Vaginal micro‑environment disorder promotes malignant prognosis of low‑grade cervical intraepithelial neoplasia: a prospective community cohort study in Shanxi Province, China
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Jiamin Liu [1] ; Nan Hu [1] ; Xiao Zheng [1] ; Huimin Li [1] ; Kailu Zhao [1] ; Jiahao Wang [1] ; Mingxuan Zhang [1] ; Le Zhang [1] ; Li Song [1] ; Yuanjing Lyu [1] ; Meng Cui [1] ; Ling Ding [1] ; Jintao Wang [1]
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[1] Shanxi Medical University
Shanxi Medical University
China
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- Localización: Clinical & translational oncology, ISSN 1699-048X, Vol. 26, Nº. 10, 2024, págs. 2738-2748
- Idioma: inglés
- Texto completo no disponible (Saber más ...)
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Resumen
Purpose Emerging evidence suggests that vaginal micro-environment disorder is closely related to the development of cervical lesions. Low-grade cervical intraepithelial neoplasia (CIN1), as an early stage of cervical lesions, exhibits a high risk of progressing to high-grade lesions or even cervical cancer. However, the effect of vaginal micro-environment on the malignant prognosis of CIN1 remains uncertain.
Methods A total of 504 patients diagnosed with CIN1 by pathology, who were from the population-based cohorts established in Shanxi Province, China, were enrolled and followed up for 2 years. Micro-environmental factors such as vaginal pH, cleanliness, hydrogen peroxide (H 2 O 2 ), β-glucuronidase (GUSB), leucocyte esterase (LE), and sialidase (SNA) were detected to evaluate their effect on the malignant prognosis of CIN1.
Results Abnormal vaginal pH (HR = 1.472, 95%CI 1.071–2.022), cleanliness (HR = 1.446, 95%CI 1.067–1.960), H 2 O 2 (HR = 1.525, 95%CI 1.155–2.013), GUSB (HR = 1.739, 95%CI 1.235–2.448), LE (HR = 1.434, 95%CI 1.038–1.981), and SNA (HR = 1.411, 95%CI 1.065–1.870) could promote a higher incidence of CIN1 malignant prognosis, and the combined effects of these micro-environmental factors resulted in a nearly twofold increased risk (HR = 2.492, 95%CI 1.773–3.504) compared to any single factor alone, especially under the high-risk human papillomavirus (HR-HPV) infection. Notably, the cumulative incidence of malignant prognosis for CIN1 gradually increased during the early follow-up period, reaching its peak at approximately 8 months, and then stabilizing.
Conclusion Vaginal micro-environment disorder could promote CIN1 malignant prognosis, particularly in HR-HPV-infected women. Taking micro-environmental factors as the breakthrough, our study provides a feasible vision for preventing early stage cervical lesions.
