title: Bacterial vaginosis and inflammatory response showed association with severity of cervical neoplasia in HPV-positive women.
abstract: Vaginal infections may affect susceptibility to and clearance of human papillomavirus (HPV) infection and chronic inflammation has been linked to carcinogenesis. This study aimed to evaluate the association between bacterial vaginosis (BV) and inflammatory response (IR) with the severity of cervical neoplasia in HPV-infected women. HPV DNA was amplified using PGMY09/11 primers and genotyping was performed using a reverse line blot hybridization assay in 211 cervical samples from women submitted to excision of the transformation zone. The bacterial flora was assessed in Papanicolaou stained smears, and positivity for BV was defined as ≥ 20% of clue cells. Present inflammatory response was defined as ≥ 30 neutrophils per field at 1000× magnification. Age higher than 29 years (OR:1.91 95% CI 1.06-3.45), infections by the types 16 and/or 18 (OR:1.92 95% CI 1.06-3.47), single or multiple infections associated with types 16 and/or 18 (OR: 1.92 CI 95% 1.06-3.47), BV (OR: 3.54 95% CI 1.62-7.73) and IR (OR: 6.33 95% CI 3.06-13.07) were associated with severity of cervical neoplasia (CIN 2 or worse diagnoses), while not smoking showed a protective effect (OR: 0.51 95% CI 0.26-0.98). After controlling for confounding factors, BV(OR: 3.90 95% CI 1.64-9.29) and IR (OR: 6.43 95% CI 2.92-14.15) maintained their association with the severity of cervical neoplasia. Bacterial vaginosis and inflammatory response were independently associated with severity of cervical neoplasia in HPV-positive women, which seems to suggest that the microenvironment would relate to the natural history of cervical neoplasia.
authors.affiliation: School of Pharmacy, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil.
authors.forename: Juçara Maria
authors.initials: JM
authors.lastname: de Castro-Sobrinho
authors.affiliation: School of Pharmacy, Federal University of Goiás, Goiânia, Brazil.
authors.forename: Silvia Helena
authors.initials: SH
authors.lastname: Rabelo-Santos
authors.affiliation: Department of Obstetrics and Gynecology, Federal University of Goiás, Goiânia, Brazil.
authors.forename: Rosane Ribeiro
authors.initials: RR
authors.lastname: Fugueiredo-Alves
authors.affiliation: Department of Obstetrics and Gynecology, State University of Campinas (UNICAMP), Campinas, Brazil.
authors.forename: Sophie
authors.initials: S
authors.lastname: Derchain
authors.affiliation: Department of Obstetrics and Gynecology, State University of Campinas (UNICAMP), Campinas, Brazil.
authors.forename: Luis Otávio Z
authors.initials: LO
authors.lastname: Sarian
authors.affiliation: Department of Obstetrics and Gynecology, State University of Campinas (UNICAMP), Campinas, Brazil.
authors.forename: Denise R
authors.initials: DR
authors.lastname: Pitta
authors.affiliation: Department of Obstetrics and Gynecology, State University of Campinas (UNICAMP), Campinas, Brazil.
authors.forename: Elisabete A
authors.initials: EA
authors.lastname: Campos
authors.affiliation: Department of Obstetrics and Gynecology, State University of Campinas (UNICAMP), Campinas, Brazil.
authors.forename: Luiz Carlos
authors.initials: LC
authors.lastname: Zeferino
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D061809:Human Papillomavirus DNA Tests; D006801:Humans; D008875:Middle Aged; D065006:Papanicolaou Test; D030361:Papillomavirus Infections / Q000150:complications* / Q000821:virology; D002583:Uterine Cervical Neoplasms / Q000150:complications / Q000453:epidemiology* / Q000473:pathology; D016585:Vaginosis, Bacterial / Q000453:epidemiology* / Q000473:pathology; D002578:Uterine Cervical Dysplasia / Q000150:complications / Q000453:epidemiology* / Q000473:pathology
keywords: bacterial vaginosis; cervical cancer; cervical smears; human papillomavirus; inflammatory response