摘要
目的探讨妇女阴道微生物群落构成与宫颈癌前病变的关系。方法选取2013年1月至2017年12月间北京中医院大学附属护国寺中医医院、北京市西城区德胜社区卫生服务中心、北京航天总医院和北京宣武中医医院共同收治的100例女性作为研究对象进行回顾性分析,其中,28例宫颈上皮内瘤变I期患者为CIN I组,38例宫颈上皮内瘤变Ⅱ~Ⅲ期患者为CINⅡ~Ⅲ组,及同期34例体检健康的女性为健康组。采集所有研究对象的阴道分泌物进行细菌基因组DNA的提取,采用PCR技术对16S rRNAV3、V4区基因片段进行扩增,并采用Illumina Miseq测序平台对扩增的PCR产物进行测序,观察分析阴道微生物群落物种的丰度和多样性进行评估,比较各组样本微生物群落菌门和菌群的组成成分。结果健康组样本的Alpha指标和CINⅡ~Ⅲ组比较,差异无统计学意义(P>0.05);而CIN I组的Chao值和ACE值均显著高于健康组,两组比较,差异均有统计学意义(均P<0.05)。在检测到的23个菌门中,CIN I组的厚壁菌门数量要低于其他两组,而放线菌门数量要高于其他两组;三组样本检测出的菌门比较,差异均有统计学意义(均P<0.05)。CIN I组乳酸杆菌属的数量低于健康组和CINⅡ~Ⅲ组;健康组和CINⅡ~Ⅲ组在加德纳菌属数量低于CIN I组;CIN I组奇异菌属数量要显著高于其他两组;三组阴道菌群分布情况比较,差异均有统计学意义(均P<0.05)。结论不同程度宫颈上皮内瘤变的患者,其阴道菌群的多样性和菌群类型与健康女性大致相同,但其中有部分细菌菌群丰度有所改变,主要为乳酸杆菌属的减少和加德纳菌属、奇异菌属水平的增加,这提示阴道微生态组成的变化可能与宫颈癌病变的发展有着极大的关联。
Objective to study the relationship composition of vaginal microbial community and precancerous cervical lesions in women. Methods A total of 100 women admitted to Beijing Huguosi Hos- pital of Traditional Chinese Medicine, Beijing Xicheng District Desbeng Community Health Service Center, Beijing Aerospace General Hospital, and Beijing Xuanwu Hospital of Traditional Chinese Medicine from January 2013 to December 2017 were selected as the study subjects for the retrospective analysis. They were divided into three groups, among which 28 women with cervical intraepithelial neoplasia I were included in CIN I group, 38 women with cervical intraepithelial neoplasia Ⅱ/Ⅲ were included in CIN Ⅱ/Ⅲ group, and of 34 healthy women who had physical examination were included in the healthy group. Bacterial genomic DNA was extracted from vaginal secretions in all women. Using PCR technology to amplify 16S rRNAV3 and V4 area gene segment, and the Illumina Miseq sequencing platform was used for amplified PCR product se- quencing. Diversity and abundance of vaginal microbial community species were assessed, and bacteria mi- crobial community and composition of each sample were compared. Results For the Alpha indexes there was no significant difference between the healthy group and CIN Ⅱ/Ⅲ grouop （P 〉 0. 05 ）. However, Chao value and ACE value in CIN I group were significantly higher than in the healthy group （ all P 〈 0. 05 ）. Among the detected 23 bacterium, the number of Firmicutes were lower in CIN I grouop than in the other tow groups and the number of Actinobacteria were higher than the other groups. There were significant difference in the detection rate among the three groups （ all P 〈 0. 05 ）. The number of Lactobacillus was significant lower in the CIN I group than in the healthy group and CIN Ⅱ/Ⅲ group. The number of Gardnerella was significant lower in the CIN Ⅱ/Ⅲ group than in the CIN I group. The number of Atopobium was significant lower in the CIN I group than other two groups. There were significant differences in the distribution of vagi- nal microflora among the three groups （ all P 〈 0.05 ）. Conclusion In patients with different degrees of cervical intraepithelial neoplasia, the diversity and flora types of vaginal microflora are roughly the same as those of healthy women, but some bacterial flora abundance has changed, mainly due to the decrease of Lac- tobacillus genus and the increase in the levels of Gardneria and Atopobium. This suggests that changes in the composition of vaginal microbiome may be strongly associated with the development of cervical cancer le- sions.
作者
周柯
马腾远
邢国征
甘璐
ZHOU Ke;MA Teng-yuan;XING Guo-zheng;GAN Lu(Department of Clinical Laboratory,Beijing University of Traditional Chinese Medicine Affiliated Huguosi Hospital of Traditional Chinese Medicine,Beijing 100035,China;Department of Clinical Laboratory,Beijing Xicheng District Desheng Community Health Service Center,Beijing 100120,China;Department of Clinical Laboratory,Beijing Aerospace General Hospital,Beijing 100076,China;Department of Clini-cal Laboratory,Beijing Xuanwu Hospital of Traditional Chinese Medicine,Beijing 100053,China)
出处
《中国肿瘤临床与康复》
2018年第9期1046-1050,共5页
Chinese Journal of Clinical Oncology and Rehabilitation
