Relationship between vaginal microecological imbalance and HR-HPV infection after CKC surgery in HSIL patients

XIA Ling; CHEN Hongyan; ZHU Xiaoxin

doi:10.3969/j.issn.2095-8331.2025.05.012

Abstract：Objective To investigate the relationship between vaginal microecological imbalance and high-risk human papillomavirus(HR-HPV)infection after cold knife conization(CKC)in patients with high-grade squamous intraepithelial lesion(HSIL)of the cervix.Methods One hundred patients with HSIL treated with CKC who were admitted to the Maternal and Child Health Care and Family Planning Service Center of Yingdong District,Fuyang City from January 2022 to March 2024 were selected as the research subjects.According to the follow-up of HR-HPV outcome 12 months after CKC,they were divided into HR-HPV negative group of 76 cases and HR-HPV positive group of 24 cases.Multivariate logistic regression analysis was used to analyze the risk factors of HR-HPV infection in patients with HSIL after CKC surgery.Results In the HR-HPV positive group the rates of cleanliness grade Ⅲ-Ⅳ,normal proportion of Lactobacillus,vaginal pH value≥4.6,vulvovaginal candidiasis and bacterial vaginosis were higher than those in the HR-HPV negative group(P<0.05),and cases of vaginal microbiota density++～+++and vaginal microbiota diversity++～+++were fewer than those in the HR-HPV negative group(P<0.05).Multivariate logistic regression analysis showed that the decreased proportion of normal Lactobacillus,vaginal pH value≥4.6,vulvovaginal candidiasis,and the rate of bacterial vaginosis were risk factors for HR-HPV infection after CKC treatment in HSIL patients,while vaginal microbiota density++～++++and vaginal microbiota diversity++～+++were protective factors(P<0.05).Conclusion The imbalance of vaginal microecology is related to HR-HPV infection after CKC in patients with HSIL.Clinically,the vaginal microecology after CKC should be regulated in a timely manner to promote the clearance of HR-HPV.