宫颈癌患者阴道微生物的分布特点  

Distribution Characteristics of Microorganisms in the Vagina of Patients with Cervical Cancer

作　　者：逯彩虹[1] 李保红[2] 李小斌[2] 王海波[2] 刘丽宁[2] 戴卫红[3] 李萍[2] 

机构地区：[1]白求恩军医学院外科教研室,石家庄050000 [2]解放军260医院院办公室,石家庄050041 [3]解放军白求恩国际和平医院药剂科,石家庄050000

出　　处：《中国医科大学学报》2011年第3期267-271,共5页Journal of China Medical University

摘　　要：目的探讨乳酸杆菌与常见阴道病原体在阴道黏膜上的分布特点以及与宫颈癌的关系。方法检测65例正常宫颈、70例慢性宫颈炎、110例宫颈上皮内瘤变(CIN)、142例宫颈癌妇女阴道黏膜分泌物中乳酸杆菌的定植密度、霉菌、细菌性阴道病(BV)、支原体、衣原体、滴虫、淋菌、人乳头瘤状病毒(HPV16/18)的感染情况,了解宫颈癌患者阴道黏膜乳酸杆菌与常见病原体的分布特点以及在宫颈癌发病中作用。结果 CIN组和宫颈癌组阴道黏膜乳酸杆菌的定植密度逐渐减少(P<0.01),霉菌、滴虫、支原体、衣原体、BV、HPV的检出率逐渐增加(P<0.01)。除宫颈癌组外,其余各组乳酸杆菌阴性患者阴道霉菌、滴虫、支原体、衣原体、BV、HPV的检出率均明显高于乳酸杆菌阳性患者(P<0.01)。宫颈癌组和CIN组感染亚组乳酸杆菌定植密度明显低于慢性宫颈炎组和正常宫颈组(P<0.01)。在正常宫颈组、慢性宫颈炎组、CIN组内感染亚组乳酸杆菌定植密度明显少于非感染亚组(P<0.01);但在宫颈癌组内比较无统计学差异。宫颈癌组和CIN组中HPV感染患者阴道乳酸杆菌阴性率高于慢性宫颈炎组和正常宫颈组;宫颈癌组和CIN组中HPV感染患者阴道乳酸杆菌阳性组乳酸杆菌定植密度明显少于慢性宫颈炎组和正常宫颈组(P<0.01)。CIN组和宫颈癌组中HPV16/18、BV的感染率增加最明显,其次是衣原体、支原体、霉菌、滴虫;淋菌的检出率在各组中均很低。结论乳酸杆菌抑制阴道常见病原体的繁殖与感染及宫颈上皮细胞异常增生与癌变。宫颈癌发生与阴道黏膜乳酸杆菌减少、阴道菌群失调相关。Objective To study the distribution characteristics of lactobacillus and common pathogens in the vaginal mucosa and their relationship with cervical cancer.Methods The planting density of lactobacillus and the detection rates of common pathogens including mycete,bacterial vaginosis（BV）,mycoplasma,chlamydia,infusorian,gonococcus,and human papillomavirus（HPV） 16/18 in the vaginal mucosa were determined in 65 cases of normal cervix,70 chronic cervicitis,110 cervical intraepithelial neoplasia（CIN）,and 142 cervical cancer.The distribution characteristics of lactobacillus and common pathogens in the vaginal mucosa and their relationship with cervical cancer were analyzed.Results In CIN and cervical cancer groups,the planting density of lactobacillus in the vaginal mucosa gradually decreased（P 0.01）,and the detection rates of mycete,infusorian,mycoplasma,chlamydia,bacterial vaginosis,and HPV gradually increased（P 0.01）.In normal cervix,chronic cervicitis,and CIN groups,the detection rates of mycete,infusorian,mycoplasma,chlamydia,BV,and HPV were significantly higher in subgroup without lactobacillus infection than in subgroup with lactobacillus infection（P 0.01）.The planting density of lactobacillus in the subgroup with infection in cervical cancer and CIN groups were significantly lower than that in chronic cervicitis and normal cervix groups（P 0.01）.In normal cervix,chronic cervicitis,and CIN groups,the planting density of lactobacillus in subgroup with infection was signficantly lower than that in subgroup without infection（P 0.01）;and there was no significant difference in cervical cancer group.Compared with normal cervix and chronic cervicitis groups,the negative rates of lactobacillus were signficantly higher in subgroup with HPV infection in cervical cancer and CIN groups（P 0.01）.The planting density of lactobacillus in subgroup with HPV and lactobacillus infection in cervical cancer and CIN groups was significantly lower than that in normal cervix and chronic cervicitis groups

关 键 词：乳酸杆菌 宫颈癌 宫颈上皮内瘤变 人乳头瘤状病毒 

分 类 号：R73[医药卫生—肿瘤]