摘要
目的采用16S rDNA高通量测序技术分析不同宫颈病变患者的阴道菌群变化特征,探讨阴道菌群多样性对宫颈病变的影响。方法选取2022年12月至2024年3月因宫颈疾病就诊银川市妇幼保健院的168例女性作为研究对象,根据宫颈病变的级别分为宫颈高级别鳞状上皮内病变组(HSIL组,n=46)、宫颈低级别鳞状上皮内病变组(LSIL组,n=76)、正常宫颈对照组(CONTROL组,n=46)。三组患者均通过16S rDNA高通量测序技术分析其阴道菌群的构成。结果HSIL组的HPV16和HPV18感染率最高,LSIL组次之,CONTROL组最低,组间比较均有显著性差异(P<0.05)。各组患者阴道微生物构成分析结果显示,门水平中,HSIL组变形杆菌门丰度较LSIL组、CONTROL组显著增加(P<0.05);纲水平中,HSIL组变形菌纲的占比较LSIL组、CONTROL组显著增加(P<0.05);目水平中,HSIL组棒状杆菌目及伯克霍尔德菌目的占比较LSIL组、CONTROL组均显著增加(P<0.05);科水平中,HSIL组分枝杆菌科及伯克氏菌科的占比较LSIL组、CONTROL组均显著增加(P<0.05);属水平中,与CONTROL组和LSIL组比较,HSIL组乳杆菌属显著下降(P<0.05),但加德纳氏菌属显著增加(P<0.05)。Shannon、chao1及Simpson指数显示,HSIL组患者阴道微生物群落的丰富度与多样性是最高的,均显著高于LSIL组(P<0.05)。结论宫颈病变的严重程度与阴道微生态紊乱相关,宫颈高级别鳞状上皮内病变女性阴道微生物构成的特点为乳杆菌减少、致病菌加德纳氏菌增多。改善HSIL患者阴道微生态,增加阴道乳杆菌可能对宫颈病变转归产生积极作用。
Objective:To analyze the characteristics of vaginal flora in different cervical lesions by 16S rDNA high-throughput sequencing technology,and to explore the impact of diversity of vaginal microbiota on the progression of cervical lesions.Methods:A total of 168 women admitted to Yinchuan Maternal and Child Health Hospital from December 2022 to March 2024 were selected as the study subjects,and they were divided into cervical high-grade squamous intraepithelial lesions(HSIL,n=46)group,cervical low-grade squamous intraepithelial lesions(LSIL,n=76)group and normal cervical group(CONTROL,n=46).The composition of vaginal flora of three groups was analyzed by 16srDNA high-throughput sequencing technology.Results:The infection rates of HPV16 and HPV18 were highest in the HSIL group,followed by the LSIL group,and lowest in the CONTROL group,with significant differences between groups(P<0.05).The analysis of vaginal microbiota composition in each group showed that at the phylum level,the abundance of Proteobacteria in the HSIL group was significantly increased compared to the LSIL group and the CONTROL group(P<0.05).At the class level,the proportion of Proteobacteria in the HSIL group was significantly increased compared to the LSIL group and the CONTROL group(P<0.05).At the order level,the proportion of Corynebacteriales and Burkholderia in the HSIL group was significantly increased compared to the LSIL group and the CONTROL group(P<0.05).At the family level,the proportion of Mycobacteriaceae and Burkholderia in the HSIL group was significantly increased compared to the LSIL group and the CONTROL group(P<0.05).At the genus level,compared with the CONTROL group and LSIL group,the HSIL group showed a significant decrease in Lactobacillus genus(P<0.05),but a significant increase in Gardnerella genus(P<0.05).The Shannon,Chao1,and Simpson indices showed that the richness and diversity of vaginal microbiota in the HSIL group were the highest,significantly higher than those in the LSIL group(P<0.05).Conclusions:The severity of cervical lesions would be related to the disturbance of vaginal microecology.The composition of vaginal microbes in women with cervical HSIL is characterized by a decrease in Lactobacillus and an increase in Gardnerella genus.The improvement of vaginal microecology in patients with HSIL and the increase of Lactobacillus vaginalis may have a regulatory effects on the outcomes of cervical lesions.
作者
张心愿
屈海蓉
许华瑞
陈莉
张洪炜
赵福英
ZHANG Xin-yuan;QU Hai-rong;XU Hua-rui;CHEN Li;ZHANG Hong-wei;ZHAO Fu-ying(Yinchuan Maternal and Child Health Hospital,Yinchuan 750000)
出处
《生殖医学杂志》
2025年第6期790-796,共7页
Journal of Reproductive Medicine
基金
银川市科技创新专项(2022SF07)。
