information and BV examination may provide a rapid, economic and accurate prediction of CIN/CC. Health education on sexual behavior and timely detection/treatment of BV should be conducted to reduce the risk of CC.

Development of a Nomogram Predicting the Risk of Persistence/Recurrence of Cervical Dysplasia

“…(iv) The present analysis did not consider several features that might influence patient outcomes. In particular, we were not able to correct our results on patient medical history, smoking history, and sexual activity [21][22][23]. All those points might influence the primary outcome measure and should be considered in everyday clinical practice.…”

“…All those points might influence the primary outcome measure and should be considered in everyday clinical practice. However, most of these features (indirectly) impacted the risk of HPV persistence, which is one of the variables that we included in our model [21][22][23][24][25]. (v) Our analysis excluded patients undergoing cold-knife conization.…”

Establishment of early diagnosis models for cervical precancerous lesions using large-scale cervical cancer screening datasets

“…The cervical microbiome has been found to be affected by HPV infection [ 20 ] and the presence of BV was reported to be associated with HPV infection and persistence [ 21 , 22 ]. BV and other factor, multiple sexual partners, were combined to predict of CIN/CC status [ 23 ]. A significant association between BV with HSIL cytologic stage in our HC2 dataset was observed, consistent with a previous report [ 24 , 25 ].…”

Preliminary Identification of the Aerobic Cervicovaginal Microbiota in Mexican Women With Cervical Cancer as the First Step Towards Metagenomic Studies

“…Recent studies have evaluated the relationship between the cervicovaginal microbiome and gynecological cancer to elucidate the involvement of bacterial communities in the establishment, progression, or cure of the disease. Dysbiosis due to the presence of bacterial vaginosis is the most studied entity, found to have a possible association with the induction of local inflammation and lactic acid depletion (Anahtar et al, 2015;Łaniewski et al, 2018), persistent high-risk Human Papillomavirus (HPV-Hr) infection (Jørgensen et al, 2009;Gao et al, 2013;Piyathilake et al, 2016;Ilhan et al, 2019;Norenhag et al, 2020;Wei et al, 2020), Cervical Intraepithelial Neoplasia (CIN) (Gillet et al, 2012;Huang et al, 2020) and the establishment of cervical cancer (Kwasniewski et al, 2018;Huang et al, 2020;Kang et al, 2021).…”