高级别宫颈鳞状上皮内瘤变锥切手术前后阴道菌群比较研究

发布时间：2018-03-14 03:00

本文选题：高级别宫颈鳞状上皮内瘤变　切入点：阴道菌群　出处：《中国实用妇科与产科杂志》2017年09期 　论文类型：期刊论文

【摘要】：目的探讨高级别宫颈鳞状上皮内瘤变(HSIL)锥切手术前后阴道菌群构成的差异。方法选择2015年12月至2016年8月南方医科大学珠江医院、广东省人民医院收治的HSIL患者20例,分别采集其锥切手术前与手术后3个月的阴道分泌物,同时检测高危型HPV-DNA含量(HC2法);随后对每个样本进行细菌总基因组DNA提取、16S rRNA V4区基因扩增及采用Illumina高通量测序技术对扩增的PCR产物进行测序等步骤,然后通过BIPES生物信息分析方法比较HSIL患者手术前后阴道菌群物种丰度和结构的差异。结果 HSIL患者术前高危型HPV-DNA均为阳性,术后3个月第1次复查均转阴性。HSIL患者手术前的阴道菌群以惰性乳酸杆菌、加德纳菌属、普氏菌属、奇异菌属等为优势菌属,而卷曲乳酸杆菌含量低。在锥切手术后,惰性乳酸杆菌、加德纳菌属、普氏菌属、奇异菌属等则明显降低,卷曲乳酸杆菌则有升高趋势。术后则以卷曲乳酸杆菌、脲原体、普氏菌属、肠球菌属等为优势菌属。结论高级别宫颈鳞状上皮内瘤变患者经手术去除病变后,高危型HPV含量显著减少甚至消失,其阴道菌群出现了向常见阴道优势菌属转变的趋势。提示HPV可能与阴道菌群构成密切相关且相互影响。
[Abstract]:Objective to investigate the difference of vaginal flora before and after conization of high grade squamous intraepithelial neoplasia of cervix (HSIL). Methods Twenty patients with HSIL were selected from Zhujiang Hospital of Southern Medical University from December 2015 to August 2016 in Guangdong Provincial people's Hospital. Vaginal secretions were collected before and 3 months after conization. At the same time, the high risk type HPV-DNA content was detected by HC2 method, and then the total genomic DNA of each sample was extracted by 16s rRNA V4 gene amplification and the amplified PCR product was sequenced by Illumina high-throughput sequencing technique. Then the species abundance and structure of vaginal flora were compared by BIPES bioinformatics analysis before and after operation in HSIL patients. Results High risk HPV-DNA was positive in HSIL patients before operation. The vaginal flora of patients with HSIL before operation was Lactobacillus inert, Gardnebacterium, Platella, Strange bacteria and so on, but the content of Lactobacillus flexurus was low. Inert Lactobacillus, Gardnebacterium, Platinum, Strange bacteria, etc., but Lactobacillus cribrae showed an increasing trend. After operation, lactobacillus, Ureaplasma, Pueraria, Conclusion the high grade cervical squamous intraepithelial neoplasia patients with high grade cervical squamous intraepithelial neoplasia can significantly reduce or even disappear the high risk HPV content after removal of the lesions. The vaginal flora changed to the common dominant genus of vagina suggesting that HPV may be closely related to the composition of vaginal flora and interact with each other.
【作者单位】：南方医科大学珠江医院妇产科;广东省人民医院(广东省医学科学院)妇产科;南方医科大学珠江医院检验医学部;
【分类号】：R737.33

【相似文献】