Актуальні проблеми сучасної медицини (Jun 2020)
The possible role of bacterial vaginosis in the pathogenesis of cervical precancerous lesions
Abstract
The role of papillomavirus infection in the development of precancerous diseases and cervical cancer is known. Bacterial vaginosis was found to induce the deficiency of immune response of the vaginal mucosa surface. This disease is a frequent satellite of papillomavirus infection. Colposcopy and cytology are routinely used in the detection of precancerous processes of the cervix. A biopsy is used to confirm the diagnosis, thereby reducing the invasiveness of treatment and related complications. A study of the possible role of bаcterial vaginosis in the pathogenesis of cervical intraepithelial lesion and cervical cancer in patients with human papillomavirus infection was performed. 126 reproductive-aged women were enrolled in the study, 30 of them were practically healthy and included in Group I. In Group II, 46 women with pathological processes of the uterine cervix and human papillomavirus infection were observed. In group III, there were 50 patients with cervical intraepithelial lesions, human papillomavirus infection and bacterial vaginosis. The vaginal discharge bacterioscopy, colposcopy, cytology, quantification and typing of vaginal commensals by polymerase chain reaction were done in the study population. It was found that even with the normal type of cytological smear, chronic cervicitis was observed in 17.7 % of patients, and cervical intraepithelial neoplasia in 11.5 %. The sensitivity of cytological Pap smears with respect to the diagnosis of cervical intraepithelial neoplasia and cervical cancer was 86.5 %, and specificity 70.0 %. The incidence of cervical intraepithelial neoplasia and cervical cancer was 42.0 % and 23.3% in Group III and Group II, respectively. The presence of bacterial vaginosis in patients with papillomavirus infection was a possible factor that increased the risk of diagnosing cervical intraepithelial neoplasia and cervical cancer by 15.8 %. This result demonstrates the necessity for further study of vaginal biotope disorders in women with papillomavirus infection and associated cervical intraepithelial neoplasia and cervical cancer.
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