廉闪闪,刘艳君,杜蓉

• 1:新疆医科大学第一附属医院妇科

摘要(Abstract)：

目的 通过Meta分析探讨高危型人乳头瘤病毒（High-risk human papillomavirus, hr-HPV）感染及宫颈病变与阴道乳酸杆菌的关系。方法 采用计算机检索Pubmed、Web of Science、Embase、Cochrane Library、中国知网、万方和维普数据库建库至2021年7月公开发表的有关hr-HPV感染、子宫颈鳞状上皮内病变（Squamous intraepithelial lesions, SIL）、宫颈癌(Cervical cancer, CC)与阴道乳酸杆菌关系的研究，由两名研究员分别筛选文献、提取有效数据进行Meta分析。结果 纳入了24项研究共2 556例研究对象。hr-HPV感染、CC与阴道乳酸杆菌，尤其是卷曲乳酸杆菌显著相关，为保护因素；SIL与阴道乳酸杆菌无相关性。结论 hr-HPV感染、CC与乳酸杆菌具有相关性。

关键词(KeyWords)： 乳酸杆菌;高危型人乳头瘤病毒;子宫颈鳞状上皮内病变;Meta分析

Abstract:

Keywords:

基金项目(Foundation): 国家自然科学基金（81660476）

作者(Author): 廉闪闪,刘艳君,杜蓉

参考文献(References)：

• [1] TEWARI K S, MONK B J, VERGOTE I, et al. Survival with cemiplimab in recurrent cervical cancer[J]. N Engl J Med, 2022,386(6):544-555.
• [2]袁源亮,刘凯,冯亚宁,等.宫颈癌NY-ESO-1特异性T细胞免疫反应分析[J].新疆医科大学学报,2020, 43(9):1136-1142.
• [3] CARRILLO-NG H, BECERRA-GOICOCHEA L, TARAZONACASTRO Y,et al. Variations in cervico-vaginal microbiota among HPV-positive and HPV-negative asymptomatic women in Peru[J].BMC Res Notes,2021,14(4):865.
• [4] CASTANHEIRA C P, SALLAS M L, NUNES R A L, et al. Microbiome and cervical cancer[J]. Pathobiology,2021,88(2):187-197.
• [5] KUDELA E, LISKOVA A, SAMEC M, et al. The interplay between the vaginal microbiome and innate immunity in the focus of predictive, preventive, and personalized medical approach to combat HPV-induced cervical cancer[J]. EPMA J, 2021,12(2):199-220.
• [6] GAJER P,BROTMAN R M,BAI G,et al. Temporal dynamics of the human vaginal microbiota[J]. Sci Transl Med,2012,4(132):132-152.
• [7] BORGDORFF H,TSIVTSIVADZE E,VERHELST R,et al. Lactobacillus-dominated cervicovaginal microbiota associated with reduced HIV/STI prevalence and genital HIV viral load in African women[J]. ISME J,2014,8(9):1781-1793.
• [8] BROTMAN R M, SHARDELL M D, GAJER P, et al. Interplay between the temporal dynamics of the vaginal microbiota and human papillomavirus detection[J]. J Infect Dis,2014,210(11):1723-1733.
• [9] OH H Y,KIM B S,SEO S S,et al. The association of uterine cervical microbiota with an increased risk for cervical intraepithelial neoplasia in Korea[J]. Clin Microbiol Infect,2015,21(7):671-679.
• [10] SEO S S,OH H Y,LEE J K,et al. Combined effect of diet and cervical microbiome on the risk of cervical intraepithelial neoplasia[J].Clin Nutr, 2016,35(6):1434-1441.
• [11] ZHANG C,LIU Y,GAO W,et al. The direct and indirect association of cervical microbiota with the risk of cervical intraepithelial neoplasia[J]. Cancer Med,2018, 7(5):2172-2179.
• [12] BERGGRUND M, GUSTVSSON I, AARNIO R, et al. Temporal changes in the vaginal microbiota in self-samples and its association with persistent HPV16 infection and CIN2[J]. Virol J,2020,17(1):147.
• [13] BORGOGNA J C,SHARDELL M D,SANTORI E K,et al. The vaginal metabolome and microbiota of cervical HPV-positive and HPVnegative women:a cross-sectional analysis[J]. BJOG,2020,127(2):182-192.
• [14] CHENG L,NORENHAG J,HU YOO,et al. Vaginal microbiota and human papillomavirus infection among young Swedish women[J].NPJ biofilms and microbiomes,2020,6(1):39.
• [15] MITRA A,MACINTYRE D A,LEE Y S,et al.Cervical intraepithelial neoplasia disease progression is associated with increased vaginal microbiome diversity[J]. Sci Rep,2015,5:16865.
• [16] SHANNON B,YI T J,PERUSINI S,et al. Association of HPV infection and clearance with cervicovaginal immunology and the vaginal microbiota[J]. Mucosal Immunol,2017,10(5):1310-1319.
• [17] DI PAOLA M, SANI C,CLEMENTE A M,et al. Characterization of cervico-vaginal microbiota in women developing persistent highrisk human papillomavirus infection[J]. Sci Rep,2017,7(1):10200.
• [18] HUANG X,LI C,LI F,et al. Cervicovaginal microbiota composition correlates with the acquisition of high-risk human papillomavirus types[J].Int J Cancer,2018, 143(3):621-634.
• [19] LANIEWSKI P,CUI H,ROE D J,et al. Features of the cervicovaginal microenvironment drive cancer biomarker signatures in patients across cervical carcinogenesis[J]. Sci Rep,2019,9(1):7333.
• [20] ONYWERA H,WILLIAMSON A L,MBULAWA Z Z A,et al.The cervical microbiota in reproductive-age South African women with and without human papillomavirus infection[J]. Papillomavirus Res,2019,7:154-163.
• [21] ONYWERA H,WILLIAMSON A L,MBULAWA Z Z A,et al. Factors associated with the composition and diversity of the cervical microbiota of reproductive-age black south african women:a retrospective cross-sectional study[J]. PeerJ,2019,7:e7488.
• [22] MITRA A,MACINTYRE D A,NTRITSOS G,et al. The vaginal microbiota associates with the regression of untreated cervical intraepithelial Neoplasia 2 lesions[J]. Nat Commun,2020,11(1):1999.
• [23] WU M,GAO J,WU Y,et al. Characterization of vaginal microbiota in chinese women with cervical squamous intra-epithelial neoplasia[J]. Int J Gynecol Cancer, 2020,30(10):1500-1504.
• [24] YANG Q,WANG Y,WEI X,et al. The alterations of vaginal microbiome in hpv16 infection as identified by shotgun metagenomic sequencing[J]. Front Cell Infect Microbiol,2020,10:286.
• [25] CHEN Y,QIU X,WANG W,et al. Human papillomavirus infection and cervical intraepithelial neoplasia progression are associated with increased vaginal microbiome diversity in a chinese cohort[J].BMC Infect Dis,2020,20(1):629.
• [26] DARENG EO,MA B,ADEBAMOWO S N,et al. Vaginal microbiota diversity and paucity of lactobacillus species are associated with persistent hrHPV infection in HIV negative but not in HIV positive women[J]. Sci Rep,2020,10(1):19095.
• [27]丁晖,唐玲丽,杨佳锦,等.宫颈癌前病变患者阴道微生物群落的构成研究[J].中华检验医学杂志,2017,40(7):505-510.
• [28]罗美,何鑫,刘军,等.阴道微生物菌群与高危型人乳头瘤病毒16和18型感染的相关性研究[J].首都医科大学学报,2018,39(6):849-857.
• [29]梁文丽,谢爱香.不同程度宫颈病变患者阴道微生物群落差异比较分析[J].实验与检验医学,2019,37(4):692-694.
• [30]周晔,袁丹丹,沈兰凤,等.子宫颈微生态与宫颈鳞状上皮内病变关系的研究[J].中华检验医学杂志,2020(4):468-474.
• [31] SIMMS K T, STEINBERG J, CARUANA M, et al. Impact of scaled up human papillomavirus vaccination and cervical screening and the potential for global elimination of cervical cancer in 181 countries, 2020-99:a modelling study[J]. The Lancet Oncology, 2019,20(3):394-407.