宫颈病变患者阴道菌群种类构成分布及意义

Distribution and significance of vaginal flora in patients with cervical intraepithelial neoplasia

摘要:

目的 探讨宫颈病变患者阴道菌群种类构成的分布及意义。方法 选取2017 年1 月—2019 年1 月 在绵阳市人民医院妇科就诊的180 例宫颈病变患者，分为宫颈上皮内瘤变Ⅰ级88 例（CIN Ⅰ组）和宫颈上 皮内瘤变Ⅱ / Ⅲ级92 例（CIN Ⅱ / Ⅲ组）；同时选取同期该院体检的健康女性75 例作为对照组。采集全部 纳入对象阴道分泌物提取细菌基因组DNA，采取PCR 扩增基因片段，且应用Illumina Miseq 测序平台检测 PCR 扩增后产物，观察各组Alpha 多样性指数评估（菌种丰度指数Chao、ACE）、菌种多样性指数（Simpson 指数与Shannon 指数）、微生物群菌落门及微菌群分布情况。结果 对照组、CIN Ⅰ组和CIN Ⅱ / Ⅲ组 Chao、ACE 比较，差异有统计学意义（P <0.05），CIN Ⅰ组较对照组、CIN Ⅱ / Ⅲ组高（P <0.05），且CIN Ⅱ / Ⅲ组高于对照组（P <0.05）。对照组、CIN Ⅰ组和CIN Ⅱ / Ⅲ组厚壁菌门、放线菌门及其他21 个菌门 构成比比较，差异有统计学意义（P <0.05）。对照组、CIN Ⅰ组和CIN Ⅱ / Ⅲ组阴道乳酸杆菌属、加德纳菌属、 奇异菌属及其他菌属构成比比较，差异有统计学意义（P <0.05）。结论 不同宫颈上皮内瘤变患者阴道菌群 丰度变化与宫颈病变存在一定的关联。

Abstract:

Objective To investigate the distribution and significance of vaginal flora in patients with cervical lesions. Methods A total of 180 patients with cervical intraepithelial neoplasia seeking medical care in our hospital from January 2017 to January 2019 were enrolled, with 88 cases of cervical intraepithelial neoplasia grade Ⅰ (CIN Ⅰ group) and 92 cases of cervical intraepithelial neoplasia grade Ⅱ / Ⅲ (CIN Ⅱ / Ⅲ group). At the same time, 75 healthy women who underwent physical examination in our hospital during the same period were selected as the control group. The bacterial genomic DNA were extracted from vaginal secretions of all selected candidates. PCR method was used to amplify gene fragments, and the Illumina Miseq sequencing platform was applied to detect the amplified products. The alpha diversity (Chao and ACE index), species diversity (Simpson and Shannon index), and distribution of the microflora were assessed. Results There were significant differences in Chao and ACE value among control group, CIN Ⅰ group and CIN Ⅱ / Ⅲ group (P < 0.05), where Chao and ACE value of CIN Ⅰ group were higher than those of control group and CIN Ⅱ / Ⅲ group (P < 0.05), and those in CIN Ⅱ / Ⅲ group were greater than those of control group (P < 0.05). In addition, the constitution ratio of Firmicutes, Actinobacteria and other 21 phyla (χ2= 40 176.180, P = 0.000) as well as that of Lactobacillus, Gardnerella, Atopobium and others in the patients’ vagina was significantly different among the groups (χ2= 79 286.753, P = 0.000). Conclusions Vaginal flora abundance in patients with cervical intraepithelial neoplasia has a certain correlation with the severity of cervical lesions.